Medicare Orthotics and Prosthetics Patient-Centered Care Act

This bill focuses on how Medicare covers orthotics and prosthetics to keep patients safe and reduce fraud. It would stop Medicare from paying for most braces and artificial limb devices that are shipped directly to a patient unless the patient first gets training from a qualified practitioner on fit, care, and use. This change would start on the first day of the year after the bill becomes law . It also aims to make it easier for people to get replacement custom-fitted or custom-made braces when needed, and it broadens which practitioners are exempt from Medicare’s competitive bidding rules for these items . The Health and Human Services Department would have one year to write the rules to put these changes in place .

Overall, people with limb loss and other orthopedic conditions should get safer, in-person fitting and education, and quicker access to needed replacements, while cracking down on risky “drop shipments” to untrained patients .

• Who is affected: Medicare patients who need orthotics or prosthetics; clinics and suppliers who provide them .
• What changes: No Medicare payment for direct-ship devices without prior training; easier access to replacement custom devices; more practitioners exempt from competitive bidding; HHS must issue rules within a year .
• When: The drop-shipment payment ban begins the first day of the year after it becomes law; regulations due within one year of enactment .