Nine Weeks of Intensive Efforts Underscore Health Care Reform Debate

Nine Weeks of Intensive Efforts Underscore Health Care Reform Debate

NAAOP

6/4/2009

Nine Weeks of Intensive Efforts Underscore Health Care Reform Debate

The first of June began nine weeks of intensive efforts to reform the
nation's health care system. By the time of the congressional recess
beginning in early August, five major House and Senate committees are
expected to introduce and mark-up legislation reforming the nation's health
care system, including the Medicare and Medicaid programs, culminating in
House and Senate floor action in late July and early August. If the schedule
holds, Congress will spend the fall reconciling the House and Senate
versions of these bills and sending the final bill to President Obama for
his signature. Simply put, this is the most active time in recent memory for
issues impacting the O&P profession, both in terms of broad health care
changes that may impact the field as well as specific legislation that may
offer significant opportunities and potential threats.

A reform of the rules that permit private health insurance plans to
medically underwrite their policies and discriminate based on health status
will benefit O&P consumers and the providers who serve them. But if O&P care
is either omitted from benefit packages offered by private insurers, or
limited by exclusions and arbitrary dollar caps, then reform will not
achieve its promise. A key goal of NAAOP and many other O&P organizations is
to promote a federal parity bill that applies to prosthetics and custom
orthotics. What began as a consumer effort organized by the Amputee
Coalition of America at the state level has blossomed into a federal
initiative to enact O&P parity, and the timing of this effort could not be
better.

The Prosthetic and Custom Orthotic Parity Act of 2009, known as HR 2575,
would provide coverage of prosthetic and custom orthotic devices and
component parts, as well as their repair and replacement, under the same
terms and conditions applicable to other medical and surgical benefits
provided under health insurance policies. The bill was introduced on May 21,
2009, by Rep. Robert Andrews (D-NJ) and assigned to the Committee on
Education and Labor. Original co-sponsors include Reps. George Miller
(D-CA), Chairman of the Committee, Lincoln Diaz-Balart (R-FL), Todd Platts
(R-PA), Joe Sestak (D-PA), and Al Green (D-TX). Senate introduction of a
companion bill is expected soon. These bills allow the O&P community to
rally around specific legislation and to illustrate the need to have private
insurance coverage of O&P benefits. With the national health care reform
debate in full swing, this message is critical to promote at every
opportunity.

In addition, many of the long-standing Medicare goals of the O&P field have
been delayed by CMS as that agency has yet to issue regulations that would
link Medicare payment with practitioner/supplier qualifications and the
complexity of O&P care. AOPA has brought significant advocacy resources to
the table in this regard, culminating in introduction of the Medicare O&P
Improvements Act of 2009, known as HR 2479. This bill seeks to save Medicare
dollars through the elimination of fraud and abuse, the improvement of
quality care, and an explicit link between payment and qualifications of
practitioners/suppliers. The bill was introduced May 19, 2009 by Rep.
Shelley Berkley (D-NV) and was assigned to the Energy and Commerce Committee
and to the Ways and Means Committee. Rep. Glenn Thompson (R-PA) is an
original House cosponsor and companion Senate legislation is expected soon.

This year is expected to set O&P policy for years to come and your strong
voice will benefit the O&P profession in this debate. Thank you for your
continued support.


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