New O&P Legislation Aims to Improve Care, Cut Fraud, and Gain Bipartisan Support

Published in Orthotics & Prosthetics on September 10, 2025

By Theresa Flaherty, originally featured in HME News

With the recent Department of Justice take-down of a $10.6 billion Medicare fraud scheme, stakeholders are “more confident than ever” that a new bill that would, among other things, prohibit drop-shipping custom-fitted and custom-fabricated orthoses and prostheses will gain traction in Congress.

Prior to Operation Gold Rush in July, the federal government took down a $1.2 billion Medicare fraud scheme as part of Operation Brace Yourself in 2019.

“Unfortunately, some of (Operation Gold Rush) was braces – it’s the same scheme they were using six or seven years ago, it’s just a different criminal element,” said Joe McTernan, director of health policy and advocacy for the American Orthotic & Prosthetic Association (AOPA). “It’s fresh in the news, so when you take a bill up to the Hill that says, ‘We have a bill here that will save you an estimated $73 million over 10 years and it will do it almost immediately,’ (that catches their attention.)”

The Medicare Orthotics and Prosthetics Patient-Centered Care Act was reintroduced July 21 in both the Senate and the House of Representatives.

In addition to the ban on drop-shipping, the bill would:

• Exempt practitioners from requiring a competitive bidding contract to provide off-the-shelf orthoses; and
• Remove “reasonable useful lifetime” restrictions for custom-fitted and custom-fabricated orthoses.

Besides AOPA, the bill has support from nearly four dozen organizations, including the National Association for the Advancement of Orthotics and Prosthetics (NAAOP) and the Orthotic and Prosthetic Group of America (OPGA), who co-hosted a congressional fly-in. Response on the Hill was “very positive,” said Adam Miller, Vice President, VGM Government Relations, who attended the fly-in.

“We had offices from both sides of the aisle express interest in lending their support by becoming cosponsors,” he said. “This bill would provide not only increased access to care, but also an increased quality of care for those who need it. On top of that, independent analysis concludes it would reduce fraud and abuse, resulting in savings for the federal government. It’s a rare bill where all parties benefit."