BREAKING NEWS: Three New Developments Impact the O&P Community

Three new developments impacting the orthotic and prosthetic profession occurred on February 9th that NAAOP would like you to know immediately:

1. Rehabilitation Research Bill Advances in Senate Committee: On February 9th, the Senate Health Education Labor and Pensions (HELP) Committee reported favorably on a bipartisan bill introduced by Senators Kirk (R-IL) and Bennet (D-CO) to advance rehabilitation research, including O&P research and development, at the National Institutes of Health (NIH). The bill would enhance coordination and improve the stature and visibility of this research at NIH’s 27 Institutes and Centers, particularly in the National Center for Medical Rehabilitation Research (NCMRR). NCMRR’s mission includes O&P research and development. This occurred in 1990 after extensive lobbying efforts by NAAOP to increase O&P research funding at NIH. This is the first major piece of legislation to address the NCMRR at NIH since that time and should spark additional attention at NIH in this area. The bill now goes to the full Senate for consideration. A companion House bill has already been introduced by Congressman Langevin (D-RI) and Congressman Harper (R-MS)

2. DC Appeals Court Ruling Offers Hope to Providers on ALJ Backlog: The D.C. Circuit Court of Appeals issued an important opinion in the American Hospital Association’s administrative law judge (ALJ) delay lawsuit. The D.C. Circuit reversed the district court’s decision and determined that the court has jurisdiction over this case because HHS has a clear duty to issue ALJ decisions in 90 days, and “escalation” to the next level of administrative review is not an adequate remedy for HHS’s failure to issue ALJ decisions in a timely manner. The court remanded the case to the district court for it to consider whether to compel HHS to comply with the deadline in light of the worsening ALJ backlog. The decision gives some hope to Medicare providers, including O&P practices, that the intolerable delay in ALJ appeals will begin to be resolved, but the court did not yet actually step in and solve the problem. A decision by the district court is expected late this year.

3. President’s Budget Proposes to Expand Competitive Bidding to ALL O&P Care: For the first time, the President’s budget for FY 2017, released yesterday, proposes to expand DMEPOS competitive bidding to include ALL PROSTHETICS AND ORTHOTICS, in addition to a number of other types of DMEPOS. The proposal is expected to save $38 billion over ten years. This is bad news in that NAAOP and the O&P Alliance organizations will have to mount a strong defense against this proposal, but it is important to put this development into perspective. Competitive bidding for anything more than off-the-shelf orthotics is currently illegal, so Congress would have to pass a law authorizing CMS to expand it to all O&P care. This is the last year of the current President’s budget. The budget represents a grab-bag of policies that the administration throws out to gather reaction, and to pad the savings they can achieve in order to pay for their other proposed priorities. In this calendar year, there is no chance this proposal will become law absent titanic developments in Congress, which are not expected. Congressional Republicans declared the budget “Dead on Arrival” and have shown no interest in this specific proposal. NAAOP will work with its Alliance partners to strongly oppose this proposal, but it is certainly not immanent.

  • Written by NAAOP


PRESS STATEMENT Contact: Peter Thomas
February 10, 2016
(202) 466-6550


Washington, D.C.: The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) applauded the Senate HELP Committee for favorably reporting out of committee yesterday a modified version of legislation entitled, the “Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act,” S. 800, introduced last year by Senator Mark Kirk (R-IL) and Senator Michael Bennet (D-CO). The bill now goes to the full Senate for consideration and, hopefully, passage.

S. 800 is designed to improve, coordinate, and enhance medical rehabilitation research at the National Institutes of Health (NIH). The National Center for Medical Rehabilitation Research (NCMRR) is the lead agency within NIH that funds rehabilitation science. NCMRR’s mission is to conduct and support rehabilitation research, “including orthotic and prosthetic research and development.” O&P research is the only specifically referenced type of rehabilitation research in the 1990 law that created the NCMRR. The 1990 law was the product of compromise legislation spearheaded by NAAOP’s predecessor organization, the American State of the Art Prosthetic Association.

