Audits: AOPA vs. CMS

Tuesday, May 14, 2013

ALEXANDRIA, Va. ­– The American Orthotic and Prosthetic Association (AOPA) has sued CMS over what it calls “unfair and unauthorized” auditing activities, according to a press release. “Today, AOPA has stated emphatically that we will not stand by when government acts inappropriately to threaten either the quality of care we provide to our patients or the economic viability of the small businesses and providers that comprise the orthotics and prosthetics profession,” stated Thomas Kirk, president of AOPA, in the release. The impetus for the lawsuit: a “flawed, and in some respects amateurish, report (by the Office of Inspector General in August 2011) alleging fraud in the O&P field where there essentially was none.” The suit claims, among other things, that the report misunderstood important nuances of the patient-physician relationship with respect to prosthetics; created confusion about whether bi-lateral amputees should have both prostheses on a single claim; and jumped to conclusions about fraud while disregarding technological advances necessitated by injuries sustained by veterans of wars in Iraq and Afghanistan.