Take Action on the Medicare Orthotics and Prosthetics Patient-Centered Care Act

Published in Orthotics & Prosthetics on September 07, 2022

Updated on: 9/7/22
Originally posted: 11/3/21

It has been over a year since H.R. 1990/S. 2556, the Medicare Orthotics and Prosthetics Patient-Centered Care Act, has been introduced in the House and Senate. This legislation would accomplish four key priorities for the O&P profession:

  • Distinguish durable medical equipment (DME) from clinical, service-oriented O&P care in the Medicare statute and regulations, leading to recognition of the clinical care O&P practitioners provide.
  • Limit the definition of “off-the-shelf” (or “OTS”) orthotics to devices that truly require only “minimal self-adjustment” by the beneficiary him- or herself. This would help ensure that patients continue to have access to the clinical orthotic services they need.
  • Ban drop-shipping to patients’ homes of custom fit and custom fabricated orthoses and prostheses to prevent fraud and abuse and ensure patient access to clinical O&P care.
  • Exempt licensed and certified O&P practitioners from OTS competitive bidding, treating them similarly to physicians and therapists by allowing them to provide OTS orthoses to their patients—without a contract—at the competitive bidding rate (not the higher fee schedule amount).

The full text of the legislation can be read here. As of September 7, 2022, the Senate bill has 6 cosponsors, and the House bill has 29 cosponsors.

OPGA has been working with NAAOP to gain additional cosponsors to the legislation. Keeping our legislation in front of key committee members is incredibly important to continue momentum. Our legislation falls under the jurisdictions of the Senate Finance Committee, the Senate Health, Education, Labor, Pensions Committee (HELP), the Senate Appropriations Committee, the House Ways and Means Committee, the House Energy and Commerce Committee, and the House Appropriations Committee.

For our legislation to gain more traction, we need more cosponsors. Thank you to those who have met with your representatives to explain how important the Medicare Orthotics and Prosthetics Patient-Centered Care Act is to your patients and your businesses. If your representatives signed on in the 116th Congress, we need them to resign on this identical legislation.

What can you do right now to support?

  1. Take action! Send a letter to your elected officials asking them to cosponsor the legislation.
  2. Tell all of your customers about the importance of the legislation and how they can help by taking action.
  3. Follow your email up with a phone call to your elected official.
  4. Setup a meeting with your elected official. They want to hear from you, their constituent, and how this legislation would affect you, your business, and your patients. Need help? VGM Government Relations has outlined how to set up meetings with congressional offices.

As the O&P profession continues to change, our legislation continues to be important. We will continue to work to gain additional cosponsors!

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