S. 800 is supported by a wide coalition of consumer, clinical and research organizations, including NAAOP, the American Academy of Orthotists and Prosthetists (AAOP) and the Amputee Coalition.

NAAOP commended Senators Kirk and Bennet as well as HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) for including in the bill many of the recommendations made by the Blue Ribbon Panel on Medical Rehabilitation Research established by NIH in December 2012. We are particularly supportive of the provisions in the bill designed to enhance strategic coordination within the Director’s office at NIH and with other agencies to update and streamline medical rehabilitation and O&P research priorities. We also support the provisions in the bill which specify that the Research Plan must be updated every five years following a scientific conference or workshop; provide for progress reports; and include a definition of medical rehabilitation research that reflects the importance of an individual’s ability to improve their functional status after illness or injury.

“We urge the full Senate to pass S. 800 and send the bill to the House of Representatives to enact H.R. 1631 as revised by the Senate bill,” stated David McGill, President of NAAOP. “Enactment of this legislation will send a powerful message that our Nation can and must improve the evidence base of medical rehabilitation, including orthotic and prosthetic care, so that individuals with limb loss and other orthopedic conditions can return to work, live as independently as possible, and have a high quality of life.”

Peter Thomas, NAAOP General Counsel stated, “NIH has devoted the vast majority of its attention and resources to technology-based O&P research and development over the years, primarily through the Small Business Innovation Research (SBIR) grant program. We intend to build on this bill’s passage to prompt NIH to conduct and support O&P research that is more clinically focused and patient centered.”

George Breece, NAAOP’s founding Executive Director, said “Since our inception, NAAOP has been an organization committed to greater funding and support for O&P research. We are pleased to join nearly 40 other national organizations in strongly supporting S. 800 and look forward to seeing the bill enacted this year.”

The DRRC is a coalition of nearly 40 national non-profit organizations committed to improving the science of rehabilitation and disability. The DRRC seeks to maximize the return on the federal investment in rehabilitation and disability research with the goal of optimizing the health and function and quality of life of persons with injuries, illnesses, disabilities, and chronic conditions.

DRRC Member Organizations

National Association for the Advancement Orthotics & Prosthetics
American Academy of Orthotists & Prosthetists
Amputee Coalition
American Academy of Physical Medicine & Rehabilitation
American Congress of Rehabilitation Medicine
American Occupational Therapy Association
American Physical Therapy Association
American Speech-Language-Hearing Association
Association of Academic Physiatrists
Brain Injury Association of America
American Academy of Neurology
American Association of People with Disabilities
American Association on Health and Disability
American Foundation for the Blind
American Medical Rehabilitation Providers Association
American Music Therapy Association
American Therapeutic Recreation Association
Association of Rehabilitation Nurses
Association of University Centers on Disabilities
Child Neurology Foundation
Child Neurology Society
Christopher and Dana Reeve Foundation
Disability Rights Education and Defense Fund
Lakeshore Foundation
March of Dimes
Mental Health America
National Alliance for Caregiving
National Association of Rehabilitation Research Training Centers
National Association of State Head Injury Administrators
National Association of Veterans’ Research and Education Foundations
National Council on Independent Living
National Multiple Sclerosis Society
Paralyzed Veterans of America
RESNA, Rehabilitation Engineering and Assistive Technology Society of North America
The Arc
Uniform Data System for Medical Rehabilitation
United Spinal Association

  • Written by NAAOP

O&P Policy Priorities Command Your Presence

January has been a month of introspection for the O&P community as leaders in the profession have come together to discuss policy priorities and the path that lies ahead.

Medicare Lower Limb LCD: NAAOP and its Alliance partners will soon meet with CMS to discuss their plans for the Work Group being convened to study and recommend a consensus statement on lower limb prostheses. The Draft LCD was placed on hold by CMS last fall but it is not clear what will occur when the Work Group makes its recommendations. By law, the Work Group is comprised of federal employees only, so stakeholder input by the O&P and rehabilitation communities is critical as the Work Group deliberates on this important issue.

