State by State
The latest news from Illinois, New York, North Carolina, Ohio, and Pennsylvania
The Illinois Society of Orthotists and Prosthetists (ISOP) is working on a plan to amend the state’s parity law to incorporate language that references O&P contracts, to protect patients’ access to care. O&P providers in the state also are concerned about the reduction of network sizes, which ultimately leads to a reduction in access to care for patients.
Illinois passed an administrative rule that will set pricing for all new codes in O&P at a rate of Medicare minus 6 percent. After two meetings with Medicaid, ISOP is now pursuing a similar rule change for all O&P codes.
There is active legislation seeking insurance fairness for amputees in both houses of the legislature in New York. Assembly Bill 2212 and Senate Bill 2080 have been introduced and have received bipartisan support. They currently are awaiting consideration before their respective chambers’ Insurance Committee.
The North Carolina Chapter of the American Academy of Orthotists and Prosthetists (NCAAOP) is seeking nominees for the positions of president, secretary, and treasurer for terms beginning in 2019. All current members will rotate off the NCAAOP Board at the end of the year.
O&P providers in Ohio have reported a successful transition after licensing boards were consolidated in the state. Because of the consolidation, the costs of annual dues decreased for O&P providers. Though no member from the original licensing board maintains a seat on the new board, an advisory committee was created to provide assistance with the oversight of
Pennsylvania O&P providers and the Pennsylvania Orthotic Prosthetic Society (POPS) are pursuing insurance fairness/prosthetic and orthotic parity to increase patients’ access to O&P care in the state. Plans are underway to introduce the bill in the fall. POPS is using similar language to New Jersey’s bill, Health Benefits Coverage for Orthotic and Prosthetic Appliances.
O&P providers in the state also have been working with Highmark Pennsylvania to correct recent changes to its coverage policy for microprocessor-controlled prostheses, which has resulted in the issuance of a new medical policy.