Medicare announced Monday that it would abandon a proposed rule that would have stripped amputees of their high-tech legs.
The Centers for Medicare and Medicaid had proposed curtailing coverage for modern-day legs, knees, ankles and feet, a move that opponents said essentially would have made people hobble on wooden legs.
Roanoke-area residents were among those protesting the rule. In August, Doug Call, president of Virginia Prosthetics and Orthotics, took a busload of 20 people who walk because of modern technology to a U.S. Department of Health and Human Services hearing. More than 110,000 signatures across the country were collected on an online petition.
“Both CMS and its contractors have heard your concerns about access to prostheses for Medicare beneficiaries,” the agency said in a statement that backed away from the rule change.
Instead, CMS will convene a work group in 2016 of clinicians, researchers, policy specialists and patient advocates from different federal agencies. The group will be tasked with reviewing clinical evidence and defining best practices in the care of Medicare patients who require lower limbs.
The group may also make other recommendations to inform CMS about patient function and quality of life.
Call said that while the announcement is good news, he remains “extremely concerned for the nation’s amputees that it’s still even being considered because of the negative impact it will have on amputees’ mobility and because policies implemented by Medicare invariably are adopted by the VA and private insurers, eventually affecting all amputees.”
The proposed change would have disallowed coverage for a new limb based on assessing a patient’s functional potential that would come with more sophisticated technology. And it would have refused new limbs for patients who had any hitch in their gait or periodically required a cane.
The rule change also would have eliminated coverage for silicone sleeves that create a personalized protective barrier between the device and patients’ skin. Without it, chafing and sores appear, leaving people reluctant to wear prosthetics, which then decreases their mobility.
Call said Medicare is looking in the wrong place to save money as orthotics and prosthetics represent less than one-half of 1 percent of Medicare’s total budget.
“Additionally, countless studies and the government’s own data show that restoring amputees’ mobility actually saves insurers and taxpayers money in three areas,” he said. “One, mobile amputees can return to work and therefore pay more in taxes and no longer depend on government assistance. Two, mobile amputees are healthier, further reducing medical costs. And three, mobile amputees — working or retired — aren’t dependent on caregivers.”