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Proposed Rule Could Impact O&P Community

January 25, 2017

Take Action: Submit A Comment by Monday, March 13

As part of our promise to be with you "every step of the way," we want to make you aware of a development that could affect compliance requirements for providing custom orthotic and prosthetic (O&P) care to Medicare beneficiaries.

 

CMS Proposed Rule CMS-6012-P

On January 12, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule, CMS-6012-P, that would enact provisions of Section 1834(h) of the Social Security Act (also known as BIPA Section 427). When BIPA was passed in 2000, BOC and other O&P organizations were pleased about the inclusion of Section 427, which outlined the specific qualifications for providing custom O&P services to Medicare beneficiaries. 

BOC’s founder, the late Dr. Donald O. Fedder, DrPH, MPH, BSP, FAPhA, was a passionate contributor to an ongoing effort to ensure that BOC was named in BIPA as an approved credentialing body for individuals and suppliers seeking certification and accreditation. It is gratifying to see the positive progress continuing to result from those endeavors.

 

How Will This Rule Affect You?

This may prove to be good news for BOC-certified professionals and BOC-accredited suppliers, as the proposed rule recognizes and reinforces the value of the credentials you worked so hard to earn. Also, the provisions of this rule appear to align with recently proposed O&P-related legislation that has been supported by BOC and other leading O&P organizations.

The future of this proposed rule is uncertain. It was published at the end of the Obama administration and we do not yet know how O&P regulations may be impacted by the Trump administration. Additionally, we anticipate pushback from powerful groups (including physicians, physical therapists and occupational therapists) affected by the O&P certification requirement, which could result in significant revisions. While much is still unknown, possible changes if this rule is adopted include:

• Currently accredited O&P suppliers may need to take steps to meet additional CMS quality and supplier standards.

• Exempt O&P suppliers will need to become accredited.

 

Next Steps

We encourage you to carefully review the proposed rule and submit your comments or concerns during the public comment period. BOC is thoroughly reviewing CMS-6012-P and will submit suggested revisions and improvements, both individually as well as in collaboration with the other organizations in the O&P Alliance.

This proposed rule would specify the following:

• Removal of current exemption from accreditation and quality standards for certain practitioners and suppliers;

• Qualifications for practitioners and suppliers to furnish and fabricate prosthetics and custom-fabricated orthotics. One such qualification is that practitioners must be certified by BOC or ABC, licensed by their state or fall under the definition of “other” qualified practitioner;

• Accreditation requirements qualified suppliers must meet to submit claims for prosthetics and custom-fabricated orthotics. Qualified suppliers are defined as those accredited by BOC or ABC or another accrediting body approved by the Secretary of Health and Human Services;

• Requirements an accrediting organization must meet to accredit qualified suppliers; and

• A timeframe by which qualified practitioners and suppliers must meet the applicable licensure, certification and accreditation requirements.

If this proposed rule is adopted, BOC will be ready, as always, to help current and prospective certificants and accredited suppliers with the support they need to meet the new requirements.

 

What You Can Do

We will continue to keep you apprised of the progress of this proposed rule. In the meantime, we invite you to weigh in during a public comment period that ends Monday, March 13, 2017.  

Please refer to file code CMS-6012-P when commenting. Comments may be submitted electronically, by mail or in person. Please visit this link for details on the various ways to submit your comment.

 

Questions?

If you have any questions, please email BOC’s Regulatory and Legislative Analyst Zack Chait, who will be happy to help.

Remember, the comment period closes Monday, March 13, 2017.  Thank you in advance for taking the time to share your thoughts on the proposed rule.