White House Pulls Obama-Era Rule for Artificial Limb Providers

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By Mike Stankiewicz

New qualifications for clinicians and suppliers of artificial limbs and custom-made orthotics have been pulled back by the Trump administration, delaying requirements signed into law 17 years ago.

The Centers for Medicare & Medicaid Services rescinded Oct. 3 an Obama-era proposal that would have required clinicians and suppliers to receive accreditation to provide durable medical equipment orthotics, prosthetics and supplies (DMEPOS). Qualified practitioners and suppliers would have had to be licensed in their state or certified by the American Board for Certification in Orthotics, Prosthetics & Pedorthics or the Board for Orthotist/Prosthetist Certification International.

The CMS said it withdrew the Jan. 11 proposal (RIN:0938-AR84) because the requirements would be too costly and time-intensive, particularly for small businesses. The agency said it received 5,000 comments on the rule that raised concerns about the complexity of the requirements.

Congress required under the Medicare, Medicaid, and State Children’s Health Insurance Program Benefits Improvement and Protection Act of 2000 that custom-fabricated orthotics and all prosthetics be provided by “qualified practitioners” and “qualified suppliers.’' President Bill Clinton signed the law on Dec. 21, 2000. No final rule on the provisions has been published.

Industry Disappointment

One group representing suppliers called the withdrawal “disappointing.”

“We recognize there were shortcomings with the proposed rule but they certainty could have been fixed,” Tom Fise, executive director of the American Orthotic & Prosthetic Association, told Bloomberg BNA Oct. 3. The group represents suppliers of artificial limbs and orthopedic braces.

Fise said the main problem with the proposal was that physicians and therapists, who long provided care for orthotic and prosthetic patients, may have been required to get additional accreditation under the rule. He said licenses to practice for such physicians and therapists are “too broad in scope.”

“This rule was designed and intended to protect patients,” he said. “It’s 17 years overdue and this withdrawal is certainty a step backwards.”

The American Society for Surgery of the Hand, a Chicago-based medical society, said in a letter to the CMS that the proposed rule would “limit patient’s access to those therapists who have the skills, knowledge, and expertise to appropriately treat these patients and will jeopardize the surgical results and undoubtedly adversely affect our patients’ treatment outcomes. Because of the nature of their education and training hand and occupational physical therapists are more qualified to fabricate hand and upper extremity orthoses than orthotists and prosthetists.”

The society did not return Bloomberg BNA’s request for comment.

To contact the reporter on this story: Mike Stankiewicz in Washington at mstankiewicz@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

For More Information

The withdrawal is at http://src.bna.com/s4d

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