A flurry of activity after Election Day culminated in an incredibly busy December thus far. As the 114th Congress makes its way out of town and the Trump Transition Team prepares to take over, there were at least four major developments important to the O&P community:
Court Compels the Department of Health and Human Services (HHS) to Extinguish the Administrative Law Judge (ALJ) Backlog:
The D.C. District Court this week compelled HHS to eliminate the extensive backlog of ALJ cases pending decision by 2020. Despite a 90-day statutory deadline for such decisions, ALJs are taking as long as 832 days due to the fact that over 750,000 Medicare denied claims await ALJ review. HHS must now figure out how to dispose of the cases within the court’s timeframe. This is a major victory for Medicare providers that NAAOP counsel, the Powers Law Firm, participated in. The decision will place great pressure on HHS to pursue settlement discussions.
The Agency for Healthcare Research and Quality (AHRQ) Seeks Guidance on Evidence Base for Lower Limb Prostheses:
AHRQ released a questionnaire and seeks public comment on the evidence base for lower limb prostheses. The questions are complex and require the attention of researchers, clinicians, and those in academia. NAAOP is working with the O&P Alliance, the Amputee Coalition, NCOPE, and allied health organizations to provide a comprehensive response to this questionnaire by the deadline on December 20, 2016.
O&P Medicare Legislation Makes Gains and Poised for Action in 2017:
Despite extensive efforts lead by AOPA and supported by NAAOP and the Alliance organizations, O&P legislative provisions advanced in Congress but were not included in the final legislation to pass in the 114th Congress. No viable legislative vehicle emerged on which to append Medicare provisions. However, the O&P community is well positioned to advance these provisions in the new Congress. These provisions include recognition of the prosthetist’s clinical notes, separation of DME from O&P, and other provisions.
Congress Passes Bill Promoting Rehabilitation Research at the NIH:
As part of the 21st Century Cures Act, Congress passed legislation that NAAOP has considered a priority for the past several years. These provisions would elevate the stature and better coordinate rehabilitation and disability research at NIH. This bill will enhance NIH’s capacity and focus on O&P research. O&P research was the reason NAAOP was founded in 1987, an effort which culminated in legislation creating the National Center for Medical Rehabilitation Research (NCMRR). The mission of NCMRR is to conduct and support medical rehabilitation research “including orthotic and prosthetic research and development.”
HAPPY HOLIDAYS AND THANK YOU FOR YOUR NAAOP MEMBERSHIP!