Advocacy at Work: The Withdrawal of CMS-6012-P

By Jeffrey A. Greenberg, MD, MS


Dr. Jeffrey A. Greenberg, Practice Division Director, discusses how CMS-6012-P would have negatively impacted the delivery of high quality care to hand surgery patients and how effective advocacy was in protecting the practice of hand and upper extremity surgery.

Advocacy at Work
Advocacy is Effective

Many of you are aware of a regulatory requirement that was being considered by CMS regarding the fabrication and dispensing of custom orthotics to Medicare beneficiaries.  Orthotists would have been certified as sole providers of custom orthotics and a facility accreditation requirement would have been mandated.  This regulation would have severely impacted our hand surgery practices and had significant negative implications for our patients.  I am pleased to share this notification from the Hand Therapy Certification Commission with our members:

Medicare Program: Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom-Fabricated Orthotics
CMS announces that proposed rule CMS-6012-P has been officially WITHDRAWN!

 Dear Colleagues,
Beginning in January of this year, a large scale effort was led by HTCC, ASHT, AOTA, APTA, among other professional organizations opposing each and every regulatory requirement outlined in CMS-6012-P. The regulatory requirements would not recognize therapists or physicians as qualified providers, leaving the orthotists as the sole provider to fabricate and dispense custom-fabricated orthotics to Medicare beneficiaries. In addition to this, a facility accreditation requirement would be mandated, which would duplicate numerous existing regulatory requirements within therapy practices and be exceptionally time-consuming and costly. Additionally, options for accreditation would largely be through the O & P accreditation bodies. 
This week CMS and the Department of Health and Human Services (HHS) indicated that the proposed rule was officially posted on the federal register as WITHDRAWN. They received over 5,000 public comments in response to this proposed rule! In part, the decision to withdraw the rule was based on the cost and time burdens that the rule would create for many providers and suppliers, particularly the cost and burden for those providers and suppliers serving as small businesses. In addition to this, the complexity of the issues raised in the detailed public comments played a role in the final decision.  
Even though the proposed rule has been withdrawn, it is important to realize various components of the proposed rule will likely be studied in the future. Each of the professional organizations will monitor future legislation and advocate on behalf of therapists and physicians alike.
Please know each letter written, email sent, congressman contacted, and patient who wrote a letter to advocate on behalf of therapists has played a powerful role in addressing our concerns with this proposed rule. Thank you for advocating for what is in the best interest of your patients and your profession! Thank you for providing the highest quality of patient care to patients with hand, wrist, elbow and shoulder problems throughout this country and around the world!  

The HTCC Board of Directors

This issue was one that would have negatively impacted our practices and the delivery of high quality care to our patients.  Many of our members took the time and made the effort to write letters, contact congressmen and women and local representatives describing and emphasizing the deleterious effects and negative impact of this regulation.  Nationwide advocacy efforts on our behalf, at least at this point, has been successful in holding off the implementation of this regulation.  This is just one example demonstrating the importance of the collective voice in these matters.  I would encourage all of you to stay active, stay involved, stay informed about issues that are critical to our patients.  When these issues do arise, take the time to make some calls, write letters, texts, tweets or email as our opinions and recommendations, when we make them heard, do count. 

Jeff Greenberg
Practice Division Director

To view the withdrawal notice that is on display on the CMS website, please follow this link (provided by John Spiegel, Director of the Division of Policy and Regulations of CMS): https://www.federalregister.gov/documents/2017/10/04/2017-21425/medicare-program-establishment-of-special-payment-provisions-and-requirements-for-qualified