WASHINGTON – The government has agreed to reconsider new rules that govern how Medicare pays for prosthetics for lower limbs.
Medicare delays new prosthetics rules
Minnesota amputees protested the issue, which will get a new look in '16.
November 3, 2015 at 3:33AM
The decision announced Monday by the Centers for Medicare and Medicaid Services (CMS) represented a big win for the nation's amputee community and those who make and fit them with artificial limbs.
The government put on hold changes in Medicare payment rules while it convenes a "work group" in 2016 to discuss those changes, a CMS news release said.
Facing protests from amputees claiming the new rules would cheat them out of insurance coverage for devices that they now qualify and limit access to new pain-relieving technology, CMS said it wanted "to develop a consensus statement that informs Medicare policy by reviewing the available clinical evidence that defines best practices in the care of beneficiaries who require lower limb prostheses."
Until that consensus develops, old reimbursement rules remain in effect.
Aaron Holm, who lost both legs in a traffic accident near Minnetonka, was among dozens of Minnesota amputees celebrating the decision. Holm and others traveled to Washington earlier this year to demonstrate outside Medicare offices in the capital.
"Medicare listened," Holm said.
He and other state amputees garnered strong support from Rep. Erik Paulsen and Sen. Amy Klobuchar to bring Medicare officials back to the negotiating table.
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Health care spending rose by 15%, driven by higher prices. Officials say solutions are needed to prevent Minnesotans from being priced out or delaying care they need.
