New Medicare Proposal Might Limit Patient Access To High-Tech Prosthetics

Thousands of patients, specialists, and other health advocates are concerned about efforts sought by several lawmakers and billing contractors to impose tougher eligibility standards for certain high-tech prosthetic limbs.  The new proposed standards come as a response to a 2011 inspector general’s report that found annual Medicare spending for lower-limb prosthesis reaching $655 million in 2009, which is a 27 percent increase from the 2005 amount.  In that same period the beneficiaries receiving these products dipped by about 2.5 percent. 

Federal inspectors believe that questionable billing practices by a number of suppliers is the cause of the increased spending.  Health experts and patients advocates are worried that the new proposals will make the process more difficult for people who need these devices.  Dr. Barbara Swan says that policies that make “the majority suffer because of what the minority does just seems like going after a flea with a baseball bat.”

See Adam Smeltz, Medicare proposal could limit access to high-tech prosthetics, The Pittsburgh Post-Gazette, September 13, 2015.