According to the U.S. Department of Health and Human Services’ Web site, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) aimed to provide “seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare.” The bill however had a serious negative impact on the reimbursement rates for therapeutic shoes and inserts for persons with diabetes (TSD).
O&P Business News talked to Randy Stevens, CPed, BOC Pedorthist, CFO, president of the Pedorthic Footwear Association (PFA) and chair of the PFA government affairs committee, to find out more about what this bill aims to do and how the PFA is helping it to reach that goal.
Impact of MMA
H.R. 2888, proposed as the “Medicare Diabetic Footwear Quality Restoration Act of 2007,” sponsored by Congresswoman Carolyn McCarthy of New York, aims to repeal the reduction in Medicare payment for TSD incurred by MMA with the help of practitioners and patients across the United States.
“The MMA had a deleterious impact on reimbursement rates for the TSD. The TSD used to be a standalone benefit, but was moved under O&P by the MMA, and subjected to a new fee schedule regiment that effectively reduced reimbursement levels approximately 21% across the A codes that comprised the benefit,” Stevens told O&P Business News.“Prior to MMA implementation, reimbursement levels for the TSD were already low… just barely keeping pace with our costs to produce and deliver the shoes and inserts to our patients.”
Additionally, these changes took a toll on the profession in that fewer and fewer credentialed pedorthists were accepting Medicare assignment, having a larger effect on patient access to practitioners, Stevens explained.
Pedorthists at the PFA’s recent symposium were sent a special video message from McCarthy about the bill. The message “encouraged them to contact their own member of Congress requesting they cosponsor this important piece of legislation,” Stevens said.
He said the PFA worked alongside McCarthy to create the bill and continues to encourage members to become active in grassroots efforts in favor of the legislation. He also explained that both practitioner and patient involvement along with time are responsible for the strides that have been made so far.
“Time helps to build awareness with the practitioners, the patients and the decision-makers in Washington. It also helps to provide leeway until the political landscape is ready to take on the legislation,” he said. “PFA will continue to meet with members of congress to advocate this legislation specifically, but, more generally, further build awareness of pedorthics and its role in the health care system.”
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Jennifer Hoydicz is a staff writer for O&P Business News.