Amputees against proposed changes to Medicare coverage that would result in less expensive, but inferior, prosthetics being given to patients gathered in Baltimore Wednesday to ask officials to strike down the proposal.
One main issue, according to Thomas Fise, executive director of the American Orthotic & Prosthetic Association, is the Centers for Medicare and Medicaid Services is already "trumping what the doctor has said," when the physician asks for superior prosthetics.
"This would make it worse," Fise said of the draft policy.
Fise and other advocates on Wednesday witnessed about 50 speakers rail against the policy before officials with the Department of Health and Human Services and medical directors for federal contractors hired by the Centers for Medicare and Medicaid Services.
Meanwhile, about 150 protestors picketed outside the agency, many of them wearing prostheses and shouting, "Limbs, limbs are not a luxury," and "Hands off my legs," according to The Washington Post.
The policy changes were proposed by the four regional companies which are responsible for Medicare's medical device benefits. They would apply only to prosthetic legs, which account for the majority of amputations.
"My sense is that it was a good meeting and there was some progress," Fise said. "The primary thing is a requirement that this cannot be put forward on the basis of saving money. There has to be evidence and a rationale."
Health officials said they would be speaking with CMS, he said.
"I think this is a case of CMS not paying attention to (its) own data," he said.
An Office of Inspector General report in 2011 that looked at the Medicare spend for prosthetics saw a 27 percent increase between 2009 and 2010, while the number of beneficiaries remained the same, according to Fise.
"The OIG speculated must be something bad going on here," Fise said. "In fact what was going on, there was quantum leap in technology for prosthetics prompted by big federal expenditures for the wounded in Iraq and Afghanistan that was now available to the general public."
Spending on better prosthetics has gone down by 30 percent, while it has risen by 28 percent for cheaper prosthetics, Fise said.
"Unfortunately, what happened in response to the OIG report, CMS and contractors have consistently tightened criteria. Claims reviewers get to overrule the doctor," he said.
Requests for prosthetics are rejected on the basis of how well a person can walk, or even if he or she is taking medication for high blood pressure.
Twitter: @SusanMorseHFN