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O&P: Pandemic pushes need for separate status to forefront

O&P: Pandemic pushes need for separate status to forefront

WASHINGTON – O&P practitioners have renewed their push to be recognized as clinicians – a distinction they say is critical now more than ever to ensure access to care. 

While stakeholders have long fought for this, the COVID-19 pandemic has emphasized the need for it, says Justin Beland, director of government affairs for the American Orthotic and Prosthetic Association, because only certain clinicians have been able to get reimbursed for telehealth services during the public health emergency. 

“It’s come to the forefront, the inability to bill for telehealth visits,” he said. “It’s not great for the profession or the patients. They can bill for the device, but not subsequent follow-ups to see if the patient is doing well.” 

The Medicare O&P Patient-Centered Care Act, introduced March 17 by Rep. Mike Thompson, D-Calif., would create separate statutory requirements for the provision of orthoses and prostheses to distinguish practitioners from DME suppliers. 

The bill also seeks to: restore the term “minimal self-adjustment” to more clearly define off-the-shelf orthoses; and prohibit the practice of “drop shipping” custom orthoses and prostheses.

“We have Hanger and a few other large providers, but it would be difficult for private practitioners (to participate in competitive bidding),” said John Kenney, PhD., and vice president of clinical development at Ongoing Care Solutions. “(With the drop shipping of OTS devices), that only requires a delivery receipt, so you’re getting a brace in a box and that can certainly be provided by anyone who wins the bid. I worry that, if you have patient with grade 4 osteoarthritis, the patient is not appropriately served.” 

AOPA is urging stakeholders to ask their members of Congress to support the bill and expects a Senate companion bill before the end of April, says Beland. 

“This is the No. 1 most important issue to members and practitioners, and they’ve already sent 400 letters to Congress,” he said. “There is a lot of education that has to be done on the hill. They view our practitioners the same as physical therapists or physicians. They think we are in there in all the regulations and legislation, and we are not.” 


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