Advocacy efforts can protect O&P practices against Medicaid cuts

BOSTON – Strong advocacy efforts and building relationships with Medicaid officials may help minimize or prevent threatened cuts to Medicaid reimbursement, according to Teri P. Kuffel, JD, who spoke at the American Orthotic & Prosthetic Association National Assembly here.

“It has become abundantly clear to us that we need to have a presence in the Capitol, we need to have a presence with our state legislators, we need to educate them about what O&P is, so what happened hopefully won’t happen again,” Kuffel said.

She spoke about the attempt by one Minnesota state senator in 2011 to remove coverage of prosthetics for adults from the Medicaid program. Members of two state O&P groups immediately contacted local legislators, while lobbyists worked the Capitol “to spread the word that cutting prosthetics would do more harm than good,” Kuffel said. Their efforts paid off, and coverage for prosthetics in the state’s Medicaid program remained intact.

“Be ready to act, educate and communicate effectively” should similar cuts be drafted in your state, Kuffel said. “If health care reform continues to move forward, the power will pass to state Medicaid plans to determine which disciplines will be included in the essential health benefits package. Does your state have a plan in place?”

O&P periodicals and national O&P websites are good ways to stay informed, she said. Be aware of state Medicaid programs and keep in contact with members of the local and national O&P communities. Lobbyists are a good investment as they are well-equipped to deal with state legislators.

It is essential to create and maintain relationships with Medicaid program personnel, specifically the prior authorization department, O&P manager, public committees and the director of state governing, Kuffel said.

Also, keep the issue before state officials by writing letters and emails, making phone calls, arranging visits to state offices with an amputee patient and inviting state officials to your facility.

“It’s really essential that you support O&P professionals working for you on the state and national levels. Attend the meetings and policy forums, maintain memberships in O&P groups and pay your dues. Know that we are a much stronger force together.”

For more information:

Kuffel TP. How to prevent or minimize Medicaid cuts to O&P in your state. Presented at the American Orthotic & Prosthetic Association National Assembly 2012. Sept. 6-9. Boston.

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