AOPA Action Alert--Contact Congress Now

AOPA Action Alert--Contact Congress Now

AOPA

7/24/2003

**AOPA LEGISLATIVE ACTION ALERT**

July 23, 2003

URGE LAWMAKERS TO SUPPORT O&P IN THE MEDICARE REFORM BILL CONFERENCE
COMMITTEE ISSUES FACING O&P

House of Representatives and Senate leaders have been appointed to a
Medicare conference committee charged with resolving the differences
between the House- and Senate-passed versions of a Medicare reform
package. The 17 Medicare reform conferees now will make decisions on
key issues that will affect the future of O&P for years to come.

Because of the magnitude of the issues at stake, it is essential that
you, as O&P practitioners, contact members of Congress immediately and
tell them how you feel about the issues currently under discussion by
the Medicare reform conferees.

Based on intensive analysis and taking into consideration the political
dynamics at play on Capitol Hill, AOPA is advocating the following
positions on issues included in this year's Medicare reform debate.
These positions best protect the long-term interests of the O&P field
and the quality of O&P services provided to patients:

1. Oppose the provision in the Senate Medicare reform bill (S. 1) that
would implement a 7-year Medicare payment freeze on non-custom orthotic
services;

2. Oppose the provision in the Senate Medicare reform bill (S. 1) that
would establish a demonstration project permitting physical therapists
to prescribe and provide health care services, including O&P services,
without a physician's prescription.

3. Accept the House of Representatives' Medicare reform bill (H.R. 1)
provision that would implement a limited Medicare competitive bidding
program only for off-the-shelf orthotic devices. While AOPA would
prefer not to accept competitive bidding in any form, it is clear that
competitive bidding or a payment freeze is imminent and competitive
bidding based on its narrow scope (i.e. limited to off-the-shelf
orthotic devices) will be less damaging on the O&P field and the
patients we serve.

**TAKE ACTION NOW**

Your members of Congress need to personally hear from you now on how
these provisions will adversely impact your practice and the quality of
O&P care.

In order to preserve the quality of and access to orthotic and
prosthetic devices that are provided to patients today, AOPA is urging
O&P practitioners: 1) to oppose the 7-year freeze on non-custom
fabricated orthotic devices; 2) oppose the establishment of a
demonstration allowing physical therapists to prescribe and provide
health care services; and, 3) accept the House of Representatives'
limited Medicare competitive bidding program for off-the-shelf orthotic
devices.

To register your opinion by e-mail, please visit AOPA's Grassroots
website at:

<URL Redacted>

At this site, click on each Action Alert and type in your zip code.
Each time, a form letter that may be customized will appear for you to
send. AOPA urges you to send letters on both the Medicare payment
freeze and direct access to physical therapy services.

To register your concerns by telephone, select an Action Alert and
enter your zip code. Your lawmakers' phone numbers will appear.

If you have questions on these issues or about how to contact your
lawmakers, please call AOPA's Walt Gorski at (571) 431-0809.

AOPA thanks you for your efforts on behalf of the O&P field. You can
make a difference.

___________________________


**AOPA BACKGROUND INFORMATION**

On June 27, the House of Representatives and the Senate passed different
versions of a Medicare reform plan (H.R. 1 and S. 1). A Medicare
conference committee is now meeting to craft a final package to send to
President Bush.

     Senate Version of the Medicare Reform Bill (S. 1)

The Senate's Medicare reform bill includes a provision that would freeze
Medicare payments for non-custom fabricated orthotic devices at 2003
levels for the next seven years. All orthotic devices that are not
custom-fabricated would be subject to this payment freeze.

The Senate bill also would establish a Medicare demonstration project
permitting physical therapists to prescribe and provide a wide variety
of health care services, including O&P services, if the demonstration is
implemented in states where the state physical therapy scope of practice
act permits PTs to provide O&P services. In essence, PTs would be able
to refer patients to themselves and provide O&P services without a
physician's prescription and without making a referral to an O&P
practitioner.

Additionally, this latter provision would assert that a qualified
physical therapist is one that is state licensed. This provision would
invalidate AOPA's position that physical therapists need proper O&P
education, training and equipment to be able to provide O&P services.
If this provision is included in the final Medicare package, the Centers
for Medicare and Medicaid Services (CMS) would be forced to equate
qualified physical therapist with state licensure in any regulation to
determine who is qualified to provide O&P services.

     House Version of the Medicare Reform Bill (H.R. 1)

The House of Representatives' Medicare reform bill does not include
either of these provisions but instead includes a provision that would
establish a limited Medicare competitive bidding program only for
off-the-shelf orthotic devices.

House leaders, with input from AOPA, crafted legislative language
defining off-the-shelf orthotic devices. This definition was developed
with the recognition that practitioners must have proper education,
training and equipment to fabricate, customize and fit most orthotic and
all prosthetic devices to the individual patient. By crafting a very
narrow definition of what constitutes an off-the-shelf device, House
lawmakers protected the vast majority of O&P services from any
competitive bidding program. It will also allow the O&P field to
further distinguish itself from DME where no customization is necessary
to provide a device to a Medicare patient. The House bill would subject
virtually all DME items to a competitive bidding program.