O&P Industry Awaits Changes in Medicare, Essential Health Benefits Package

In a recent statement released by the National Association for the Advancement of Orthotics and Prosthetics, Peter W. Thomas, JD, general counsel for the NAAOP, spoke about the potential advancements and obstacles the O&P field could face in 2012.

Thomas began by discussing the 2-month extension given to the Medicare Physician Fee Schedule and Therapy Caps Exceptions Process at the end of 2011, deferring the 27.4% cut in Medicare spending. Congress will soon resume its deliberations on how to extend both provisions for another year without costing Medicare more money. This could potentially affect the O&P field, because Congress may offset the provisions by cutting funding to other Medicare programs such as O&P and durable medical equipment.

“NAAOP will be watching very closely, continuing our advocacy and monitoring and making sure that O&P gets a fair shake in that process. We’ll also try to take advantage of any opportunities there may be to try to move forward the O&P legislative agenda,” Thomas said in the statement.

He also discussed the potential advantages of the Essential Health Benefits Package, which was published on December 16, 2011 by the Department of Health and Human Services, with a comment period ending on January 30. The Essential Health Benefits Package is a package of benefits that all private health care providers will have to offer individuals in 2014. The benefits will include rehabilitative and habilitative services and devices, which will greatly benefit the O&P industry.

“The O&P field, NAAOP included, will be submitting comments by January 30 and will be making a spirited case for coverage of O&P services,” Thomas stated.

All of these changes are dependent on decisions made by Congress and the Supreme Court later this year, as well as the outcome of the 2012 presidential election.

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