September NAAOP Video update regarding VA Bill of Rights and Physician Documentation
September 12, Update
Update on Injured and Amputee Veterans Bill of Rights
VA Bill of Rights, (formerly H.R. 805): The House VA Health Subcommittee has taken a keen interest in appropriate prosthetic care for amputee veterans by hosting three separate hearings, one “listening session,” and commissioning two separate OIG reports in the past two years. NAAOP participated in these hearings and listening sessions and has been working closely with the VA Committee staff and members of Congress for years. The one thing Congress has not done is enact legislation. The House actually passed the Injured and Amputee Veterans Bill of Rights in December 2010, but Congress adjourned before the Senate could act.
There is a strong bipartisan commitment to finally address VA prosthetics through legislation. NAAOP is working closely with key Members of Congress to ultimately re-introduce the VA Bill of Rights this Fall and prepare the bill for ultimate passage. The bill would not solve all of the problems with VA prosthetics, but it would enable veterans to know their rights and expectations of VA prosthetic and orthotic care. In turn, veterans would have the tools they need to become their own best advocate in securing the most appropriate prosthetic technology from the provider of their choice.
NAAOP: Conference Call July 23, 2013
Physician Documentation, who makes the K Level determination. The physician has to document appropriately. OIG report brought issues specifically about lower limb prostheses. This is what triggered the nationwide audits. We are going to come out stronger in the end. Alliance has been taking a coordinated approach to address the concerns of the profession.
Federal Budget: proposals from all three entities. The House Bill would completely reframe and restructure Medicare entitlement. Ultimately that is a defined contribution. This would also be applied to Medicaid. There is really no chance of a joint budget resolution. Fiscal year 2014 begins on Oct. 1. The House and the Senate each passed a budget but they will not agree on a budget. The appropriations committees are now going to have to do their work without a budget, which is happening now. Grand bargain on a budget, exceed the debt limit may have to shutdown due to exceeded the debt. More revenue coming into the Federal Government and the deficit is being reduced. Sequestration is going to play out if there is no solution, the cuts will remain. 1.2 Trillion dollars in savings over 10 years. Could wind up in the long run strengthening the economy.
Medicare Legislation: NAAOP monitors CMS on a daily basis. New proposals impose a home health co-pay, impose higher obligations for wealthy Americans, and impose cuts that impact beneficiaries. The President proposed these three in his budget proposal. Congress is working on a long-term solution to the physician fee schedule. They are supposed to be voted on today. It is a bipartisan bill. 139 million dollar cost over 10 year period. In the mix O&P is at risk if this passes today.
Looking across the healthcare setting, DME has competitive bidding, proposal for dialysis to be cut 10% outpatient therapy is being cut 18-20%. These strains are happening across the medical field.
Important Bills to watch for and support
*** The Medicare O&P Improvement Act has been revised and is being reintroduced soon.
*** Insurance Fairness for Amputees
*** Injured and Amputees Bill of Rights (introduced in past 3 congresses)
*** Wounded Warrior research enhancement Act
*** Wounded Warrior workforce enhancement Act
*** S1027 (Kirk and Johnson) seeks to validate and enhance coordination and stature of rehabilitation from the National Institute of Health
Affordable Health Care Act: suspended employer mandate. House voted to delay the individual mandate as well. Both for one year. Starting Oct. 1 when the exchanges open and Jan 1. Many patients will begin to have a 3rd party payor. This is important to pay attention to by way of contracts, except in North Carolina the leader will still likely remain BlueCross BlueShield. State by State exercise to determine what is covered. Important to get to know the people involved in our State exchange.