Representatives Glenn ‘GT’ Thompson (R-PA) and Shelley Berkley (D-NV) introduced HR 1958, the Medicare Orthotics and Prosthetics Improvement Act of 2011, legislation to improve the quality of orthotic and prosthetic (O&P) care and reduce fraudulent payments for orthotic and prosthetic services under Medicare, according to a release on Thompson’s website.
“Fraud and abuse contributes not only to rising costs, but it also harms patients, particularly when medically necessary devices are provided without expert care or without necessity,” Thompson stated in the release. “We need to collectively look to create savings by combating waste, fraud, and abuse. This legislation will enhance patient care and ensure that Medicare fraud is addressed, particularly when the fiscal solvency of the program is in question.”
In the Benefits Improvement and Protection Act of 2000 (BIPA), Congress mandated that a practitioner or supplier had to be certified in order to be paid for certain orthotic and prosthetic services under Medicare. This was never implemented, contributing to fraudulent payments and leaving Medicare patients vulnerable to substandard care. According to the release, HR 1958 would require CMS to reimburse only those providers who have been accredited or licensed in orthotics and prosthetics.
“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,” Berkley stated.