CMS outlines qualifications for O&P

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Friday, January 13, 2017

WASHINGTON – CMS published a sweeping proposed rule in the Federal Register on Jan. 12 outlining the qualifications needed for practitioners and suppliers to furnish and fabricate prosthetics and custom-fabricated orthotics, and the accreditation requirements needed to bill for them.

The proposed rule also outlines the timeframe by which qualified practitioners and suppliers must meet applicable licensure, certification and accreditation requirements. Additionally, it outlines the requirements that an organization must meet to accredit qualified suppliers to bill for prosthetics and custom-fabricated orthotics.

The proposed rule also removes the current exemption from accreditation and quality standards for certain practitioners and suppliers.

The American Orthotics and Prosthetics Association has begun analyzing the proposed rule, but says at first glance it’s a move in the right direction.

“The provisions appear to be in line with what AOPA has supported with the Medicare O&P Improvements Act in defining qualified providers as those accredited with ABC or BOC and that only qualified providers can submit claims for prosthetics or custom-fabricated orthotics,” the association said in a bulletin. “That said, clearly, there are areas of the proposed regulations which will require revisions, edits and improvements, via comments to be prepared and submitted by AOPA and others in the O&P profession.” 

AOPA has long sought to have CMS enforce longstanding O&P licensure and certification requirements.

CMS is accepting comments on the proposed rule no later than 5 p.m. on March 13, 2017.