“NAAOP’s primary purpose is to promote public policy that is in the interest of O&P patients. NAAOP does this by advocating for professional O&P patient care.”
–Nathan Kapa, CP
NAAOP Vice President
NAAOP’s Efforts on Key Issues Facing O&P
Research: Advancing O&P Care
One of NAAOP’s top priorities is O&P research, including funding, federal engagement, and prioritizing O&P research within the federal agencies that fund O&P research and development. One of NAAOP’s first successes in the legislative arena resulted in the Claude Pepper Act for Amputees, which led to passage of the National Institutes of Health Reauthorization Act of 1990, establishing the O&P research program at NIH. NAAOP continues to support efforts to fund research and elevate O&P as a priority with the federal agencies that fund rehabilitation and disability research. NAAOP is fully engaged in all efforts to advance professional O&P patient care through reliable outcome measures, evidence of clinical efficacy, and advancements in O&P technology.
Access to quality orthotic and prosthetic care is paramount, which often translates into an effort to broaden coverage of O&P care. Medicare is an important program that affects millions of Americans, but it also tends to set the standard of coverage for other government programs and private payers. NAAOP has been a leader in fighting coverage restrictions in O&P care for decades, from the establishment of Medicare’s functional levels in 1993 to the establishment of essential health benefit packages in the states under the Affordable Care Act. Most recently, NAAOP led the fight to overturn New York State’s “one limb per lifetime” coverage restriction under private insurance in that state.
Coding and Payment
Consumers will only have access to quality O&P care if providers are able to be appropriately compensated for their services. This includes a need for accurate coding, reasonable reimbursement levels, and confidence that reimbursements will not be subsequently recouped when coverage decisions are subsequently reversed. This is a major priority for NAAOP because without appropriate reimbursement, quality and access to patient care will suffer. This priority includes separation of DME from O&P, maintaining the O&P exemption from competitive bidding, clarifying the competitive bidding authority for off-the-shelf orthotics, ensuring annual updates to the Medicare fee schedule, improving coding of O&P care, and challenging overly aggressive auditing practices that create huge delays in access to fair hearings when coverage, coding and payment disputes arise.