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Congress is facing several deadlines that could greatly impact the O&P industry, according to a statement from the National Association for the Advancement of Orthotics and Prosthetics (NAAOP).

Congress and President Obama recently agreed to pass legislation to suspend the debt ceiling until May 19. In exchange for this suspension, each house of Congress will have to produce a budget by April 15 or risk congressional pay withholding.

At the end of February, the current 2-month delay in across the board spending cuts, defined as sequestration, will expire. This may create some bipartisan agreement as Congress will be forced to delay the cuts again or pass an alternative solution to sequestration that will save an equal amount of money.

If sequestration takes effect on March 1, all Medicare providers will receive a 2% cut in their fees. According to the NAAOP, it is unknown how long it would take for CMS to implement these cuts or whether this will delay payment for claims pending after March 1. This 2% cut will also apply to the O&P fee schedule.

“As bad as this is for all Medicare providers, many believe this is far preferable to passage of a major Medicare bill that reduces spending over 10 years by as much as $400 to $600 billion,” the NAAOP statement said.

Outside of Congress, the NAAOP said that the Department of Health and Human Service continues to produce regulations implementing the Patient Protection and Affordable Care Act (ACA), including regulations on the essential benefits package for both private insurance and Medicaid plans. GOP governors in six states have agreed to expand their Medicaid programs in 2014 under the ACA, including Ohio and Michigan. CMS is also still applying problematic physician documentation standards that are causing serious issues for claims denials.

“NAAOP will continue to address all of these issues and ensure that the O&P community’s voice continues to be heard,” according to the statement.

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