The measure would change Medicare rules for orthotics and prosthetics. It would stop Medicare payments for certain orthotic and prosthetic items that are directly shipped to a patient who has not received training or education from a qualified practitioner. It adds physical therapists, occupational therapists, orthotists, and prosthetists to a list of practitioners exempt from a competitive acquisition program. It also clarifies that Medicare covers replacement custom-fitted and custom-fabricated orthotic devices. The Secretary of Health and Human Services must write final rules to carry out these changes within one year. The payment prohibition starts on the first day of the first year after the measure is enacted.
If you use orthotics or prosthetics, the proposal would require training or education from a qualified practitioner before Medicare will pay for some items that are shipped directly to you. It also makes it clearer that replacements for custom-fitted and custom-fabricated orthotics are covered. More types of clinicians (physical and occupational therapists, orthotists, prosthetists) are named in Medicare rules related to how items are acquired and paid for.
No publicly available information.
The text of the measure says its purpose is to protect beneficiaries with limb loss and other orthopedic conditions by providing access to appropriate, safe, effective, patient-centered orthotic and prosthetic care and to reduce fraud, waste, and abuse.
No publicly available information.