Prior Authorization of Prostheses: The final rule on prior authorization MAY impact as many as 84 lower limb prosthetic codes, but CMS will issue additional guidance before implementing this program. NAAOP and the Alliance members will continue to work with CMS as it determines which prosthetic codes, if any, will be subject to prior authorization and how they will implement this new process. Our first approach is to dissuade CMS from imposing prior authorization on prosthetic limbs and components at all. This new process is supposed to be targeted to Medicare benefits that are over-utilized, but recent Medicare data suggests a significant decrease in Medicare spending for prosthetic care in the past several years. If CMS does impose prior authorization on certain prostheses, we will stress to them that delays and denials are unacceptable for patient care and that transition to this new system must be as seamless as possible.

Injured and Amputee Veterans Bill of Rights: Please email us by clicking on “Contact NAAOP” on our website,, to let us know your current experience with the Veteran Administration as you try to provide services to veterans in need of prostheses. Congresswoman Ellmers (R-NC) intends to soon reintroduce the Injured and Amputee Veterans Bill of Rights, which has been a long-standing priority of NAAOP. We need to hear your current experience in treating veteran patients. Do you confront barriers in gaining access to veterans in need of prosthetic care? Do you have an O&P contract with the VA? Do you experience long delays in gaining approval to provide prosthetic care to veterans? Please let us know your current experience with VA prosthetic care as we finalize our policy proposals to address problems and concerns in the O&P field.

O&P Congress and Policy Forum: Please plan to attend this year’s O&P Policy Forum on April 26th and 27th in Washington, DC. The policy forum is an annual event where leaders in the O&P profession come to Washington, DC to learn about O&P policies and advocate on behalf of patients and the providers who serve them. While AOPA organizes the policy forum, all Alliance organizations participate in this event, including NAAOP. This year, former U.S. Senator BobKerrey, a long-time friend of NAAOP, will lead an “O&P Congress” where we will all help draft legislation to address O&P policy priorities. We will then bring this bill to our legislators and promote our key priorities. NAAOP hopes to see you there!

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Mixed Bag in Final Prior Authorization Regulations for DMEPOS

CMS issued final regulations on prior authorization of certain durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) as 2015 came to a close. These regulations permit CMS to impose prior authorization requirements on a wide variety of DMEPOS that are “frequently subject to unnecessary utilization.” NAAOP participated with the O&P Alliance in submitting extensive comments to the proposed rule in July 2014 and met with CMS officials on this issue. Some of our comments were adopted in the final regulations and some were not, but in the end, prior authorization will be another tool that CMS and its contractors can use in the future to help control Medicare spending.

Not everyone in the O&P profession opposed prior authorization when it was proposed. Some see benefits to obtaining approval to provide an orthosis or prosthesis up front, before delivering care to a Medicare beneficiary and being denied for that claim. With the appeals process taking years to resolve disputes, there is an argument that prior authorization may bring additional certainty to the provision of orthoses and prostheses. But there are many drawbacks to prior authorization as well, and this is why NAAOP and the O&P Alliance raised serious objections to prior authorization during the comment period. There were some genuine victories in the final rule, namely:

  1. Prior authorization may be implemented gradually, with a select number of items identified on the “Master List” being exposed to prior authorization in the near term. It can also be implemented in certain regions of the country, rather than nationally for all billing codes.
  2. Once a billing code is subject to prior authorization, it need not be imposed for a full 10-year period, as the proposed rule stated. If certain conditions are met, it can be discontinued at any time; and,
  3. CMS recognizes that claims that have received prior authorization are subject to some protection from future auditing activity. There are exceptions for cases of suspected fraud and for CERT audits, which are mandated by federal law. While prior authorization is not a guarantee of Medicare payment, this is a significant concession by the government which was not included in the proposed rule.

