Three Critical Pieces of O&P Legislation Still in Congress

There are now three critical pieces of legislation pending in the U.S. Congress that impact the O&P profession and the patients we serve. NAAOP strongly supports each of these bills and urges its members and friends to take 5 minutes to visit our website’s Legislative Action Center to tell your representatives in Washington, D.C., to cosponsor and support these bills.

The first bill is H.R. 1958, the Medicare Orthotics and Prosthetics Improvement Act of 2011. This bipartisan bill is designed to reduce fraud and abuse in the O&P Medicare benefit while improving the quality of care and saving Medicare money in the process. The legislation presses CMS to fully implement regulations that will link the right to receive Medicare payment with the complexity of O&P care provided and the qualifications of the supplier. It would ensure that Medicare does not pay for O&P claims filed by unlicensed suppliers in states that have O&P licensure statutes, and it would refine and tighten the accreditation process for O&P suppliers under the Medicare program. As the federal government continues to crack down on fraud and abuse of DMEPOS suppliers, it is critical that the O&P profession offer constructive approaches to reducing fraud and abuse that are tailored to the O&P profession, not the separate and distinct field of DME. This bill is also expected to be introduced in the Senate soon.

The second bill is H.R. 805, the Injured and Amputee Veterans Bill of Rights. This bipartisan legislation has been championed by NAAOP and was actually passed by the House of Representatives in the last Congress but the Senate ran out of time to act before the 111th Congress adjourned. The bill was reintroduced this year by Congressman Bob Filner (D-Calif.), Ranking Member of the House Veterans Association Committee. The bill seeks to educate veterans in need of O&P care about their rights and expectations through the publication and prominent display of a “Bill of Rights.” These rights include the right to appropriate technology, the practitioner of the veteran’s choice both inside and outside the VA system, and the right to a functional spare device, to name a few. A mechanism for reporting complaints is also included in the bill.

The third critical O&P bill in Congress is S. 773, the Insurance Fairness for Amputees Act of 2011. Also a bipartisan bill, this legislation would require plans that cover orthotic and prosthetic services to provide those benefits at the same level as other surgical and medical benefits provided under a private health plan, with no separate caps, arbitrary exclusions or lifetime limits for O&P care. Because the bill does not mandate coverage, the bill should not cost the federal government anything. However, this bill would send a strong signal that unrealistic dollar caps and coverage exclusions of particular O&P technology are not permissible in the insurance market. This bill is also expected to be introduced in the House of Representatives soon.

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