NAAOP Announces Unique Public Policy
and Advocacy Fellowship

ATTENTION ALL O&P CONSUMERS:  The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) is soliciting applications for its inaugural health policy/advocacy fellowship. NAAOP is a national nonprofit association advocating for consumers/patients requiring orthotic and prosthetic care, as well as the providers who serve them.  The NAAOP Fellowship is a paid, 10-week summer program based in Washington, D.C.  The fellow will learn about orthotic and prosthetic (O&P) policy, advocacy, and how NAAOP and other O&P organizations function on behalf of the O&P community and within the broader rehabilitation and disability policy and advocacy community at the federal and state level.  The fellowship also includes exposure to (1) O&P clinical and business settings, and (2) state-based public policy and advocacy at no cost to the fellow.

One fellow will be selected for the summer of 2018 through a competitive process using the application on the website.  The deadline to electronically submit this application is March 31, 2018 by 12:00 Midnight.  Three finalists will be interviewed via videoconference and one will be selected.  If the finalist selected cannot accept the fellowship for any reason, the next highest ranked fellow will be offered the position.

Selection CriteriaAll applicants must:

  • Personally use a custom fabricated orthosis or prosthesis;
  • Have an interest in public/health policy and advocacy;
  • Demonstrate an interest in advancing O&P care;
  • Have excellent writing, speaking, and analytical skills (see application for additional factors).

The NAAOP Fellow will receive a stipend of $500 per week.  NAAOP will provide the fellow with an office, phone, and computer in its offices at NAAOP’s counsel, the Powers Law Firm, 1501 M Street, NW, Washington, DC 20005.  NAAOP will assist the fellow in exploring inexpensive summer housing options with area colleges for those with no other housing options.  The NAAOP Fellow will be responsible for his/her housing costs.

The NAAOP Fellow will shadow NAAOP’s General Counsel, Peter Thomas, who will assign and oversee the fellow’s health policy and advocacy work.  That work will focus on O&P policy but also include exposure to the broader rehabilitation and disability policy environment.  Other O&P organizations will host the fellow for a day of activities.  The fellow will also be exposed to policy and advocacy speakers, attendance at Congressional hearings, participation in coalition and “think tank” meetings/presentations throughout Washington, and meetings with organizations in the broader rehabilitation and disability field.

Application Deadline:  12:00 Midnight, Saturday, March 31, 2018

Fellowship Selection Announcement:  By the end of April, 2018

Fellowship Term:  10-weeks (late May or early June through early to mid-August)

  • Written by Web Updates

Congress Passes O&P Clinical Notes Provision

In the early morning hours today, Congress passed and the President signed a massive budget agreement that sets budget levels for two years, continues to fund the federal government through March 23rd, and sets up a massive omnibus spending bill to fund the federal government through the remainder of fiscal year 2018.  One of the provisions in this bill directly impacts the O&P community:  Recognition of the prosthetists’ and orthotists’ clinical notes as part of the Medicare patient’s record for purposes of determining the medical necessity of O&P care.


‘‘(5) DOCUMENTATION CREATED BY ORTHOTISTS AND PROSTHETISTS.—For purposes of determining the reasonableness and medical necessity of orthotics and prosthetics, documentation created by an orthotist or prosthetist shall be considered part of the individual’s medical record to support documentation created by eligible professionals described in section 1848(k)(3)(B).’’

This provision addresses a problem that started in 2011 with publication by CMS of a “Dear Physician” letter that stated that the physician’s notes, not the prosthetist’s, determine medical necessity.  This letter, and subsequent CMS guidance, resulted in a raft of unnecessary Medicare denials of O&P claims, many of which still sit at the ALJ level of review awaiting hearings.  The clinical notes of the prosthetist or orthotist will now be recognized along with the records of physicians and other professionals involved with O&P care.  NAAOP expects this provision to impact the reversal rate of Medicare O&P denials in favor of O&P practitioners at all levels of administrative appeal.

NAAOP congratulates and thanks AOPA and its lobbyists for their leadership on this provision, as well as NAAOP’s membership, the O&P Alliance organizations, the Amputee Coalition, and the ITEM Coalition, all of which worked to achieve enactment of this legislation.  NAAOP and the O&P community will continue the fight to enact two additional provisions from the Medicare O&P Improvement Act (S. 1191 and H.R. 2599), namely:

  • Section 7 of the Medicare O&P Improvement Act: This provision clarifies Congressional intent regarding the definition of “minimal self-adjustment,” which defines off-the-shelf orthotics for purposes of competitive bidding.
  • Section 8 of the Medicare O&P Improvement Act: This provision would direct CMS to finally implement long-overdue regulations for Section 427 of the Benefits Improvement and Protection Act of 2000 (BIPA), which links the right to bill the Medicare program for custom fabricated orthotics and prosthetics with the qualifications of the practitioner or supplier. This is an important fraud & abuse and patient protection.
  • Written by NAAOP

Contact your Senators/Representatives Today to Support the Medicare O&P Improvement Act

The House and Senate are seriously considering inclusion of key provisions of the Medicare O&P Improvement Act (S. 1191 and H.R. 2599) in the Medicare “extenders” legislation expected to be considered in the coming weeks.  The Medicare O&P Improvement Act is bipartisan legislation introduced by Senators Grassley (R-IA) and Warner (D-VA) and Congressmen Glenn Thompson (R-PA) and Mike Thompson (D-CA).  It is designed to improve the quality of patient care and treatment outcomes while limiting waste, fraud and abuse in the Medicare orthotic and prosthetic benefit.  There are a number of critical provisions in the act that should be included in the Medicare “extenders” legislation and passed immediately.

Recognition of Clinical Notes:  The House already has passed one of the provisions in the bill (Section 5) as part of the Medicare Part B Improvement Act (H.R. 3178, Section 103).  This provision would clarify that the clinical notes of the prosthetist or orthotist are considered part of the patient’s medical record, and will help establish the medical necessity of prostheses and orthoses provided to Medicare beneficiaries.

Linking O&P Provider Qualifications with Medicare Billing Privileges:  Section 8 of the Medicare O&P Improvement Act directs CMS to issue regulations on a section of the federal law that was enacted in 2000 but never implemented (BIPA Section 427).  Congress should enact this provision to require CMS to implement this federal law governing the qualifications necessary to provide custom-fabricated orthotics and prosthetics to Medicare beneficiaries.

Clarifying the Scope of Off-the-Shelf Orthotics: Congress exempted custom O&P care from DME competitive bidding in the Medicare Modernization Act of 2003 but permitted competitive bidding for “off-the-shelf” orthotics, defined in the statute as orthoses requiring “minimal self-adjustment.”  CMS subsequently issued regulations that dramatically expanded the scope of off-the-shelf orthotics, contrary to congressional intent.  Section 7 of the Medicare O&P Improvement Act would restore the original definition, protecting patients who require orthotic treatment by ensuring they receive the clinical services needed for orthoses to fit and function properly.

HOW TO HELP:  Go to and access the Legislative Action Center.

  1. Use the template letter and amend it as you deem appropriate. Send three messages, one to your Congressman, and one to each of your Senators.
  2. Make three phone calls: Call your Congressman (202-225-3121) and follow the prompts to reach your representative.  Then call the Senate (202-224-3121) and ask to speak with each of your two Senators.
  3. MESSAGE:  Please actively support inclusion of the Medicare O&P Improvement Act in the Medicare “Extenders” Legislation currently pending in Congress.
  • Written by NAAOP