Re: Proposed LCD changes - please get involved for today and for the future of our patients
Laurie Saunders
Description
Collection
Title:
Re: Proposed LCD changes - please get involved for today and for the future of our patients
Creator:
Laurie Saunders
Date:
8/4/2015
Text:
Great post by Don Cummings. I just wanted to add that Ossur is doing their
part as a manufacturer as well. They are hosting a webinar on this very
topic tomorrow, and if you're registered but unable to listen live, they are
saying they'll send you a recorded version of the webinar. See below:
----------------------------------
Huge Changes for Prosthetics? The New Draft LCD
Join us for a webinar on Aug 05, 2015 at 12:00 PM EDT.
Register now!
<URL Redacted>
The DME MACs released a new draft LCD for lower limb prostheses that could
replace the current one. The ramifications are potentially far reaching. It
is not an exaggeration to say that this might be the most significant change
to prosthetic billing and coverage requirements since the creation of the L
codes if the draft were implemented in its current form.
Dave McGill, Ossur Vice President of Reimbursement & Regulatory will be
joined by Peter Thomas, General Counsel for NAAOP.
Join us on this webinar to learn more about the proposed changes and how you
can get provide input on the changes.
The webinar will be recorded. If you are not able to participate during the
live call, please register anyway so you can receive a follow up email with
a link to the recording.
After registering, you will receive a confirmation email containing
information about joining the webinar.
-------------------------------------
Laurie Saunders
Operations Manager
ABC Prosthetics & Orthotics
115 W. Columbia St. Suite A & B
Orlando, FL 32806
Ph. 407.999.8977 Fx. 407.999.0057
www.abcamputee.com
CONFIDENTIALITY NOTICE: This message is intended to be confidential and may
be legally privileged. It is intended solely for the addressee. If you are
not the intended recipient, please delete this message from your system and
notify us immediately. Any disclosure, copying, distribution or action taken
or omitted to be taken by an unintended recipient in reliance on this
message is prohibited and may be unlawful. Thank you.
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Don Cummings
Sent: Tuesday, August 04, 2015 1:46 PM
To: <Email Address Redacted>
Subject: [OANDP-L] Proposed LCD changes - please get involved for today and
for the future of our patients
The proposed LCD changes do not just impact people getting prosthetic
services - it impacts anyone who needs a custom orthosis as well, and
potentially every American who might someday need P&O care as they age.
Has anyone tried to get this story to the Media? It seems like a compelling
story of a small profession and the Americans with disabilities that they
serve being squashed by Big Government. I wonder, where are the
manufacturers on this issue? Where is the VA?
Where are retired Veterans who wear prostheses? Are the P&O university
programs and their students getting involved? What about the large P&O
Corporations; are they and their staff and patients trying to stop this?
(If I owned stock in a publicly traded P&O Corporation, I would be very
worried because they too, along with their clients with disabilities may
take a big hit if this goes through...) We're likely to see large lay-offs
and consolidation of branch offices, particularly in rural practices result
from this.... From the small company to the large, from rural America to
Urban centers, for patients regardless of where they get their P&O care,
this will potentially send our long-term care back into the relative dark
ages.... I have seen the petition to change, delay or overturn the proposed
LCD changes sent from AAOP, AOPA, ABC, BOC, NAAOP, the Amputee Coalition and
others. But I have seen only one request for signatures and/or action by
Otto Bock. Kudos to them...
Hopefully other manufacturers, suppliers and those in P&O R&D will follow.
It may seem as if the manufacturers have a profit motive by getting
involved and passing this information on to clients. Downstream, however, it
is Americans with disabilities who need P&O care who will suffer, have
reduced access to care and technologically-outdated prostheses at that. If
these LCD changes are enacted, there will be many components that will no
longer be covered for the average amputee, so the market for them in the US
will mostly die out. US manufacturers of components and materials along with
small private practices are likely to take a huge financial hit, forcing
many out of business altogether unless they're established in Canada,
Europe, the UK, etc. Small practices in rural areas are likely to take the
first and hardest hit if they aren't already out of business due to the
oppressive and unfair RAC audits (which let's face it, are just a
money-making racket for the Contractors who could care less about people
with disabilities who need P&O care). Ironically, even the RAC auditors
would suffer because the Prosthetics profession will shrink, meaning fewer
practices to audit and
from which to squeeze the life from. Consider that incentives for R &
D into improved and advanced technology will likely die on the vine in
the US. Sure, some companies are developing techniques and components
for wounded warriors from Government grants, but most of those developments
will only survive if they can be utilized by the much larger civilian
population (and eventually wounded warriors would likely be getting the same
technology that made it to mass-market when they
retire). The proposed LCD changes potentially negate 7 decades of
advancement in Prosthetic care, much of it a direct result of R&D that was
funded federally for the express purpose of improving the lives of our
wounded veterans. Some advancements have also been by entrepreneurs who had
great ideas, developed them and built businesses on advanced techniques and
technology. Will they survive this if CMS has killed the market and
incentive for innovative and advanced P&O technology? Now, CMS intends to
turn its back on those who have bled and died for our country, by pushing
prosthetic care for civilians and veterans alike to pre-WWII standards of
care. The US, which has led the world in advancement of prosthetic care in
many ways, will be the laughing stock of providers of P&O services in
Canada, Europe, the UK, and many urban centers even in developing nations.
