H.R. 5045, introduced by Reps. Ellmers (R-NC) and Schakowsky (D-IL), addresses the July 2015 Medicare Administrative Contractor (DME MAC) proposed draft LCD for prosthetic limbs (DL 33787) that would completely rewrite the coverage rules for prosthetic limb care for Medicare beneficiaries with limb loss. The new coverage policy was so restrictive that it would have sent amputees back to a 1970’s level of care. This draft LCD was not based on any credible evidence, would seriously restrict access to modern prosthetic limbs, and was widely criticized by patients, prosthetists, physicians and numerous beneficiary and clinical organizations. Under these proposed policies, beneficiaries would be eligible for prosthetic limbs that are functionally outdated, less durable and less safe.
H.R. 5045 is bipartisan legislation that would:
- Place a moratorium on issuance of this draft LCD (or any part of it) until spring of 2017, after a new administration is in office;
- Instruct CMS and the DME MACs to remove the draft LCD from their websites to eliminate the risk of private insurers adopting this misguided coverage policy; and,
- Clarify that CMS does, in fact, have the authority to provide guidance and oversight of LCDs developed by Medicare Administrative Contractors.
Ask your Member of Congress to Co-Sponsor H.R.5045 and help protect access to modern prosthetic care for Medicare beneficiaries and others with limb loss. You may contact your Member of Congress at this link: http://capwiz.com/naaop/issues/alert/?alertid=71698631