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ACA Legislative Action Alert: Support O&P in the Medicare Reform Bill

August 1, 2003

URGE LAWMAKERS TO SUPPORT O&P IN THE MEDICARE REFORM BILL CONFERENCE COMMITTEE ISSUES FACING O&P

House of Representatives and Senate leaders have been appointed to a Medicare conference committee charged with resolving the differences between the House- and Senate-passed versions of a Medicare reform package. The 17 Medicare reform conferees now will make decisions on key issues that will affect the future of O&P for years to come.

Because of the magnitude of the issues at stake, it is essential that you, as consumers contact members of Congress immediately and tell them how you feel about the issues currently under discussion by the Medicare reform conferees.

Based on intensive analysis and taking into consideration the political dynamics at play on Capitol Hill, ACA is advocating the following positions on issues included in this year's Medicare reform debate. These positions best protect the long-term interests of the O&P field and the quality of O&P services provided to patients:

1. Oppose the provision in the Senate Medicare reform bill (S. 1) that would implement a 7-year Medicare payment freeze on non-custom orthotic services;

2. Oppose the provision in the Senate Medicare reform bill (S. 1) that would establish a demonstration project permitting physical therapists to prescribe and provide health care services, including O&P services, without a physician's prescription.

TAKE ACTION NOW

Your members of Congress need to personally hear from you now on how these provisions will adversely impact your life and the quality of O&P care.

In order to preserve the quality of and access to orthotic and prosthetic devices that are provided to patients today, AOPA is urging O&P practitioners: 1) to oppose the 7-year freeze on non-custom fabricated orthotic devices and 2) oppose the establishment of a demonstration allowing physical therapists to prescribe and provide health care services.

To register your opinion by e-mail, please visit ACA's Grassroots website at:

http://capwiz.com/aca_advocacy/home/

At this site, click on each "Action Alert" and type in your zip code. Each time, a form letter that may be customized will appear for you to send. AOPA urges you to send letters on both the Medicare payment freeze and direct access to physical therapy services.

To register your concerns by telephone, select an "Action Alert" and enter your zip code. Your lawmakers' phone numbers will appear.

ACA thanks you for your efforts on behalf of the O&P field. You can make a difference.

BACKGROUND INFORMATION

On June 27, the House of Representatives and the Senate passed different versions of a Medicare reform plan (H.R. 1 and S. 1). A Medicare conference committee is now meeting to craft a final package to send to President Bush.

Senate Version of the Medicare Reform Bill (S. 1)

The Senate's Medicare reform bill includes a provision that would freeze Medicare payments for non-custom fabricated orthotic devices at 2003 levels for the next seven years. All orthotic devices that are not custom-fabricated would be subject to this payment freeze.

The Senate bill also would establish a Medicare demonstration project permitting physical therapists to prescribe and provide a wide variety of health care services, including O&P services, if the demonstration is implemented in states where the state physical therapy scope of practice act permits PTs to provide O&P services. In essence, PTs would be able to refer patients to themselves and provide O&P services without a physician's prescription and without making a referral to an O&P practitioner.

Additionally, this latter provision would assert that a "qualified physical therapist" is one that is state licensed. This provision would invalidate ACA's position that physical therapists need proper O&P education, training and equipment to be able to provide O&P services. If this provision is included in the final Medicare package, the Centers for Medicare and Medicaid Services (CMS) would be forced to equate "qualified physical therapist" with state licensure in any regulation to determine who is qualified to provide O&P services.

House Version of the Medicare Reform Bill (H.R. 1)

The House of Representatives' Medicare reform bill does not include either of these provisions but instead includes a provision that would establish a limited Medicare competitive bidding program only for off-the-shelf orthotic devices.

House leaders, with input from AOPA, crafted legislative language defining off-the-shelf orthotic devices. This definition was developed with the recognition that practitioners must have proper education, training and equipment to fabricate, customize and fit most orthotic and all prosthetic devices to the individual patient. By crafting a very narrow definition of what constitutes an off-the-shelf device, House lawmakers protected the vast majority of O&P services from any competitive bidding program. It will also allow the O&P field to further distinguish itself from DME where no customization is necessary to provide a device to a Medicare patient. The House bill would subject virtually all DME items to a competitive bidding program.

Leslie Duncan, MIS
Manager, Information Services
Amputee Coalition of America
900 East Hill Ave., Suite 285
Knoxville, TN 37915-2568
888-267-5669 ext. 8115
Fax 865-525-7917
lduncan@amputee-coalition.org
http://www.amputee-coalition.org/