Update on the LCD Draft Policy Report

Everyone throughout the orthotics and prosthetics world has pulled together and gone “all in” on the effort to fight back the DME MAC proposed revisions to the Local Coverage Determination (LCD) for Lower Limb Prosthetics, and hopefully restore some sanity to delivery of prosthetic limbs to Medicare amputee beneficiaries in the future. We are more than halfway through the short 45 day comment period which ends August 31. The meeting where the DME MACs will hear from interested stakeholders is August 26th – eight days from now.

This is the AOPA summary:
1. AOPA has activated communications to members, and placed explanatory content on both the AOPA website for members and on the Mobility Saves website for patients– we had recorded about 1,175 O&P/AOPA members comment letters, as well as 2,075 patient comment letters.

2.NAAOP President (and AOPA Board Member) Dave McGill has initiated and provided excellent promotion for a “We the People” petition to the White House which achieved its 100,000 mark this past weekend reaching 102,770.

3. AOPA is partnering with the Amputee Coalition on Postcards that have been distributed to O&P facilities for distribution to patients.

4. AOPA has registered at least 4 participants, including AOPA President Charlie Dankmeyer, and AOPA Member Tom Watson, to appear and provide statements at the DME MAC meeting in Linthicum, Maryland on August 26 from 8-12 noon.

5. AOPA has activated plans to hold an amputee patient demonstration at the HHS building in DC on August 26 from 2 to 5 pm-know an amputee who would like to attend? Click here for details.

6. AOPA has initiated PR efforts focusing on The “Glass Ceiling of Prosthetics” concept, and is being transformed into (i) broadcast and print ads to run in the DC area August 23-26 and (ii) placement on the Mobility Saves website. Print advertising is slated over the next 3 weeks, and TV broadcast advertising, starting with two messages that will appear in the Washington DC market on ABC’s Sunday morning News programs, “This Week with George Stephanopoulus,” on August 23, and continuing with morning programs all week on CNN, Fox News, CSNBC and other media outlets.

7. AOPA has worked on challenging the absence of scientific/ medical/ literature support for the LCD, having generated a request to the DME MACs for such information in light of its absence from the proposal.

8. AOPA has generated a series of true to life Patient Vignettes in cooperation with the Amputee Coalition that capture the very specific impact of the proposed LCDs on patient care.

9. AOPA, in consultation with former CMS Administrator, Tom Scully and other AOPA lobbyists scheduled one and possibly more meetings with CMS officials to discuss the LCDs. The first meeting took place on August 11 with Sean Cavanaugh, the Deputy Director of CMS.

10. Input from physicians–three past presidents of the American Association of Orthopedic Surgeons, plus communications from a President of the Association of Bone & Joint Surgeons, the American Orthopaedic Foot and Ankle Society, and the International Federation of Foot and Ankle Societies. A draft letter is in the works from a couple of Past Presidents of the American Academy of Physical Medicine and Rehabilitation, and the American Medical Rehabilitation Providers Association has started its own sign-on letter.

11. AOPA Analysis of Data Since 2010 Shows Steady Decline in Medicare Prosthetics Payments–OIG Report has dictated CMS and contractors behaviors for the past five years. Medicare’s determination to squelch that progression as ‘fraudulent (in some unknown way)’ pushed the number of all types of K3s down, resulting in an increase in K2s AND reduction in the total dollars Medicare spends on prosthetics each of the past 4 years. CMS and the DME MACs have succeeded in practicing medicine and changing the prevailing standard of amputee care for the worse. You’ll want to take a look at this, which demonstrates that data shows no reason for the LCD. Medicare prosthetic costs DOWN 13.8% in past 4 years.

12. If you go to the www.mobilitysaves.org home page, you’ll find: (a) list of amputee talking points; and (b) you’ll be able to link to the remarkable letter authored by former U.S. Senator Bob Kerrey. (website update in progress)

For details and a full report of all the actions AOPA has taken on the LCD proposal, click here.

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