If these changes are enacted, it may soon make more sense to leave the US
and travel to Mexico City for example to get decent prosthetic care. In many
ways, thermoplastic prostheses using the ICRC technology that was
implemented after the earthquake in Haiti as emergency relief care, will be
of higher quality than the basic device that CMS says Americans with
Disabilities can receive.
Finally, this concept that someone who gets a crutch, cane, or walker paid
for by Medicare is not eligible for components that are advanced or for
active amputees is ridiculously short-sighted. I'm a 56 year old double
Trans Tibial amputee who also had major unrelated surgery last year. Within
a span of four months, I needed a walker, then I used my crutches and a
single crutch briefly before returning to work full time.
With my prostheses with dynamic response, multi-axial feet, I walk on uneven
terrain, climb stairs, can jog, snow-ski, and am very active and productive.
I did not need new prostheses after this surgery, and I am not currently on
Medicare. But since Insurance follows CMS guidelines often, this could
easily be the situation for anyone needing a prosthesis. Had I been on
Medicare and needed a new pair of legs, CMS would have said, Oops, too bad,
no dynamic or multiaxial foot nor elevated vacuum sockets for you...! We
bought you a walker, thus you are relegated to K-2 components. I once met
with a double amputee who at 81 had only just lost both legs to
Meningococcemia. He was successfully fitted with temporary and intermediate
prostheses, using a walker at first, that enabled him to regain his health
and vitality instead of languishing in bed or being told he could only get a
wheelchair. After rehab, he returned on his definitive prostheses to an
active lifestyle including golfing several times a week. He was not
dependent on the system, he continued to be productive, pay taxes and
contribute to his community and to be a grandfather and great grandfather
for another decade. Today, if CMS enacts these changes, I think he would be
far less likely to make it out of the wheelchair at all. Is that really how
the US, via CMS's regressive policies, is going to reward its retired
citizens who've paid into the system all their lives?
Don Cummings, CP (LP) FAAOP
part as a manufacturer as well. They are hosting a webinar on this very
topic tomorrow, and if you're registered but unable to listen live, they are
saying they'll send you a recorded version of the webinar. See below:
----------------------------------
Huge Changes for Prosthetics? The New Draft LCD
Join us for a webinar on Aug 05, 2015 at 12:00 PM EDT.
Register now!
<URL Redacted>
The DME MACs released a new draft LCD for lower limb prostheses that could
replace the current one. The ramifications are potentially far reaching. It
is not an exaggeration to say that this might be the most significant change
to prosthetic billing and coverage requirements since the creation of the L
codes if the draft were implemented in its current form.
Dave McGill, Ossur Vice President of Reimbursement & Regulatory will be
joined by Peter Thomas, General Counsel for NAAOP.
Join us on this webinar to learn more about the proposed changes and how you
can get provide input on the changes.
The webinar will be recorded. If you are not able to participate during the
live call, please register anyway so you can receive a follow up email with
a link to the recording.
After registering, you will receive a confirmation email containing
information about joining the webinar.
-------------------------------------
Laurie Saunders
Operations Manager
ABC Prosthetics & Orthotics
115 W. Columbia St. Suite A & B
Orlando, FL 32806
Ph. 407.999.8977 Fx. 407.999.0057
www.abcamputee.com
CONFIDENTIALITY NOTICE: This message is intended to be confidential and may
be legally privileged. It is intended solely for the addressee. If you are
not the intended recipient, please delete this message from your system and
notify us immediately. Any disclosure, copying, distribution or action taken
or omitted to be taken by an unintended recipient in reliance on this
message is prohibited and may be unlawful. Thank you.
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Don Cummings
Sent: Tuesday, August 04, 2015 1:46 PM
To: <Email Address Redacted>
Subject: [OANDP-L] Proposed LCD changes - please get involved for today and
for the future of our patients
The proposed LCD changes do not just impact people getting prosthetic
services - it impacts anyone who needs a custom orthosis as well, and
potentially every American who might someday need P&O care as they age.
Has anyone tried to get this story to the Media? It seems like a compelling
story of a small profession and the Americans with disabilities that they
serve being squashed by Big Government. I wonder, where are the
manufacturers on this issue? Where is the VA?
