The American Orthotic and Prosthetic Association (AOPA) released a statement addressing rumors that the Centers for Medicare & Medicaid Services (CMS) may be extending the competitive bidding program for off-the-shelf (OTS) orthotics to more than 100 orthotic devices.
According to AOPA, this extension of the competitive bidding program would be harmful to Medicare beneficiaries and would violate the law.
“There is no reason to believe this unofficial hearsay to be accurate. But what is clear is that there would be two very serious legal problems if CMS were inclined to try to proceed in such a direction,” AOPA wrote in the statement. “First, this approach implicitly assumes that CMS would competitively bid orthotics well beyond the OTS orthotics…Because the sole statutory authority CMS has been granted by Congress relates solely to “off-the-shelf orthotics,” as that term is defined in the statute — nothing has happened to change that — CMS venturing beyond true off-the-shelf orthotics would still be illegal. Secondly, CMS would have to completely modify the payment/reimbursement system for all orthotics by administrative fiat — a thorough, detailed, comprehensive rulemaking process must be observed if CMS seeks to restructure any Medicare payment system.”
Should this rumor prove true, AOPA has developed a contingency plan. The plan includes possible requests for meetings with CMS officials, a comprehensive analysis on all aspects of competitive bidding and the limited authorization Congress has provided for its applicability to OTS orthotics from outside legal counsel, and activation of a program to engage and inform O&P patient care facility owners and clinical personnel, manufacturers and distributors about specifics and strategy.
To read the full statement issued by AOPA, click here.