Prosthetic community ups ante

LINTHICUM, Md. - O&P stakeholders commented at a public hearing, staged a protest and participated in a high-stakes meeting with CMS, all in one day, in their bid to reverse proposed coverage changes for lower limb prostheses.

“These changes are mean spirited,” said Charles Dankmeyer, president of the American Orthotics & Prosthetics Association, during a press call rallying stakeholders for the week's various events. “It is obviously designed to wear people down so they just plain give up.”

In July, the four DME MACs released draft local coverage determinations for lower limb prosthetics that include proposed changes like requiring a face-to-face visit; and requiring patients complete a rehab program.

About 300 people attended a public comment hearing hosted by the four DME MACs on Aug. 26, and about 50 people spoke.

“The message was extremely clear,” said Wendy Miller, chief credentialing officer for the BOC, who attended the hearing. “The proposed lower limb LCD has many flaws that would have an adverse effect on the quality of care and prosthetic device an amputee would receive.”

After the hearing, hundreds of protesters, many of them amputees, rallied in front of the Health & Human Services building, holding up signs that read “Get your hands off my legs.”

“All sorts of people came out to support this,” said Elizabeth Mansfield, president of Outsource Marketing Solutions, who attended both the hearing and rally. “It was really an impressive display and a moving experience.”

Also that same day, stakeholders met with Acting CMS Administrator Andrew Slavitt and other senior officials.

“They said that they intend to go back to the DME MACs and consult with them to address some of the concerns we raised,” said Tom Fise, executive director of AOPA. “That's all positive but what's important is what actually happens as opposed to what people say is going to happen. But it seemed to be encouraging.”

The changes have their roots in cost savings. But of the 2 million Americans who are amputees, only 200,000 are Medicare beneficiaries and their prosthetic care amounts to less than one half of 1% of total Medicare spending, said Dankmeyer.

“If the goal was to save money, they picked an empty target,” he said.