6/10/2008
ACTION ALERT: Call Your Congressman and Two Senators TODAY!
The Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics, and supplies ("DMEPOS"), authorized by the Medicare Modernization Act of 2003 ("MMA"), is scheduled to enter its first phase on July 1, 2008. As you may know, O&P care has been statutorily exempt from Medicare competitive bidding due to the fact that this highly clinical set of services is not commodity-based, as are canes, crutches, and other DME items.
Recently, there has been a push to delay implementation of competitive bidding of DME due to serious concerns about the program’s impact on patients. The House Ways and Means Committee is working on a bill to delay competitive bidding for 18 months for the 10 categories of DME covered by phase I of competitive bidding. These categories are also the most costly types of DME for the Medicare program. To offset the cost of this delay, the House is considering a cut to the entire DMEPOS fee schedule nationwide to make the delay "budget neutral," i.e., not cost the government anything.
NAAOP has received word that this proposed cut may include orthotics and prosthetics, despite the fact that orthotics and prosthetics are specifically exempted from the competitive bidding program. The Senate may adopt whatever the House develops.
This makes no sense and is patently unfair. The O&P field may be exposed to a significant cut in fees to delay a program that does not even apply to the O&P field. There was no bidding process that occurred under the O&P benefit because there is no indication that the O&P fee schedule is inflated. The fields of DME and O&P could not be more different. The cost structure of providing O&P care is completely different from commodity-based DME.
- O&P professional care is a highly clinical service that is totally customized to meet the needs of individual patients.
- The level of education, skill, and experience necessary for practitioners to provide comprehensive O&P care differs dramatically from the supply of DME and translates into substantial human resources costs to the field.
- Additional costs include maintaining patient care facilities, technical laboratories and purchasing O&P materials and components.
- To cut the O&P fee schedule in this instance would be no different than cutting payment to hospitals or doctors.
Any fee schedule cut to help make the delay in DME competitive bidding "budget neutral" should apply only those DME categories that would otherwise be subject to competitive bidding. This does not include O&P care and we therefore urge Congress to reject any cut to the O&P fee schedule as the Medicare package progresses through Congress this week.
CONGRESS NEEDS TO HEAR FROM THE O&P FIELD TODAY AND ALL THIS WEEK!
ACTION ALERT
PICK UP THE PHONE TODAY AND CALL CONGRESS RIGHT NOW!! KEEP THE PRESSURE ON ALL THIS WEEK.
Instructions:
- Dial (202) 225-3121 to get the switchboard for the House of Representatives.
- Ask to speak with your Congressman’s office. If you do not know your Congressman’s name, ask the operator for help to identify him or her.
- Tell your Congressman’s office that you are a constituent and would like to speak to the health Legislative Assistant about an urgent matter.
- If you get voice mail, leave a detailed message and ask for a return call.
- If you get the Health L.A., tell them the following:
- I am a prosthetist/orthotist in your state.
- I am very concerned that Congress might cut the O&P Medicare fee schedule to pay for a delay to DME competitive bidding.
- This would make no sense and be very unfair because O&P is exempt by law from competitive bidding.
- Only those categories of DME that are subject to competitive bidding should be the only ones included in an "offset" to the Medicare fee schedules.
- There is no justification to cut O&P fees at this time and doing so would only jeopardize patient care.
- REQUEST: Please work to exempt orthotics and prosthetics from any cut to the Medicare fee schedules to help pay for a delay to DME competitive bidding.
- After you have contacted your Representatives’ office, call (202) 224-3121 to get the switchboard for the Senate.
- Ask to speak with each one of your Senators. The operator can help identify who they are if you do not know.
- Follow steps three through five above.
- If you get what appears to be valuable information or if your Congressman’s or Senators’ offices state that they support your issue, thank them and urge them to do all they can to help you.
- Let NAAOP know what you have done by emailing George@Breece.com so we can follow up and monitor our level of support.
Thank you.
WE RARELY ISSUE ACTION ALERTS TO NAAOP MEMBERS BECAUSE WHEN WE DO, WE WANT A STRONG LEVEL OF RESPONSE. THIS IS A BIG DEAL.
NOW, TODAY, IS THE TIME TO TAKE 15 MINUTES AND MAKE THREE VERY IMPORTANT CALLS. THANK YOU IN ADVANCE FOR YOUR ADVOCACY!