Nonetheless, prior authorization will be permitted for the 135 DMEPOS items on the initial Master List, 84 of which are prosthetic codes. No orthotic codes appear on the list in 2016, but this may change in future years. If prior authorization is imposed on a code, all claims that do not have an affirmed prior authorization will be denied payment. The Master List will be automatically updated annually based on whether new billing codes have been identified in government reports (i.e., GAO, OIG and CERT reports) as being overutilized, and if these items exceed a payment threshold of $1,000. Denial of prior authorization is not appealable, but the provider can submit as many prior authorization requests as necessary to gain approval. Initial requests should be processed within 10 business days while resubmissions can take up to 20 days for a decision. CMS and its contractors will issue sub-regulatory guidance in the future to provide additional detail as to filing requests for prior authorization.

  • Written by NAAOP

2015 was a banner year for NAAOP and you can expect more of the same in 2016.

2015 was a banner year for NAAOP and, as a member of our association, you can expect more of the same in 2016. The year was defined by four major issues affecting the O&P profession:

  • NAAOP wrote to and met with the Secretary of the VA to advance protections for veterans in need of O&P care and continued to work toward adoption of the Injured and Amputee Veterans Bill of Rights;
  • NAAOP contributed to a major victory in February 2015 when CMS issued federal regulations clarifying that ACA health plans must cover rehabilitation “devices” as well as services, prompting New York State to expand its coverage of replacements and repairs of prostheses for the 2015-2016 benefit years, contrary to its one-limb-per-lifetime policy;
  • NAAOP played a leading role in working independently and through the O&P Alliance to oppose the Medicare Draft LCD for Lower Limb Prostheses, spearheading the White House “We the People” petition to rescind the Draft LCD and creating the webpage to galvanize opposition to the proposal; and,
  • NAAOP worked with rehabilitation organizations to promote O&P research and development, commenting on draft research priorities to be pursued by the National Institutes of Health and other federal agencies.

Your membership will enable NAAOP to continue to be on the front lines of these important issues and we cannot thank you enough for your support. We truly appreciate your financial contribution to NAAOP and your direct involvement in our collective O&P advocacy efforts.

Thank you again for your continued membership in NAAOP.

  • Written by NAAOP

Year-End Update on Policies Impacting O&P Care

Spending Bill and ACA Repeal: As Congress heads toward the holiday Congressional recess, there is major unfinished legislative business to address, some of which has a direct impact on O&P providers and patients. An Omnibus Spending Bill is being negotiated to fund the federal government past the current deadline of December 12th. If Congress is not able to agree to a spending bill by that date, they will have to pass another short-term resolution to continue funding federal government programs until a longer-term compromise can be achieved. This week, the Senate is busy working to pass a Budget Reconciliation bill that would repeal key aspects of the Affordable Care Act. It is expected to pass the Senate with a simple majority vote but will be vetoed by the President.

Audits and Appeals: On the audit and appeals front, there is movement on the Senate Finance Committee’s efforts to streamline the RACs and the Medicare appeals process. Legislative language has recently been shared that would directly impact O&P audits and appeals in a very positive way. However, there are also a series of provisions in this draft bill applicable to all providers that would essentially erect barriers for providers to appeal claims denials. NAAOP is working in conjunction with AOPA and the O&P Alliance on this important legislation.

Inflation Update: The annual inflation update to the Medicare O&P fee schedule was released by CMS and, unfortunately, the lack of inflation created a negative update of .4 percent. This means that CMS will pay .4 percent less on January 1st on the O&P fee schedule than it is paying in 2015. This is based on a statutory formula created in 2010. In recent years, the formula created increases in inflation updates, but this year resulted in a negative update. Short of changing the federal law, there is not much that can be done to oppose these reductions in reimbursement for O&P or for any provider under the Medicare program. In addition, sequestration will continue to siphon an additional 2 percent off of all Medicare provider fees.

