AOPA meetings with HCFA Re: SNFs
Description
Collection
Title:
AOPA meetings with HCFA Re: SNFs
Text:
I hope I am not alone in my concerns about the direction of talks between
AOPA and HCFA regarding payment for orthotic and prosthetic devices while the
Medicare enrollee is in a skilled bed in a SNF. If you share my concerns I
encourage you to contact the government relations committee at AOPA.
July 20 AOPA In Advance reported that as a result of meetings with HCFA
they were willing to consider removing a limited number of high cost items
from this [PPS) billing methodology, primarily in lower limb prosthetics.
During the discussion, AOPA discouraged HCFA from limiting the items being
removed to prosthetics. Sounds good on the surface. When I called the
reimbursement expert at AOPA I got a clear impression that it is AOPA that is
recommending that the exceptions be limited to prosthetics. I was told that
it was the big ticket items that posed a particular hardship for SNFs, and
that the SNFs should be able to pay for those little items like $800 AFOs
from their Medicare reimbursements. The AOPA expert said we couldn't
approach them with the whole shebang all at once
Well excuse me but those little items are my bread and butter!!
Orthotics has been just as impacted by this ridiculous payment methodology as
prosthetics. Whether the item costs $500 or $5,000 the fact is that very few
nursing homes are willing to spend anything that they don't have to. We can
piss and moan all we want to and report the situations to the OIG or the
state investigatory agencies but I feel nothing is going to change until HCFA
recognizes that O and P AS A WHOLE needs to be excepted from the PPS. I
believe AOPA should be very clear on this, the issue does not just impact
big ticket prosthetics.
Again, I encourage all practitioners that are impacted by this to
contact AOPA to let them know how you feel.
AOPA and HCFA regarding payment for orthotic and prosthetic devices while the
Medicare enrollee is in a skilled bed in a SNF. If you share my concerns I
encourage you to contact the government relations committee at AOPA.
July 20 AOPA In Advance reported that as a result of meetings with HCFA
they were willing to consider removing a limited number of high cost items
from this [PPS) billing methodology, primarily in lower limb prosthetics.
During the discussion, AOPA discouraged HCFA from limiting the items being
removed to prosthetics. Sounds good on the surface. When I called the
reimbursement expert at AOPA I got a clear impression that it is AOPA that is
recommending that the exceptions be limited to prosthetics. I was told that
it was the big ticket items that posed a particular hardship for SNFs, and
that the SNFs should be able to pay for those little items like $800 AFOs
from their Medicare reimbursements. The AOPA expert said we couldn't
approach them with the whole shebang all at once
Well excuse me but those little items are my bread and butter!!
Orthotics has been just as impacted by this ridiculous payment methodology as
prosthetics. Whether the item costs $500 or $5,000 the fact is that very few
nursing homes are willing to spend anything that they don't have to. We can
piss and moan all we want to and report the situations to the OIG or the
state investigatory agencies but I feel nothing is going to change until HCFA
recognizes that O and P AS A WHOLE needs to be excepted from the PPS. I
believe AOPA should be very clear on this, the issue does not just impact
big ticket prosthetics.
Again, I encourage all practitioners that are impacted by this to
contact AOPA to let them know how you feel.
Citation
“AOPA meetings with HCFA Re: SNFs,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/211974.
