# Medicare Orthotics and Prosthetics Patient-Centered Care Act

If you're a Medicare beneficiary who needs artificial limbs, braces, or other orthotic and prosthetic devices, this bill is designed to make sure you get proper care and training instead of just receiving equipment in the mail. Right now, some companies ship prosthetics and orthotics directly to patients without any in-person fitting, training, or adjustment by a qualified professional. This bill stops Medicare from paying for those "drop shipments" and requires that patients receive hands-on training and education from a licensed practitioner before receiving their devices.

The bill makes several practical changes to how Medicare covers these devices. First, it prohibits payment for prosthetics and custom-made or custom-fitted orthotics that are shipped directly to a patient without professional fitting and training. This applies to artificial limbs, custom braces, and other specialized orthotic devices. Second, the bill expands who can order these devices without going through competitive bidding processes—now physical therapists, occupational therapists, orthotists, and prosthetists can order them directly, not just physicians. This gives patients more options for where they can get care. Third, the bill clarifies that Medicare will cover replacement orthotic and prosthetic devices when patients need them, similar to how replacement artificial limbs are already covered.

The practical effect is that if you need a prosthetic leg or a custom-fitted back brace, Medicare won't pay for it unless you actually meet with a trained professional who fits it to your body, teaches you how to use it, and makes adjustments as needed. The bill also aims to reduce fraud and waste by preventing companies from profiting by simply mailing devices without proper care. These changes take effect starting the first full calendar year after the bill becomes law, giving Medicare and providers time to adjust their systems.

Medicare Orthotics and Prosthetics Patient-Centered Care Act

Thompson, Glenn

Medicare Orthotics and Prosthetics Patient-Centered Care ActThis bill prohibits payment under Medicare for a prosthesis, custom-fabricated orthosis, or off-the-shelf orthotics that is&nbsp;delivered via a&nbsp;drop shipment (i.e., shipped to an individual who does not have training in how to properly fit or care for the device). It also specifically allows for payment of replacements of custom-fitted devices.