April 3, 2017

NAAOP Update: Major Policy Priorities Confront O&P

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The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) released a webcast in which NAAOP General Counsel Peter Thomas, JD, discusses the following major public policies that affected O&P in March:

ACA Repeal and Replace Falters: Republicans in the U.S. House of Representatives were unable to bridge differences between their conservative and moderate factions on the Affordable Care Act (ACA) repeal and replace legislation known as the American Health Care Act (AHCA). All House Democrats opposed the bill. This resulted in the bill being pulled from the House floor before a vote was taken. The bill is indefinitely on hold, and the Senate is not likely to take up health reform any time soon.

NAAOP’s major concern with the AHCA centered on preservation of access to O&P care. The bill would have repealed the essential health benefits (EHB) package for Medicaid expansion populations, which includes coverage of “rehabilitative and habilitative services and devices.” This statutory language, coupled with the regulations that interpret the statute, was instrumental in securing coverage of O&P care across the country in both Medicaid expansion states and ACA individual insurance plans. As negotiations on the AHCA continued before its ultimate demise, there were tentative agreements to extend the repeal of the EHBs from Medicaid expansion states to private plans as well. With the bill’s failure, EHBs dodged a bullet. Ultimately, health reform is not over. The threat to O&P coverage will continue, especially through the regulatory process. But for the time being, the effort to repeal and replace the ACA is in disarray.

BIPA Section 427 Proposed Rule: Over 5,000 individuals and organizations commented, by the March 13 deadline, on the proposed regulations interpreting Section 427 of the Benefits Improvement and Protection Act (BIPA) of 2000. This regulation would implement the statutory provision that would limit Medicare payment for custom orthotics and prosthetics only to qualified practitioners and suppliers. Much of the proposed rule defined exactly which healthcare professionals will be considered qualified. NAAOP will be working with the O&P Alliance to continue to engage the Centers for Medicare & Medicaid Services (CMS) to publish a final regulation at the earliest possible time. However, with the Trump administration’s regulatory relief initiative, there is a stiff headwind in efforts to secure a final rule.

AHRQ Issues Revised Protocol for Lower Limb Prosthetic Evidence Base: A contractor of the Agency for Healthcare Research and Quality (AHRQ) recently released a revised “protocol” addressing the evidence base for lower-limb prostheses. The revised protocol, “Error Rate Reduction for Lower Limb Prostheses,” seeks information from researchers on evidence that answers a series of research questions. The revised protocol adopted many comments drafted by the O&P Alliance, in which NAAOP participated. Therefore, far more studies will be considered relevant under the new study protocol.

The webcast is posted on the NAAOP website and on oandp.com, shared with members via email, and made available through the NAAOP page on Facebook.

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