S. 2329: Medicare Orthotics and Prosthetics Patient-Centered Care Act

This bill, known as the Medicare Orthotics and Prosthetics Patient-Centered Care Act, aims to enhance protections and access for Medicare beneficiaries who need orthotic and prosthetic care. Below are the key provisions of the bill:

Prohibition on Drop Shipments

The bill prohibits Medicare from paying for certain orthotic and prosthetic items that are delivered directly to an individual without them receiving training from a qualified practitioner. This means that if a person orders orthotic or prosthetic items through a drop shipment (where items are sent directly to them without professional fitting or education), Medicare will not cover the costs. This is intended to ensure that beneficiaries receive proper guidance on how to use and care for their devices.

Inclusion of Additional Practitioners

The bill allows additional types of healthcare practitioners—namely physical therapists, occupational therapists, orthotists, and prosthetists—to be exempt from competitive acquisition rules when it comes to orthotic and prosthetic devices. This change aims to expand access to care by enabling more healthcare practitioners to supply these essential devices directly to beneficiaries.

Access to Replacement Custom Devices

The legislation ensures that Medicare beneficiaries have access to replacement devices for custom-fitted orthotics and custom-fabricated orthotics. This is crucial for individuals who may need replacements for their devices, similar to how replacements are currently managed for prosthetic devices.

Implementation Regulations

The Secretary of Health and Human Services is tasked with developing regulations to enforce the changes made by this bill. These regulations must be in place within one year of the bill's enactment, helping to ensure that the provisions are implemented effectively and in a timely manner.

Overall Purpose

Overall, the bill focuses on improving the quality of orthotic and prosthetic care for Medicare beneficiaries by ensuring that they receive proper training and access to qualified practitioners, as well as guaranteeing access to necessary replacements for their devices.

Relevant Companies

• PHM - A company that manufactures and supplies prosthetics may experience business impacts due to the restrictions on payment for drop shipments.
• OTTR - This company specializes in orthotic devices and could be affected by changes in how Medicare reimburses for custom-fitted devices.
• ALK - This medical technology company develops orthopedic solutions that may encounter regulatory changes as a result of the bill's provisions.