Draft LCD: The Draft LCD continues to be available on the CMS and DME MAC websites while CMS convenes an Interagency Workgroup to study the issue of prosthetic coverage and try to arrive at a consensus statement on the issue. This workgroup must be limited to federal employees by law and is expected to meet throughout 2016. CMS has recently confirmed that it is investigating whether it can remove the Draft LCD from its website while deliberations on this policy area continue. The agency remains committee to including robust public stakeholder input into this policy as it takes shape next year, but how that actually occurs is still under development. A meeting between CMS and NAAOP/the O&P Alliance is being scheduled for January to discuss next steps.

Heartfelt Thank You! 2015 has been an incredibly active year and one that witnessed extreme threats coupled with some of the most inspiring grassroots advocacy the O&P field has seen in years, perhaps decades. Patients came together with providers, manufacturers, and other health professions to defend access to appropriate O&P patient care. The O&P community should be proud of its collective accomplishments. NAAOP sincerely thanks all of its members and friends for their part in making this happen. Happy Holidays.

Contact Peter Thomas at 202-455-6550 or for further information.

  • Written by NAAOP

Draft Prosthetic LCD Will NOT be Finalized! More Work Required to Arrive at Appropriate Medicare Coverage Policy

After spending weeks waiting for the White House to respond to the NAAOP-created “We the People” Petition calling on the President to rescind the draft Local Coverage Determination (LCD) for Lower Limb Prostheses, NAAOP is pleased that the Centers for Medicare and Medicaid Services (CMS) WILL NOT FINALIZE the flawed draft LCD! This removes the immediate threat that this unwarranted and poorly-supported policy posed to patient access to modern prosthetic care. Derailing the draft LCD was Job One for NAAOP, other organizations in the prosthetic, rehabilitation and disability communities, and thousands of individuals who united to express their concerns. The controversial draft LCD generated over 100,000 petition signatures in just 17 days this past August, obligating the White House to formally respond. Considering how rare it is for CMS to reconsider LCDs, this is an important short-term victory. But our work on this issue is far from over.

While the draft LCD is essentially on hold, CMS will convene a multidisciplinary “Lower Limb Prostheses Interagency Workgroup” in 2016. The Workgroup will be comprised solely of federal employees from various agencies with some familiarity with limb prosthetics. The Workgroup is charged with developing a consensus statement that informs Medicare policy by reviewing the available clinical evidence that defines best practices in the care of beneficiaries who require lower limb prostheses. The Workgroup will also seek to identify evidence gaps and recommend study designs and outcome measures that inform function, quality of life and service satisfaction in this area.

Patients and providers from outside the government will not be included in the Workgroup. This is because of federal rules that prohibit private citizens from serving on advisory panels in most circumstances. But the White House and CMS statements say that they “will ensure there is opportunity for public comment and engagement” with the Workgroup’s activities. A meeting is already being set up with CMS officials to explore how the public will be able to impact the deliberations of the Workgroup.

The meeting will also include discussions designed to ensure that CMS and its contractors remove the draft LCD from their websites so that private insurers and other payers do not adopt draft CMS p.olicy as if it were final coverage policy. Unfortunately, this already occurred in September when United Healthcare discontinued coverage for vacuum socket technology just seven days after the comment period on the draft LCD ended. For this reason, NAAOP intends to continue pressing CMS and its contractors to formally rescind the draft LCD.

The White House/CMS announcements are a major first step forward and we commend them for listening to our concerns and putting a stop to the draft LCD. The decision underscores how patients with limb loss, prosthetists, physicians, rehabilitation providers, and members of the disability community can band together to effect positive change. NAAOP would like to thank its board of directors and members, O&P Alliance partners, the Amputee Coalition, thousands of individuals, other organizations, O&P clinics, providers, manufacturers, researchers and educators for their collective efforts to challenge the draft LCD.

Contact Peter Thomas at 202-455-6550 or for further information.

