The Medicare O&P Patient-Centered Care Act Introduced in the Senate
on August 02, 2021
Senate bill S. 2556, the Medicare O&P Patient-Centered Care Act, was introduced on Friday, July 30. This bill is being led by Sens. Mark Warner (D-VA) and Steve Daines (R-MT). Additional original co-sponsors include Sens. Tammy Duckworth (D-IL), Charles Grassley (R-IA), Bill Cassidy (R-LA), and John Cornyn (R-TX). This is a companion bill to H.R. 1990.
The bill would accomplish four key priorities for the orthotic and prosthetic profession. It would:
- 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).
Todd Eagen, President of OPGA, said, “On behalf of the OPGA community, we are very glad to see the bipartisan Medicare O&P Patient Centered Care Act introduced in the Senate and would also like to thank Iowa’s own Senator Grassley (R) for being an original co-sponsor. OPGA and the VGM Government Relations team has been advocating for this legislation for many years, and we look forward to continuing our efforts to garner more support and get this Bill passed. At its core, this Bill ensures beneficiaries access to quality O&P clinical care while providing appropriate regulation and reducing fraud and abuse within the system.”
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