CMS Sued Over Medicare Prosthetics Payment Rule

By Daniel Wilson (May 15, 2013, 7:27 PM EDT) -- The American Orthotic and Prosthetic Association on Monday sued the Centers for Medicare and Medicaid Services in Washington federal court, accusing the agency of implementing rules denying Medicare claims for prosthetic devices lacking supporting documentation from doctors without legal authority or a proper rulemaking process.

According to the AOPA, a trade association for more than 800 suppliers of artificial limbs, CMS's rules requiring that the agency and its contractors deny Medicare payments for prosthetics without documentation from a prescribing doctor, even when other documents could show medical necessity, have been implemented and applied arbitrarily and put an unfair burden on prosthetic...

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