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David McGill Blogger

Ground Zero for #NotALuxury: Action in Baltimore and D.C.

Posted by David McGill | August 27, 2015

​Hundreds of amputees, as well as prosthetists, physicians and physical therapists, converged on Baltimore and Washington D.C. yesterday to express their concerns about the draft Local Coverage Determination for Lower Limb Prostheses published in mid-July. Both Linda Collins and David McGill of Ossur R&R attended in person. In a departure from our normal fare, this post will provide a quick summary of yesterday's events, along with key steps you can take in the coming days and weeks.

1. The Public Hearing Meeting: Highlights

Close to 200 amputees attended the meeting in person. The room, with a capacity of nearly 400, was close to full, with the remaining participants consisting of amputees' family members and friends, prosthetists, physicians, physical therapists, and some Medicare and other government officials.

Roughly 50 individuals provided comments, almost all of them in person. The vast majority of speakers were amputees themselves. 

Several common themes emerged in the spoken comments, most notably (1) the negative effect of the draft LCD on access to and the quality of prosthetic care/components, (2) the lack of evidentiary support for the proposed changes, and (3) the need to include prosthetists as "Licensed and Certified Medical Professionals." 

In his well-received comments early in the meeting, O&P Alliance Counsel Peter Thomas announced that he had received confirmation that the Veterans Administration would be submitting written comments requesting rescission of the draft LCD, a significant position from a major government payer.

David McGill of Ossur R&R spoke, emphasizing that his comments were from his personal perspective as an amputee. He addressed the following issues:

The fact that the draft LCD, if adopted, would affect not only amputees in the Medicare program, but those covered by private insurance as well;

The disporportionately negative impact it would have on new amputees;

The limitations ​it would impose on amputees' access to certain types of components; 

The damage that eliminating the concept of "potential" from amputees' functional assessments would cause.

​​He concluded by requesting that the MACs rescind the draft LCD, or alternatively, suspend it while getting feedback from all relevant stakeholders, including amputees. He noted that amputees' fundamental right to mobility surely outweighed any administrative or economic gains sought by the MACs via the draft LCD.

2. The HHS Rally

Following the meeting, a large contingent of the amputees attending it made their way south to Washington D.C. to protest in front of the offices of Health and Human Services. Turnout was high, and amputees marched while chanting slogans from 2 to nearly 5 pm. 
While the rally went on, a small group of O&P and amputee leaders went inside HHS's office at the invitation of high-ranking Medicare officials for a meeting to discuss the draft LCD. Initial feedback about the meeting to the protesters outside after it concluded was positive. Significantly, the Washington Post published a story only hours later in which Aaron Albright, a Medicare spokesman, said that CMS officials would "work with the medical directors of the regional contractors to ensure that any rule changes are based on scientific evidence and do 'not limit necessary services' for Medicare patients."

What can you do?
The DME MAC Medical Directors made clear at the Baltimore meeting that while they welcomed the opportunity to hear directly from the public verbally, written comments submitted by August 31st would be the only ones formally reviewed and responded to. 

So if you have not yet drafted and submitted your written comments to the draft LCD - whether you are a CPO, business owner, physician, physical therapist, or amputee - your time to do so is nearly up! August 31st is the deadline. 

In addition, we encourage you to make your congressmen/women aware of the proposed changes. A multi-pronged approach is more likely to promote serious consideration by the DME MACs about how best to proceed to address the concerns raised during the comment period. 

To obtain information about both comment submission and how to reach your representatives, visit

Össur​ R&R will keep you apprised of additional developments as they occur.
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