Senators introduce bill to improve O&P standards in Medicare

Sens. Chuck Grassley, R-Iowa, and Mark Warner, D-Va., have introduced legislation to apply accreditation and licensing standards for O&P devices under Medicare.

The goal of The Medicare Orthotics and Prosthetics Improvement Act of 2015 is to guarantee product quality for Medicare beneficiaries and reduce fraud, according to a press release issued by Grassley’s office.

“Orthotics and prosthetics, like other medical equipment, is an area that attracts a lot of fraud,” Grassley said in the release. “Having accreditation and licensing will help weed out bogus products. This will benefit the people who rely on orthotics and prosthetics for their health and mobility, and it will protect the taxpayers at risk of paying for fraudulent equipment.”

The bill would modify requirements under Medicare to designate organizations for accreditation of suppliers of orthoses and prostheses; apply existing accreditation and licensure requirements to certain prostheses and custom-fabricated or custom-fitted orthoses; and base Medicare eligibility for payment on O&P supplier qualifications and complexity of care. Additionally, the bill would include the O&P practitioner’s clinical notes as part of the patient’s medical record; would distinguish orthotists and prosthetists from DME suppliers; and would clarify the definition of “minimal self-adjustment” in reference to off-the-shelf orthoses.

“The Medicare Orthotics and Prosthetics Improvement Act puts in place needed reforms that will improve the quality of orthotic and prosthetic care for seniors on Medicare while reducing fraud,” Warner said in the release.

Grassley and Warner serve together on the Senate Finance Committee, with jurisdiction over most federal health care programs, according to the release.


Disclosure: Grassley and Warren report no relevant financial disclosures.

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