  • Written by NAAOP

NAAOP Responds to White House Reply to “WE THE PEOPLE” Petition on Proposed Medicare Coverage Restrictions for Lower Limb Prostheses

October 19, 2015

Washington, D.C.-The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) issued its response today to the White House’s “initial” reply to the “We the People” petition requesting the President to rescind the draft Medicare Local Coverage Determination for Lower Limb Prostheses (DL 33787). The White House response to the petition was posted October 16th.

While not a substantive reply to the petition’s request, the White House acknowledged that it will provide an “update” in the future. The White House’s initial response mentions that “HHS has met with stakeholders on this important issue, and both CMS and its contractors understand the questions that have been raised about access to the right prosthetic care – including related technologies – for Medicare beneficiaries.” It also states that “CMS wants to make clear that they’re committed to providing high quality care to all Medicare beneficiaries.”

Peter W. Thomas, NAAOP General Counsel, noted that, “While we would have preferred a final answer instructing the DME MACs to rescind the draft LCD, we are encouraged that the White House recognized the need to publicly respond and provide this initial update. NAAOP will continue to work with CMS and the White House and press the issue by educating legislators and government officials to achieve the outcome both Medicare beneficiaries with limb loss and privately-insured amputees in the United States deserve.”

David McGill, NAAOP President, added, “After attracting over 100,000 signatures in 17 days, witnessing the prosthetic and orthotic community submit thousands of public comments, and participating in both an amputee protest and a high-level meeting with CMS and HHS officials, we cannot hide our disappointment that the draft LCD has not yet been rescinded. But we take CMS at its word that they understand the concerns we have raised and look forward to working with them to achieve a good outcome for patients, their families, and the providers who serve them. NAAOP will recommit itself to advocacy work on this vital issue.”

Rescission of the draft LCD is critical because it lacks virtually any clinical or medical evidence to support its proposals while other payers look to it for guidance. United Healthcare has already discontinued coverage of vacuum socket technology by referencing the draft Medicare policy. 
”NAAOP believes strongly that the public must be offered another opportunity to comment on the final LCD when it is announced. The draft LCD was so fundamentally flawed that the next iteration must be considered a draft subject to public comment,” stated McGill.

To see the initial response from the White House, click here.

NAAOP had previously announced that it had surpassed the 100,000 signature mark on its “We the People” White House petition on July 17, 2015. The petition, which calls for the Obama Administration to “rescind the Medicare proposal restricting access to prosthetic limbs and returning amputees to 1970’s standards of care,” was supposed to have received a formal response from the White House by October 16th.

Numerous organizations endorsed and promoted the petition, including the Amputee Coalition, a consumer organization, as well as professional organizations such as the American Orthotic & Prosthetic Association (AOPA), the American Academy of Orthotists and Prosthetists (AAOP), the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC), the Board of Certification, International (BOC), the National Commission on Orthotic and Prosthetic Education (NCOPE), prosthetic clinics and business, as well as multiple organizations representing rehabilitation hospitals, physician organizations and disability groups through a coalition known as the ITEM Coalition.

For future updates on this and other orthotic and prosthetic issues, please link to NAAOP’s Twitter and Facebook page or visit

Contact: Peter W. Thomas
(800) 622-6740


  • Written by NAAOP

NAAOP Press Statement on August 26 Meetings in Maryland and Washington

August 27, 2015, 2:30 PM ET

Washington, D.C.—The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) had a strong presence at yesterday’s Public Comment Meeting hosted by the Medical Directors of the DME Medicare Administrative Contractors (MACs) and at a subsequent meeting in the HHS Secretary’s Office in Washington D.C.

