O&P stakeholders add bill to arsenal

Tuesday, April 26, 2016

WASHINGTON – Rep. Renee Ellmers, R-N.C., has introduced a bill that would halt CMS’s plans to make dramatic changes to coverage for prosthetic devices.

H.R. 5045, the “Preserving Access to Modern Prosthetic Limbs Act of 2016,” would “impose a moratorium on the implementation of a proposed Medicare local coverage determination on lower limb prostheses,” according to a bulletin from the American Orthotics and Prosthetics Association.

The bill would restrict CMS from implementing the proposed LCD until at least June 30, 2017. It would also require the agency and its contractors to remove it from their websites. Private payers like United Healthcare and Cigna have made coverage changes since the proposed LCD was made public in July.

The bi-partisan bill has been co-sponsored by Reps. Marsha Blackburn, R-Tenn., and Jan Schakowsky, D-Ill.

The changes in the proposed LCD include requiring a face-to-face visit and a completed rehab program to receive a prosthetic device.