Update on OTS Orthoses and Competitive Bidding

comp biddingOn April 21, 2015, the Centers for Medicare and Medicaid Services (CMS) announced the product categories and Metropolitan Statistical Areas (MSAs) that will be included in the next round of DMEPOS Competitive Bidding, now being called Round 1 2017. While it appeared that off the shelf (OTS) orthoses were being considered for inclusion in competitive bidding, OTS orthoses were not among the eight product categories identified for inclusion in the Round 1 2017 competitive bidding program.

AOPA’s Take on this issue is that while this is certainly a positive development, it does not mean that OTS orthoses will not be included in competitive bidding at some point. The descriptor changes that were implemented in 2014 to clearly distinguish OTS orthoses from custom fitted orthoses certainly indicate the intent of CMS to eventually include OTS orthoses in competitive bidding at some point in the future.

AOPA will continue its ongoing discussion with CMS regarding its concern about the continued expansion of what are considered OTS orthoses through regulatory and policy based channels rather than following the appropriate notice and rulemaking process required by the Administrative Procedures Act.

AOPA’s Take. Where you go….When you need to know!