Important legislation is currently being debated that will have a great impact on the field of Orthotics and Prosthetics. If passed, the quality of care received by O&P patients throughout this country will be improved substantially. OPC supports this important legislation.
HR 1958- the Medicare Orthotics and Prosthetics Improvement Act of 2011, has received wide bipartisan support. This bill simply enforces existing regulations placed upon the Centers for Medicare and Medicaid Services (CMS). CMS is responsible for providing payment for services and prosthetic devices billed through the Medicare and Medicaid system.
A current policy exists instructing CMS to reimburse only for services and devices built by licensed or credentialed Orthotic and/or Prosthetic practitioners. This standard is habitually being ignored by the agency. HR 1958 seeks to enforce the existing guideline. If HR 1958 passes and becomes a law, reimbursement for services and devices will be provided only to practitioners who have met the necessary standards.
OPC believes in establishing a baseline standard of care by which all O&P practitioners must abide. By ignoring licensing requirements, practitioners with insufficient training are building devices and treating patients. By enforcing the licensure requirement, CMS is sending a strong message that only quality care will be reimbursed.
The passage of HR 1958 will improve care for O&P patients. By closing the licensure loophole, fraudulent billing will be reduced by an estimated $250 million over the next five years, according to an independent study.
Shelley Berkley (D-NV), a co-sponsor of this legislation, summed up HR 1958 by saying, "“Our legislation seeks to improve care for patients with orthotics and prosthetic devices and to ensure they are receiving treatment from those who are best suited to address their particular medical needs. At the same time, our bill will save money by cracking down and ending fraudulent payments through Medicare.”
We encourage contacting your local representative to voice your support for HR 1958. A contact form can be found here. Thank you for supporting this important piece of legislation.