Congress Begins Its Second Session in Familiar Territory

Congress Begins Its Second Session in Familiar Territory

NAAOP

1/6/2010

Congress Begins Its Second Session in Familiar Territory

Congress returns from its holiday break this month to continue negotiating
health care reform legislation. After months of debate and missed deadlines
in 2009, the U.S. Senate voted Christmas Eve morning to pass their version
of healthcare reform legislation (HR 3590) by a partisan vote of 60 to 39.
This vote sets up a conference process that has already begun where the
House and Senate versions of the bill are negotiated into one piece of
legislation before being sent to the President's desk for enactment.

While both bills dramatically expand insurance coverage and reform insurance
market rules, significant differences between the House and Senate versions
of the bill remain. For instance, the House bill includes a national public
insurance option to be offered through a new health insurance exchange,
as well as a new tax on wealthy Americans to help pay for the bill's
expansion of coverage. The Senate takes a very different approach. It omits
the public option entirely and imposes a tax on high-premium health plans,
not on individuals' incomes.

Impact on O&P: The health bills are each over 2000 pages long, so the direct
impact on orthotics and prosthetics needs to be teased out. However, there
are clearly important differences between the House and Senate bills that
NAAOP is engaged in supporting or opposing, along with the O&P Alliance
organizations.

First and foremost is the standard benefits package that all private health
plans that participate in the health insurance exchange must offer. The
House bill explicitly states that such plans must offer insurance coverage
of durable medical equipment, prosthetics, orthotics, and related
supplies. The Senate bill is less specific. It states that the standard
benefits package must include coverage of rehabilitative and habilitative
services and devices. NAAOP will be working to ensure that orthotics and
prosthetics is specifically included in the standard benefits package in the
final health reform bill.

The House bill also omits orthotics and prosthetics from a new productivity
adjustment that stands to reduce annual Medicare reimbursement updates for
many types of Medicare providers. While the House productivity adjustment
provision does not apply to O&P, the Senate bill's provision does. This is a
significant threat to O&P reimbursement in future years and NAAOP is
actively opposing its application to O&P and supporting the House approach.

Finally, NAAOP joins the O&P Alliance organizations in supporting Senator
Ron Wyden's (D-OR) Amendment offered during the Senate's health reform
debate that would explicitly link provider qualifications with Medicare
payment. This provision was not adopted by the Senate but still remains
viable in that the bill would save the federal government Medicare dollars
while improving the quality of care and reducing the risk of fraud and
abuse. NAAOP will continue to keep its membership informed of developments
as they occur.

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