Qualified Provider Negotiated Rulemaking and Medicare Competitive Bidding Demonstration: Setting the Record Straight for Prosthetic Consumers

Leslie Duncan

Description

Title:

Qualified Provider Negotiated Rulemaking and Medicare Competitive Bidding Demonstration: Setting the Record Straight for Prosthetic Consumers

Creator:

Leslie Duncan

Date:

6/11/2002

Text:

Qualified Provider Negotiated Rulemaking and
Medicare Competitive Bidding Demonstration

Setting the Record Straight for Prosthetic Consumers

As the national consumer education organization for people with limb
loss, ACA has been under a constant barrage of attacks from a small and
very vocal minority of individuals who have questioned the ACA's
tactical approach to addressing two issues of great significance to the
O&P field. These issues are: (1) the negotiated rulemaking process that
is currently underway to determine who is qualified to provide certain
services and (2) the proposals by the House Committees on Energy and
Commerce and Ways and Means to expand a demonstration program that was
launched in San Antonio, Texas, to provide certain O&P procedures on a
competitively bid basis in an effort to achieve a cost savings in the
Medicare program.

It is essential to note that ACA fully supports ensuring that consumers
of prosthetic care are afforded the highest levels of protection
available. While ACA has not taken and will not take sides in the
ongoing credentialing battles (nor have the federal payers such as
Medicare and the VA), ACA strongly believes that patient education
affords the most effective protection to consumers of prosthetic
services. As a result, consumer education is central to all of ACA's
programmatic efforts. (To learn about ACA's educational programs, log
onto www.amputee-coalition.org < <URL Redacted>> and
go to RE:News & RE:Views).

Moreover, as the national consumer organization for people with limb
loss, ACA's mission is to address issues affecting persons who are
amputees. After comprehensive analysis, ACA has concluded that both the
qualified provider negotiated rulemaking and the proposed expansion of
the Medicare competitive bidding demonstration are issues affecting
mostly the orthotic side of the orthotic and prosthetic equation, and,
while ACA is certainly sympathetic towards people who have experienced a
range of birth defects and neurological, neuromuscular and paralyzing
conditions that are addressed through orthotic care, these issues are
within neither the purview nor the mission of the ACA.

With regard to the negotiated rulemaking, ACA has been in communication
with the conveners of the committee and with many of the organizations
that will be seated at the negotiated rulemaking table, including the
American Academy of Orthotists and Prosthetics (AAOP), the American
Orthotic & Prosthetic Association (AOPA), and the American Board for
Certification in Orthotics and Prosthetics (ABC). ACA will be closely
monitoring the rulemaking deliberations and if and when an issue arises
during the process that in any manner addresses or affects the provision
of prosthetic care, ACA will take necessary and aggressive action as a
public attendee of the negotiation to ensure a voice on behalf of
prosthetic consumers.

A similar situation exists on the competitive bidding front. The House
committees with jurisdiction of the Medicare program, Ways and Means and
Energy and Commerce, are each likely to introduce legislation that
includes an expansion of a competitive bidding demonstration for certain
non-custom orthotic devices. ACA vehemently opposes competitive bidding
for O&P services and is in communication with its congressional
supporters on this issue. The reality of this situation, however, is
that the focus of the proposed language is on non-custom orthotics such
as fracture braces and not on highly complex prosthetic devices.
Moreover, the proposed legislative language specifically exempts
customized orthotics and prosthetics from the scope of the proposed
demonstration. Again, ACA strongly opposes competitive bidding in the
field of O&P, and should legislation ever involve prosthetics, ACA will
fight aggressively; however, the current issue of concern is solely one
involving non-custom orthotics.

As a mission-based organization, it is essential that ACA focus its
resources and attention on issues that truly affect the provision of
care to people with limb loss and not the host of other issues that do
not meet this criterion. ACA has urged consumers to become educated on
issues involving their care so that they may make informed decisions,
rather than relying on hype and misinformation. This, too, applies in
the area of public policy. Consumers must become educated on the issues
and consider the various sources of information on which they rely so
that they may also make informed decisions regarding the policies that
affect their care. ACA's role is to provide the credible, unbiased
information that is necessary for an individual to become an empowered
consumer.

Sincerely,

Paddy Rossbach,
Prosthetic Consumer and President and CEO
Amputee Coalition of America

                          

Citation

Leslie Duncan, “Qualified Provider Negotiated Rulemaking and Medicare Competitive Bidding Demonstration: Setting the Record Straight for Prosthetic Consumers,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 27, 2024, https://library.drfop.org/items/show/219138.