Medicare Orthotics and Prosthetics Patient-Centered Care Act Introduced in the U.S. House of Representatives

Published in Government Relations on June 28, 2023

Representatives GT Thompson (R-PA), Mike Thompson (D-CA), Brett Guthrie (R-KY), and Angie Craig (D-MN) have introduced the Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R. 4315) in the U.S. House of Representatives. This legislation aims to address several critical issues faced by Medicare beneficiaries in need of orthotic and prosthetic care. With three major provisions, the bill seeks to enhance the quality of care, streamline the patient experience, and ensure timely access to necessary replacements.

The three provisions include:

  1. Prohibiting “drop shipping” for custom orthoses and prostheses
  2. Access to the full range of orthotic care from one practitioner
  3. Access to replacement custom-fitted and custom-fabricated orthoses

“OPGA is excited and anxious to learn that this important piece of legislation has been introduced into this year’s Congress,” said Adam Miller, President, OPGA. “This is, however, just the beginning, and OPGA remains committed to helping industry stakeholders continue the fight to get it passed into law.”

The introduction of the Medicare Orthotics and Prosthetics Patient-Centered Care Act in the U.S. House of Representatives marks a significant step toward improving the quality of care and accessibility for Medicare beneficiaries in need of orthotic and prosthetic services. The provisions outlined in the bill address critical issues such as drop shipping, fragmented care, and timely access to replacements. If passed into law, this legislation has the potential to enhance patient outcomes, streamline the care process, and ensure that Medicare beneficiaries receive the comprehensive orthotic and prosthetic care they deserve.

“This important legislation will ensure that individuals living with limb loss and limb difference have access to the safe, quality clinical care they need and deserve,” noted Teri Kuffel, JD, President of the American Orthotic and Prosthetic Association. “It will also help address the costly fraudulent practices from providers outside the orthotics and prosthetics profession that Medicare beneficiaries have been experiencing in the recent years.”


TAGS

  1. orthotics & prosthetics
  2. vgm
  3. vgm government

From Our Experts

CMS Releases CPI-U Adjustments for DMEPOS In 2026 And Fee Schedule Q1 thumbnail CMS Releases CPI-U Adjustments for DMEPOS In 2026 And Fee Schedule Q1 The Centers for Medicare & Medicaid Services (CMS) released the annual inflation factor to be applied to DMEPOS items effective January 1, 2026, with an implementation date of January 5, 2026. The breakdown of the adjustment is dependent upon whether the serviced items are included in the competitive bidding program (CBP) or are in formerly competitive bid areas (CBAs) such as rural and non-rural. Update from the Board of Certification/Accreditation thumbnail Update from the Board of Certification/Accreditation Yesterday, the Board of Certification/Accreditation (BOC) issued a clarification regarding the Centers for Medicare & Medicaid's (CMS) recent announcement about withdrawing BOC Accreditation. Here are the key updates... CMS Withdraws BOC Accreditation Authority For DMEPOS Suppliers thumbnail CMS Withdraws BOC Accreditation Authority For DMEPOS Suppliers On December 2, 2025, the Centers for Medicare & Medicaid Services (CMS) officially revoked the Board of Certification/Accreditation International (BOC) as an approved accreditation organization for suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). The DMEPOS Competitive Bid Program (CBP) And The New Remote Item Delivery Competitive Bidding Program – What Suppliers Need To Know thumbnail The DMEPOS Competitive Bid Program (CBP) And The New Remote Item Delivery Competitive Bidding Program – What Suppliers Need To Know A major development to come out of the CMS DMEPOS/Home Health Final Rule is the creation of a new Remote Item Delivery (RID) competitive bid program (CBP). This article provides the key items DMEPOS suppliers need to be aware of regarding this significant development in the competitive bidding program. CMS Changes Accreditation Requirements For All DMEPOS Suppliers Effective January 1, 2026. thumbnail CMS Changes Accreditation Requirements For All DMEPOS Suppliers Effective January 1, 2026. As we shared last week, CMS finalized the DMEPOS accreditation rule change that requires Accrediting Organizations (AOs) to survey and recredential DMEPOS suppliers annually, instead of every three years. This change is outside of competitive bidding and applies to all DMEPOS suppliers as a condition of Medicare enrollment. FAQs from the Webinar: Understanding the Final Rule on the DMEPOS Competitive Bidding Program thumbnail FAQs from the Webinar: Understanding the Final Rule on the DMEPOS Competitive Bidding Program Thank you to everyone who joined last week's webinar! We've compiled the most frequently asked questions from the session along with updated answers to help you stay informed. Major Update On Product Categories For The Next Round Of Competitive Bidding thumbnail Major Update On Product Categories For The Next Round Of Competitive Bidding Since the publication of the Final Rules on the Competitive Bidding Program (CBP) was announced, VGM has been in conversation with CMS officials as well as other industry groups regarding additional products being included into the CBP. The unofficial feedback we received indicated that there would be no additional products beyond those reported in the Final Rule. CMS Finalizes Rule Changing The Next Round Of The Competitive Bidding Program And Updating Other Provisions Related To Provider Enrollment And Prior Authorization thumbnail CMS Finalizes Rule Changing The Next Round Of The Competitive Bidding Program And Updating Other Provisions Related To Provider Enrollment And Prior Authorization Final Rule Analysis from the VGM Payer Relations and Reimbursement team  On Nov, 28, 2025, CMS finalized Final Rule CMS-1828-F that includes updates to the Competitive Bidding Program (CBP) and other provisions related to provider enrollment and prior authorization. Next round is expected to be implemented no later than Jan. 1, 2028.