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O&P Policy Forum and Separation of O&P from DME

NAAOP, in conjunction with the O&P Alliance, submitted formal comments last week on the proposed federal regulations to create a definition of the term “orthotics and prosthetics” in the Uniform Glossary of Medical Terms. This definition will be separate and distinct from the term, “Durable Medical Equipment.” The Uniform Glossary is a collection of commonly used insurance and medical terms that is intended to help inform the general public about its insurance plans and insurance options. Defining O&P separately from DME does not guarantee coverage of all O&P care in private insurance policies, but it will help consumers understand these benefits and will alert them to potential coverage, and coverage limitations and exclusions.

Not only will this separate O&P definition increase awareness of orthotics and prosthetics in private insurance, but it essentially breaks the connection between O&P and DME in these health plans. If the final rule is consistent with the proposed rule, strong arguments will exist to no longer apply DME limitations and exclusions on O&P services. And once consumers better understand what constitutes O&P care, they are likely to pressure plans into defining coverage under this benefit. While this victory does not impact the Medicare program, it represents the achievement of a long-standing goal that NAAOP has been waging, both independently and in concert with the O&P Alliance, since 2009, during Congress’ consideration of the ACA.

Please ATTEND the O&P Policy Forum

The O&P Policy Forum is fast approaching and NAAOP joins its Alliance partners in strongly encouraging leaders in the O&P profession to attend. AOPA spearheads the O&P Policy Forum each year and the Alliance organizations have promoted it for the past several years. It is a key opportunity for the O&P community to come to Washington, learn about the policies that impact the O&P professionals, and advocate on behalf of themselves and their patients.

This year, the Policy Forum will include an opportunity to help write legislation that can make a real difference. We are honored that Former U.S. Senator Bob Kerrey, himself a lower limb amputee, will participate in the forum by leading the effort to draft a bill, and will help advocate this bill on Capitol Hill. Your presence at the Policy Forum has never been more important!

Think about the challenges: The draft Lower Limb LCD, competitive bidding, prior authorization, and the list goes on and on. Come learn about these policies and bring your advocacy to your representatives in Washington. We strongly encourage you to attend and hope to see you in D.C. in late April.

O&P Policy Forum and Legislative Writing “Congress” Tuesday, April 26th and Wednesday, April 27th (Arrive Monday night, April 25th) Marriott Metro Center, Washington, D.C. For more information, contact NAAOP or AOPA directly.

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