WASHINGTON, D.C. — A newly introduced bill in the U.S. House of Representatives sets out to impose a moratorium on the implementation of the proposed Medicare local coverage determination on lower limb prostheses. The bill was introduced by Rep. Renee J. Ellmers, R-N.C., who shared the details at the American Orthotic and Prosthetic Association Policy Forum, here.
The bill (H.R. 5045), also known as the “Preserving Access to Modern Prosthetic Limbs Act of 2016,” would place a moratorium on the implementation of the proposed Medicare local coverage determination (LCD) on lower limb prostheses until June 30, 2017, and would require the HHS secretary and Medicare administrative contractors to remove the LCD from their websites until that date. Ellmers said the moratorium allows time for stakeholders to offer “meaningful feedback” on the proposed guidelines.
Rep. Renee J. Ellmers
“It is bureaucrats in Washington who are making those decisions, and those who are directly affected and those who are within that realm or that industry, are many times left out of the discussion,” Ellmers said.
The bill states the policies proposed by the LCD would ultimately place serious restrictions on access to modern prostheses and force amputees to settle for devices that are “functionally outdated, less durable and less safe.”
Ellmers previously introduced a bill to improve prosthetic care for injured veterans that would help them better navigate the health care system.
“We have to take care of our veterans and this is a fabulous way to lay out for them, in plain English, what they can receive as far as good health care and treatment,” she said. “I have yet to convince the Veterans’ Affairs Committee that this is something worth fighting for, but we will not give up.”
Ellmers said prevention should be the focus of health care legislation.
“The real savings in Medicare comes with keeping patients out of the emergency rooms, out of the nursing homes, obviously subsequent care, and then that continuous cycle. That is where the dollars are being spent. The treatment that you will provide for [patients] is going to keep that patient healthy and functioning in their home, living the life that they want to live. That is going to save money,” Ellmers said. – by Amanda Alexander
Ellmers RJ. Welcome and insight into health care in the 114th Congress. Presented at: American Orthotic and Prosthetic Association Policy Forum; April 26-27, 2016; Washington, D.C.
Disclosure: Ellmers reports no relevant financial disclosures.