Medicare: Separate Payment for Fitting Braces and Artificial Limbs Is Not Needed
HRD-93-98
Published: Jul 21, 1993. Publicly Released: Jul 21, 1993.
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Highlights
Pursuant to congressional requests, GAO reviewed whether: (1) orthotic and prosthetic (O&P) practitioners should receive separate payments for their professional services in fitting patients; (2) there were items covered under the O&P fee schedule that could be moved to a more appropriate payment category; and (3) the criteria used to determine patient eligibility for O&P items were consistent across the country.
Recommendations
Matter for Congressional Consideration
| Matter | Status | Comments |
|---|---|---|
| Congress should amend the Social Security Act to permit the Secretary of Health and Human Services to reclassify items currently covered as O&P items, such as ostomy and urological supplies and certain braces that the Secretary determines do not require significant amounts of fitting and adjustments, to the fee schedule for inexpensive or routinely purchased durable medical equipment. | In the Omnibus Budget Reconciliation Act of 1993, Congress shifted specific O&P items to the inexpensive or routinely purchased category. However, Congress did not authorize the Secretary of HHS to shift other items. |
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Topics
DisabilitiesEligibility criteriaHealth care costsHealth care personnelMedical equipmentMedicareMedical suppliesPaymentsProsthetic devicesPhysicians