The Public Comment Meeting, which took place in Maryland to address the draft Local Coverage Determination for Lower Limb Prostheses, included 200 amputees from around the United States as well as hundreds of other concerned individuals both in the room and participating by teleconference. Peter Thomas, NAAOP’s general counsel and a bilateral amputee himself, brought the audience to its feet early on, saying “This draft policy makes it more difficult for patients seeking to walk again after the loss of a limb when it should be encouraging patients to push themselves through the difficult rehabilitation process to become ambulatory. It will lead to added costs to Medicare as more individuals with limb loss simply give up, remain in a wheelchair or become long-term residents of nursing homes.”

NAAOP President, David McGill, spoke about the draft LCD from his perspective as an above-knee amputee, noting that “the elimination of the concept of ‘potential’ when assessing an amputee’s functional level creates an artificial ceiling that many amputees will never be able to break through.” He also asked the Medical Directors “to not sacrifice the physical and emotional well-being of amputees on the altar of administrative or economic efficiency,” concluding, “surely our right to mobility is worth more than that.”

NAAOP Vice President Jim Rogers, CPO, also a speaker at the meeting, later described the days’ events as “heartfelt, emotional and deeply humbling.” He added, “At no other time in the history of our profession have we come together, patients, clinicians, educators and allied health professionals at one time with one voice in support of those we serve. We upheld the right of amputees to access modern technology; we attacked the imposition of barriers to that care and we argued that the O&P professional is indeed qualified – and perhaps the most qualified professional – to accurately evaluate the amputee and determine the best treatment plan.”

NAAOP live-tweeted the event and gave people the opportunity to watch some of the proceedings in real time via Periscope. Ashlie White, NAAOP Secretary and Director of Social Media, stated, “I believe this is the first time in the history of the O&P profession that any organization has provided live video access to a Medicare public meeting.” White further noted that she thinks it increasingly likely that live streaming tools like the one used by NAAOP will give all licensed and certified practitioners and patients the ability to be a part of Medicare and DME MAC processes more directly.

NAAOP Immediate Past President Paul Prusakowski observed that “[b]y listening in on the meeting by phone and following the updates online minute-by-minute, it was clear that this event represented one of the most significant moments in the history of our profession. The passionate testimonies by both diverse professionals and the people who rely upon our care clearly struck both emotional and intellectual chords that resonated far beyond the four walls of that room and underscored the significant role that our profession plays as part of the rehabilitation team in restoring the lives of the patients we all serve.”

George Breece, Executive Director of NAAOP, added, “We were gratified to hear that the Veterans Administration will also oppose this proposal, calling for it to be rescinded. They understand the impact this restrictive policy will have on all amputees using prosthetic limbs, including veterans and those with private insurance. This is not just a Medicare issue and we are grateful to the VA for taking such a strong stand and protecting access to appropriate prostheses for its veteran amputees.”

Later in the day, McGill and Thomas participated in a meeting with high-ranking CMS officials, including Acting Director Andrew Slavitt and Acting Principal Deputy Administrator, Dr. Patrick Conway. Both walked away satisfied that senior Medicare officials understand the issues and share serious concerns with the policy proposed by Medicare’s contractors, the DME MACs.

“Administrator Slavitt specifically stated that Medicare officials would be speaking with the DME MAC Medical Directors to talk about this policy,” noted Thomas, labeling the willingness of CMS’s central office to get involved a “positive sign.” McGill added, “It was encouraging to hear Acting Administrator Slavitt state that his team ‘is very personally engaged’ on this issue, and it is clear that he and Dr. Conway have devoted significant time and attention to the concerns raised by NAAOP, the O&P Alliance, the Amputee Coalition and many other stakeholders.”

While Thomas termed the days’ events “historic,” he cautioned that much work remains to be done. “We’re not yet at the finish line,” he said. “It is imperative that as many people as possible submit comments to this proposed LCD before the August 31st deadline.” McGill agreed, pointing out that “comments made at the public meeting yesterday, while powerful, are not part of the official record the DME MAC Medical Directors will review when assessing their next steps with this draft LCD. That would be impossible because literally none of the medical directors took notes during the three hours of public comments. We implore all NAAOP members and anyone else interested in making their voice heard to utilize the formal written comment submission process before the end of the day Monday.”

