A policy change proposed by the Centers for Medicare and Medicaid Services (CMS) may possibly lead to the loss of Medicare, Veterans Administration, and private-insurer insurance coverage for prostheses, as well as access to medically necessary equipment.
A coalition of amputee advocacy organizations and orthotics and prosthetics (O&P) industry groups note in a media release from Virginia Prosthetics & Orthotics Inc that they have developed the website www.SaveProsthetics.org, where people can sign a petition and share their thoughts about the proposed policy change.
According to the media release, the Local Coverage Determination (LCD) for Lower Limb Prosthetics policy proposed by CMS reportedly is a comprehensive rewrite of Medicare’s entire lower limb prosthetic benefit, and it is opposed by national amputee and O&P industry groups, including the Amputee Coalition of America (ACA), the American Orthotic & Prosthetic Association (AOPA), and the National Association for the Advancement of Orthotics & Prosthetics (NAAOP).
While the LCD would initially affect only those amputees receiving Medicare benefits, its changes would undoubtedly grow to impact all amputees, J. Douglas Call, CP, president and CEO of Virginia Prosthetics & Orthotics Inc, and industry officials note in the release. That’s because many of the proposed policies involve major changes to the Uniform Code Set, which all insurers, including the Veterans Health Administration, use to cover and pay prosthetic limb claims.
Call, as well as O&P industry representatives, state in the release that they hope the LCD is withdrawn, or at the very least have revisions made to the draft policy that, when implemented, would ensure timely and appropriate patient care.
At the same time, they also call prosthetic-industry experts to be engaged in developing future CMS policies to ensure they are based on science and valid clinical evidence.
[Source(s): Virginia Prosthetics & Orthotics Inc, PR Newswire]