The current standard of care for amputees is being threatened by Medicare. About 2 weeks ago Medicare announced proposed changes to the rules for prosthetic coverage. These changes are far reaching and will affect every amputee. It has been shown that when Medicare adopts a cost saving policy, private insurances quickly follow.
Some in the prosthetic industry are saying that these proposed changes would set prosthetic treatment back to the 1970s.
Please help prevent these proposed changes from becoming permanent policy. We have until August 30th to voice our opposition.
YOU DO NOT HAVE TO BE AN AMPUTEE TO WEIGH IN ON THIS. ALL HELP IS APPRECIATED!!
Dear Valued Anderson O&P Client,
On July 16, 2015, Medicare announced proposed changes to the rules for Lower Limb Prosthetics. These changes will greatly reduce your access to prosthetic advancements. It will limit your choices, and ultimately limit your quality of life. Some in the prosthetic industry are saying that these proposed changes will set prosthetic treatment back to the 1970s. The most alarming proposed changes are listed on the next page for your reference.
At this point these are PROPOSED changes. These changes will become effective October 1, 2015 if they are approved. We have until August 30th to stop this.
It has been shown that when Medicare adopts a cost saving policy, private insurance companies quickly follow. These changes will affect every amputee. Please become involved even if you are not currently on Medicare.
You, your family, and your friends can help prevent these changes (you do not have to be an amputee to express your voice). There are 2 simple ways to do this:
1) Sign the petition at http://wh.gov/iIIoi
With 100,000 names, we are guaranteed a White House-level response to the proposed changes.
At the time of this letter, the petition had over 21,000 signatures in 4 days. This is obtainable. PLEASE TAKE ACTION.
2) Send a letter to your representatives in congress by going to
Click on the 2nd “take action” button (titled Prosthetic Patients)
Fill in your information in the margin and click “view recipients”
Click on “send message”
This will email your letter to all of your congressional representatives.
**You DO NOT have to be an amputee to send these letters to congress (even though it says “prosthetic patients”, loved ones and supporters of amputees are encouraged to use this letter), anyone can oppose these changes**
Please share this information with anyone who may help with this effort. As we all know, health care is changing and we need to have our voice heard to maintain the quality of healthcare in the United States.
Sherrie Anderson, CP, LPO
Some of the proposed changes include:
1) Restructuring of coverage for prosthetic feet that will significantly limit access to more functional, carbon graphite feet.
2) No coverage for prosthetic skins (unless you are routinely in an unusually harsh environment, such as exposure to harsh chemicals and high water, etc).
3) No coverage for vacuum suspension.
4) If you use a walker or crutches with your prosthesis, you will only qualify for a very basic prosthesis. Your foot options will not include feet that provide flexibility or multi-axial motion.
5) If you use a cane with your prosthesis, you will qualify for a prosthesis that utilizes a foot with flexibility and motion, but not a carbon graphite foot that provides a more efficient gait and helps you participate in activities where you walk on uneven ground and walk quickly.
** The new rules say that the use of a walker, crutches, or cane (#4 and #5 above) FOR ANY REASON results in these restrictions. There are no exceptions if the assistive device is used on occasion, such as in unfamiliar terrain or at the end of a long day. **
6) Potential is no longer considered. Medicare will judge you on your current abilities and will not consider your potential to become stronger and more active. This closes the door to technology that could help you improve.
7) There are many proposed changes (that are too clinical and technical to mention) that deal with the way we (prosthetist) make your socket. The new rules would limit the use of different weight bearing techniques, materials, and technologies that we commonly use to increase the comfort and improve the control you have with your prosthesis. These limitations would result in a socket that is not as comfortable, would likely lead to more skin break down and would cause you to lead a life that is less active.
It is my belief that the proposed changes would significantly limit the progress that an individual makes during the prosthetic rehabilitation process. The basic prosthesis that Medicare will pay for would make it unnecessarily difficult to become more mobile. This will increase the number of amputees that require home health assistance (which would cost Medicare more money). The new rules would also result in more amputees living in nursing homes (which would cost Medicare more money).
Thank you for taking an interest in this issue that has the potential to change your life significantly. I hope that I will be able to post a letter in October that informs you that we were successful and you will continue to have access to the best prosthetic treatment available.