Medicare delays new prosthetics rules

Minnesota amputees protested the issue, which will get a new look in '16.

November 3, 2015 at 3:33AM
Minnesota sent the largest contingent of any state in the country to Washington Wednesday to protest newly proposed Medicare payment rules for prosthetic devices that amputees and the prosthetics industry claim will restrict needed device adjustments as well as limit access to new technology. The state�s 11-person contingent included eight amputees. From left Bob Nichols, Matt Wise, Scott Bonebroke, Ann Morris, Scott Tjaden, Rob Rieckenberg, Aaron Holm and Tony Benesh.
Minnesota sent the largest contingent of any state in the country to Washington Wednesday to protest newly proposed Medicare payment rules for prosthetic devices that amputees and the prosthetics industry claim will restrict needed device adjustments as well as limit access to new technology. The state�s 11-person contingent included eight amputees. From left Bob Nichols, Matt Wise, Scott Bonebroke, Ann Morris, Scott Tjaden, Rob Rieckenberg, Aaron Holm and Tony Benesh. (Jim Spencer/The Minnesota Star Tribune)

WASHINGTON – The government has agreed to reconsider new rules that govern how Medicare pays for prosthetics for lower limbs.

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.

Jim Spencer • 202-383-6123

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about the writer

Jim Spencer

Washington Correspondent

Washington correspondent Jim Spencer examines the impact of federal politics and policy on Minnesota businesses, especially the medical technology, food distribution, farming, manufacturing, retail and health insurance industries.  

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