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New Act Protects Medicare Orthotics and Prosthetics Patents From Substandard Care

September 18, 2013
HARRISBURG- Legislation that will reduce federal spending by eliminating fraudulent payments from Medicare, while ensuring that adequate prosthetic and orthotic services are provided to Medicare beneficiaries has been introduced. It is called the Medicare Orthotics & Prosthetics Improvement Act.

Representatives Glenn ‘GT’ Thompson and Mike Thompson today introduced, the act.

"When unlicensed and unaccredited providers deliver prosthetic and orthotic services, both Medicare beneficiaries and the American taxpayer are shortchanged," stated Rep. Glenn Thompson. "Despite previous Congressional mandates, not enough has been done to ensure that legitimate and licensed practitioners are providing these items and services. The Medicare Orthotics and Prosthetics Improvement Act of 2013 will protect Medicare beneficiaries by identifying and addressing fraudulent payments, and hold government accountable by reducing fraud and abuse within Medicare.”   

“Keeping fraudulent providers out of the Medicare program will save money and help make sure that high quality care is provided,” said Rep. Mike Thompson. “This bill will strengthen Medicare benefits for orthotics and prosthetics beneficiaries by reducing fraud and abuse, improving health care quality and reducing Medicare spending.” 

The Benefits Improvement and Protection Act of (BIPA), legislated by Congress in 2000, mandated that a "practitioner" or "supplier" had to be certified in order to be paid for certain orthotic and prosthetic services under Medicare. 

The Center for Medicare and Medicaid Services (CMS) has not enforced these provisions, which has contributed to fraudulent payments and leaving Medicare patients vulnerable to substandard and in some cases duplicative or unwarranted, care. 

The Medicare Orthotics & Prosthetics Improvement Act of 2013 would require CMS to reimburse only those providers who have been accredited or licensed in orthotics and prosthetics.

Rep. Glenn Thompson, a former therapist and licensed nursing home administrator with 28 years of experience in a non-profit health care setting, currently serves on the House Education & the Workforce Committee. Rep. Mike Thompson serves on the House Committee on Ways and Means’ Health Subcommittee.

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