Limb loss community speaks out against LCD proposal at open comment meeting

LINTHICUM, Md. — Impassioned amputees, prosthetists and other members of the limb loss community shared their concerns during the DME LCD Open Comment Meeting.

Hosted by the four Durable Medical Equipment Medicare Administrative Contractors (DME MACs), the meeting allowed members of the public to share their concerns about the proposed Local Coverage Determination (LCD) for Lower Limb Prosthetics.

One theme among commenters was the importance of recognizing that each amputee is different and each amputation brings a different set of complications.

“Every amputee is unique and so are their needs,” Dan Berschinski, chair of the Amputee Coalition board of directors and lower limb amputee, told the DME MACs. Similarly, amputee Tammy Higginbotham said in her testimony over the phone, “It is hard to find the right combination for any amputee … no two people are alike.”

Marlis Gonzalez-Fernandez, MD, PhD, medical director of Outpatient Physical Medicine and Rehabilitation Clinics for Johns Hopkins Hospital, echoed this thought: “The shape and the size of a limb is dynamic. It changes throughout the day, it changes throughout time and we need to be able to accommodate that for patients,” she said. “What we [as health care providers] want … is the ability to prescribe the right device for the right patient and do that at the right time and make sure that they do reach the full potential that they have. This LCD will not allow us to do that anymore.”

Amputees gathered together in Linthicum, Md. to share their concerns with the proposed LCD at a public comment meeting.

Source: Alexander A. 

One of the most fervent speeches was given by Charles H. Dankmeyer, Jr., CPO, president of the American Orthotics & Prosthetics Association (AOPA), who had hash words for the DME MACs. “Have you started the clock yet?” he asked the officials, referring to his time limit for speaking. “Why don’t you turn it back. You folks have proven you know how to do that very well,” he said. Dankmeyer called the LCD “mean-spirited” and “absolutely insulting” to amputees, saying the barriers it creates for amputees are “intentionally designed to wear people out so they would just give up.”

One of the concerns most mentioned was the idea that the LCD views prosthetists as suppliers of devices rather than health care professionals invested in the care of their patients.

Peggy Chenoweth, known as blogger “Amputee Mommy,” urged the DME MACs to include amputees in the conversation.

“We may be missing legs but we have a lot to offer the world,” she said. “Please consider our potential.”

Motorcycle racer and snowboard instructor Reggie Showers shared his many accomplishments thanks to prosthetics technology.

“My story is one of many here, many inspirational stories … I cannot help but think of all the stories that will never be shared if this proposal passes and future amputees are not given the lower limb devices that they need and deserve to live a better life,” Showers said. — By Amanda Alexander

Reference: DME LCD Public Comment Meeting; Aug. 26, 2015.

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