The recently released draft policy that, once finalized, will govern Medicare coverage of lower limb prostheses, will create significant limitations to care for amputees, according to representatives from the Amputee Coalition and the American Orthotic and Prosthetic Association.
A joint statement from the two organizations noted the Proposed/Draft Local Coverage Determination (LCD) for Lower Limb Prostheses released by the four Durable Medical Equipment (DME) Medicare Administrative Contractors (MACs) in July would impact the roughly 2 million amputees living in the U.S., since Medicare policy tends to lead commercial health care payers.
“This proposal represents a significant setback for amputees in the United States,” Susan Stout, president of the Amputee Coalition, said in a press release. “It would mean that hundreds of thousands of Americans who now are active parents, grandparents, employees and community volunteers would not be able to receive the most appropriate device for their needs at the most appropriate time. The Amputee Coalition is working hard to ensure that amputees are able to reach their full potential and that two million Americans do not see their standard of care negatively impacted by this proposal. Amputees must be able to continue to receive the most appropriate device for their needs.”
The joint statement details the following highlights of the policy:
- Amputees using assistive devices including canes, crutches or walkers will be considered to operate at low functional levels and be limited in their options for prosthetic devices.
- Amputees who are unable to attain what the LCD refers to as the “appearance of a natural gait” or who have health issues including high blood pressure could be provided with less functional prosthetic devices or denied a device.
- New amputees are required to undergo a rehabilitation process using what Amputee Coalition and American Orthotic and Prosthetic Association (AOPA) consider “out-of-date technology that they will not even use once they receive their permanent device.” Common practice today for rehabilitation is to provide the amputee with the most appropriate prosthetic device for their needs, according to the release.
“It is very difficult to imagine any other aspect of American healthcare where multiple millions of people would not be able to receive appropriate treatment and devices that can speed their return to the fullest and most active possible life,” Charles Dankmeyer, AOPA president, said in the release. “Even worse, there is no medical or scientific justification for these unreasonable and inappropriate hurdles that would amount to a return to a 1970s standard of care. No one is asking for more here; this is simply a situation where an appeal is being made to avoid forcing millions of Americans to suffer with much less in terms of the care readily available to them today.”
The organizations encourage amputees to join the more than 105,000 Americans who have signed a “We the People” White House petition to rescind the proposed policy. They can also visit www.facebook.com/AmputeeUSA on Facebook and @AmputeesUSA on Twitter, and are encouraged to join the social media campaign using the hashtag #notaluxury.