For information on how you can submit comments before August 31st, visit NAAOP’s website at and

Contact: David McGill

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August 17, 2015 (11:08 a.m. Eastern Time)
Contact: Peter W. Thomas
(800) 622-6740

White House Obligated to Respond to Request to Rescind Draft LCD

Washington, D.C.—The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) announced today that it had surpassed the 100,000 signature mark on its “We the People” White House petition. The petition, which calls for the Obama Administration to “rescind the Medicare proposal restricting access to prosthetic limbs and returning amputees to 1970’s standards of care,” started only 17 days ago. Achievement of this milestone requires the White House to formally respond to the petition’s rescission request.

“This is a significant achievement,” said David McGill, President of NAAOP and an above-knee amputee himself. “100,000 signatures in only 17 days demonstrates that the public recognizes the major deficiencies of the draft LCD. Clearly, the restrictions on access to appropriate care resulting from this proposed policy resonate with amputees, the health care professionals who treat them, and the American public. NAAOP looks forward to the White House’s response.”

Peter Thomas, General Counsel for NAAOP and counsel to the O&P Alliance, a coalition of orthotic and prosthetic organizations, noted that “the 40-page proposed LCD completely re-writes coverage, coding and reimbursement policy for artificial legs in a way that will severely limit access to modern technology and standards of prosthetic care. As a bilateral below-knee amputee since age ten, I have witnessed modern prosthetic care become an American health care success story. The Proposed LCD will relegate amputees like me to antiquated and less functional prostheses. It will turn back the clock on lower limb amputees, who in recent years have achieved remarkable levels of health, function, activity, and independence,” he said.

Numerous organizations endorsed and promoted the petition, including the Amputee Coalition, a consumer organization, as well as professional organizations such as the American Orthotic & Prosthetic Association (AOPA), the American Academy of Orthotists and Prosthetists (AAOP), the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC), the Board of Certification, International (BOC), the National Commission on Orthotic and Prosthetic Education (NCOPE) as well as multiple organizations representing rehabilitation hospitals, physician organizations and disability groups through a coalition known as the ITEM Coalition.

“NAAOP helped coordinate efforts by designing a webpage at which proved to be highly effective in educating the amputee, the prosthetic profession, and the general public about this issue,” stated Paul Prusakowski, Past President of NAAOP and a certified prosthetist. “The site has a wealth of information on this proposed policy.”

George Breece, Executive Director of NAAOP, pointed out that “cracking the 100,000 signature mark is only the first step in a multi-pronged effort to get the draft LCD rescinded. While we’re gratified at the response to the petition, there are still a number of actions we need people to take in order to keep the momentum rolling and build on the petition’s success.”

Formal comments on the draft policy must be submitted to the government by the end of August and the DME MACs are holding a public meeting on August 26th to obtain comments about the proposed policy. “NAAOP intends to be highly engaged in these ongoing efforts,” Breece said, adding, “Medicare patients paid all their lives to receive care when they need it. They deserve better than this policy allows in their time of need.”

“We encourage all members of the public who care about access to health care to submit comments to the Medicare contractors on this policy. The webpage has everything anyone needs to make this happen,” stated Ashlie White, Chair of NAAOP’s Social Media Committee and member of the NAAOP Executive Committee. “Anyone can find out more by linking to NAAOP’s Twitter and Facebook page.”

“As a practicing prosthetist who treats amputees every day, I can attest to the absurdity of this Proposed LCD and the furor it has set off in the amputee community,” stated Jim Rogers, CPO and NAAOP Vice President. “The policy ties the hands of prosthetists, physicians and therapists in designing the optimal treatment plan for each individual patient and, thereby, does a disserve to Medicare beneficiaries and, eventually, all lower limb amputees who use prostheses to function,” he said, adding, “The policy must be stopped in its tracks.”


  • Written by NAAOP