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O&P Policy Challenges in the Year Ahead

2016 brought important policy victories that bear repeating. But as we enter the new year, a whole new set of challenges and opportunities will confront O&P patients and providers.

O&P Research: NAAOP participated in a major effort to pass S. 800/H.R. 1631, legislation that will elevate the stature and better coordinate rehabilitation and disability research at the National Institutes of Health (NIH), including orthotic and prosthetic research and development. O&P research policy and funding was the issue on which NAAOP was founded 30 years ago and we continued to have an impact on this critical issue in 2016.

ALJ Appeals Backlog: In a major victory for Medicare providers in which NAAOP counsel participated, the D.C. District Court recently compelled the Secretary of HHS to eliminate the extensive backlog of ALJ Medicare cases by 2020. HHS must now figure out how to dispose of the cases within the court’s timeframe. The government may appeal the decision by the deadline in early February, but pressure will continue to build on HHS to settle thousands of ALJ appeals in order to reduce the 750,000 case Medicare backlog. NAAOP will be pushing to have O&P claims considered for potential settlements, assuming providers have the option to accept the settlements.

Incoming Trump Administration and the 115th Congress: The incoming Trump Administration and a Republican-led House and Senate will mean that many proposals to fundamentally restructure and reform major government health care programs will be hotly debated, and significant changes to long-standing programs may occur, including:

  1. Affordable Care Act: Repeal and replace the existing private health insurance law

  2. Medicare: Restructure the program into a “defined contribution” approach

  3. Medicaid: Repeal Medicaid expansion and “block grant” the traditional program

Despite serious challenges on many fronts, incoming HHS Secretary, Tom Price, a former Georgia Congressman and orthopedic surgeon, understands the world of DMEPOS and may offer some key opportunities to advance O&P policy.

NAAOP will continue to assess all proposals based on their impact on the O&P patient and the providers who serve them, and is expecting an extraordinarily busy year.

Thank you for your past membership and continuing support of NAAOP and we look forward to confronting the challenges and opportunities in 2017 together.

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