US-Politics: Qualified Provider Negotiated Rulemaking
Anthony T. Barr
Description
Collection
Title:
US-Politics: Qualified Provider Negotiated Rulemaking
Creator:
Anthony T. Barr
Date:
6/19/2002
Text:
----- Original Message -----
From: < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Wednesday, June 19, 2002 7:12 AM
Subject: [OANDP-L] US-Politics: Qualified Provider Negotiated Rulemaking
> I have been asking some back channel questions and would like confirmation
> from this List to the following questions. A simple yes or no answer is all
> that is needed.
>
> The pending Negotiated Rulemaking relates to only some orthotic devices not
> all ? YES
Contrary to ACA's recent reporting, the purpose of the negotiated rulemaking would be to establish standards regarding making ,fitting and billing Medicare for prosthetics and certain customized orthotics.*
*These negotiations were mandated by Congress under Section 427 of the Benefit Improvement and Protection Act(BIPA) of 2000 as per August 8, 2001 Federal Mediation and Conciliation Service report.
> Issues relating to prosthetics are resolved?
NO
>
> MDs, PTs, and OT's are qualified providers for prostheses?
YES except for perhaps in some of the six regulated states .
>
> This pertains only to billing Medicare / Medicaid?
YES
The Convener's Findings and Recommendations regarding formation of a negotiated rulemaking committee is to develop a proposed rule(qualifications) for Centers for Medicare and Medicaid services(CMS).However other third party payer are more likely to adopt the criteria developed by the CMS.
>
> MDs could supervise the fitting of prostheses by others in their offices?
YES- allegedly under direct supervision.
>
> In states without licensure anyone may fit a prosthesis without a
> prescription and bill the amputee directly?
YES- Currently,there are NO Medicare requirements for suppliers of prosthetics or orthotics(custom or off the shelf) to be certified, credentialed or to meet any other special education requirements, other than what individual states may require.
Presently only 6 states have licensing requirements for prosthetic or orthotic providers.**
**Federal Mediation and Conciliation Service August 8,2001 Report
Most states don't require any type of certification in regard to qualification to provide these services.
Additional comments:
It appears that NO national consumer organizations of O&P health care services, with the exception of PVA (Paralyzed Veterans of America ) whom are mostly wheel chair users, will be representing Medicare beneficiaries, have been recommended as committee members to the Negotiated Rules Committee Hearings. Most committee members to date represent industry interests.
The Amputee Coalition of America was unable to be interviewed and therefore was not recommended for inclusion of this group.
***
***Federal Mediation and Conciliation Service Report August 8,2001
I would be delighted to receive corrections from those whom have updated information.
Tony Barr
From: < <Email Address Redacted> >
To: < <Email Address Redacted> >
Sent: Wednesday, June 19, 2002 7:12 AM
Subject: [OANDP-L] US-Politics: Qualified Provider Negotiated Rulemaking
> I have been asking some back channel questions and would like confirmation
> from this List to the following questions. A simple yes or no answer is all
> that is needed.
>
> The pending Negotiated Rulemaking relates to only some orthotic devices not
> all ? YES
Contrary to ACA's recent reporting, the purpose of the negotiated rulemaking would be to establish standards regarding making ,fitting and billing Medicare for prosthetics and certain customized orthotics.*
*These negotiations were mandated by Congress under Section 427 of the Benefit Improvement and Protection Act(BIPA) of 2000 as per August 8, 2001 Federal Mediation and Conciliation Service report.
> Issues relating to prosthetics are resolved?
NO
>
> MDs, PTs, and OT's are qualified providers for prostheses?
YES except for perhaps in some of the six regulated states .
>
> This pertains only to billing Medicare / Medicaid?
YES
The Convener's Findings and Recommendations regarding formation of a negotiated rulemaking committee is to develop a proposed rule(qualifications) for Centers for Medicare and Medicaid services(CMS).However other third party payer are more likely to adopt the criteria developed by the CMS.
>
> MDs could supervise the fitting of prostheses by others in their offices?
YES- allegedly under direct supervision.
>
> In states without licensure anyone may fit a prosthesis without a
> prescription and bill the amputee directly?
YES- Currently,there are NO Medicare requirements for suppliers of prosthetics or orthotics(custom or off the shelf) to be certified, credentialed or to meet any other special education requirements, other than what individual states may require.
Presently only 6 states have licensing requirements for prosthetic or orthotic providers.**
**Federal Mediation and Conciliation Service August 8,2001 Report
Most states don't require any type of certification in regard to qualification to provide these services.
Additional comments:
It appears that NO national consumer organizations of O&P health care services, with the exception of PVA (Paralyzed Veterans of America ) whom are mostly wheel chair users, will be representing Medicare beneficiaries, have been recommended as committee members to the Negotiated Rules Committee Hearings. Most committee members to date represent industry interests.
The Amputee Coalition of America was unable to be interviewed and therefore was not recommended for inclusion of this group.
***
***Federal Mediation and Conciliation Service Report August 8,2001
I would be delighted to receive corrections from those whom have updated information.
Tony Barr
Citation
Anthony T. Barr, “US-Politics: Qualified Provider Negotiated Rulemaking,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/219190.