Where are retired Veterans who wear prostheses? Are the P&O university
programs and their students getting involved? What about the large P&O
Corporations; are they and their staff and patients trying to stop this?
(If I owned stock in a publicly traded P&O Corporation, I would be very
worried because they too, along with their clients with disabilities may
take a big hit if this goes through...) We're likely to see large lay-offs
and consolidation of branch offices, particularly in rural practices result
from this.... From the small company to the large, from rural America to
Urban centers, for patients regardless of where they get their P&O care,
this will potentially send our long-term care back into the relative dark
ages.... I have seen the petition to change, delay or overturn the proposed
LCD changes sent from AAOP, AOPA, ABC, BOC, NAAOP, the Amputee Coalition and
others. But I have seen only one request for signatures and/or action by
Otto Bock. Kudos to them...
Hopefully other manufacturers, suppliers and those in P&O R&D will follow.
It may seem as if the manufacturers have a profit motive by getting
involved and passing this information on to clients. Downstream, however, it
is Americans with disabilities who need P&O care who will suffer, have
reduced access to care and technologically-outdated prostheses at that. If
these LCD changes are enacted, there will be many components that will no
longer be covered for the average amputee, so the market for them in the US
will mostly die out. US manufacturers of components and materials along with
small private practices are likely to take a huge financial hit, forcing
many out of business altogether unless they're established in Canada,
Europe, the UK, etc. Small practices in rural areas are likely to take the
first and hardest hit if they aren't already out of business due to the
oppressive and unfair RAC audits (which let's face it, are just a
money-making racket for the Contractors who could care less about people
with disabilities who need P&O care). Ironically, even the RAC auditors
would suffer because the Prosthetics profession will shrink, meaning fewer
practices to audit and
from which to squeeze the life from. Consider that incentives for R &
D into improved and advanced technology will likely die on the vine in
the US. Sure, some companies are developing techniques and components
for wounded warriors from Government grants, but most of those developments
will only survive if they can be utilized by the much larger civilian
population (and eventually wounded warriors would likely be getting the same
technology that made it to mass-market when they
retire). The proposed LCD changes potentially negate 7 decades of
advancement in Prosthetic care, much of it a direct result of R&D that was
funded federally for the express purpose of improving the lives of our
wounded veterans. Some advancements have also been by entrepreneurs who had
great ideas, developed them and built businesses on advanced techniques and
technology. Will they survive this if CMS has killed the market and
incentive for innovative and advanced P&O technology? Now, CMS intends to
turn its back on those who have bled and died for our country, by pushing
prosthetic care for civilians and veterans alike to pre-WWII standards of
care. The US, which has led the world in advancement of prosthetic care in
many ways, will be the laughing stock of providers of P&O services in
Canada, Europe, the UK, and many urban centers even in developing nations.
If these changes are enacted, it may soon make more sense to leave the US
and travel to Mexico City for example to get decent prosthetic care. In many
ways, thermoplastic prostheses using the ICRC technology that was
implemented after the earthquake in Haiti as emergency relief care, will be
of higher quality than the basic device that CMS says Americans with
Disabilities can receive.
Finally, this concept that someone who gets a crutch, cane, or walker paid
for by Medicare is not eligible for components that are advanced or for
active amputees is ridiculously short-sighted. I'm a 56 year old double
Trans Tibial amputee who also had major unrelated surgery last year. Within
a span of four months, I needed a walker, then I used my crutches and a
single crutch briefly before returning to work full time.
With my prostheses with dynamic response, multi-axial feet, I walk on uneven
terrain, climb stairs, can jog, snow-ski, and am very active and productive.
I did not need new prostheses after this surgery, and I am not currently on
Medicare. But since Insurance follows CMS guidelines often, this could
easily be the situation for anyone needing a prosthesis. Had I been on
Medicare and needed a new pair of legs, CMS would have said, Oops, too bad,
no dynamic or multiaxial foot nor elevated vacuum sockets for you...! We
bought you a walker, thus you are relegated to K-2 components. I once met
with a double amputee who at 81 had only just lost both legs to
Meningococcemia. He was successfully fitted with temporary and intermediate
prostheses, using a walker at first, that enabled him to regain his health
and vitality instead of languishing in bed or being told he could only get a
wheelchair. After rehab, he returned on his definitive prostheses to an
active lifestyle including golfing several times a week. He was not
dependent on the system, he continued to be productive, pay taxes and
contribute to his community and to be a grandfather and great grandfather
for another decade. Today, if CMS enacts these changes, I think he would be
far less likely to make it out of the wheelchair at all. Is that really how
the US, via CMS's regressive policies, is going to reward its retired
citizens who've paid into the system all their lives?
Don Cummings, CP (LP) FAAOP
Citation
Laurie Saunders, “Re: Proposed LCD changes - please get involved for today and for the future of our patients,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/237622.
