Amputees unite against new Medicare proposal for prosthetic limb coverage

Posted at 2:51 PM, Aug 26, 2015
and last updated 2015-08-27 08:16:10-04

A recent proposal to Medicare could mean millions of amputees would be denied prosthetic legs. But amputees and advocacy groups are using social media to show their concern with what they’ve called a heartless cost-cutting measure.

Amputees and supporters gathered Wednesday in front of the Department of Health and Human Services building in Washington to rally and raise awareness of the proposed change.

The proposal — which was made by Medicare’s durable medical equipment contractors — would require more scrutiny of lower-limb amputees before they were prescribed prosthetics.

“It basically rewrites the rules for which prosthetics [Medicare coverage] would pay for,” said Lauren Anderson, manager of policy and strategic initiatives for the American Orthotic and Prosthetic Association. “It’s a cost-cutting measure that would allow them to pinch a few pennies, although prosthetics are less than one half of one percent of annual Medicare expenditures.”

Anderson pointed to several specific provisions that she said were proposed and would create obstacles for amputees seeking prosthetics.

“If somebody has been prescribed another mobility aid, like a cane, crutches or a walker, and it’s on their record that Medicare has paid for this mobility aid, then they are not going to be eligible for any high-level prosthetics,” she said.

“If a patient cannot achieve a ‘natural gait’ with a prosthetic, they might not be eligible to receive one at all,” Anderson continued, pointing to “natural gait” as a vague term. Another proposed provision could put people who have mental disabilities and heart problems at risk of not being approved for a prosthetic, according to Anderson.

When asked about AOPA’s concerns regarding the new proposal, an official from the Centers for Medicare and Medicaid Services said in a statement, “[We] believe that Medicare beneficiaries will continue to have access to lower-limb prosthetics that are appropriate, and the intent of this proposed local coverage determination is not meant to restrict any medically necessary prosthesis.”

The statement went on to state that comments from the public “on how to improve the proposal” will be accepted until Aug. 31. Amputee advocacy groups like AOPA and the Amputee Coalition have pre-written letters available on their websites that can be downloaded and sent to CMS policy makers ahead of the deadline.

Since the proposal was announced, current amputees have used many online avenues to make their concerns heard. Perhaps most notable is the Twitter hashtag “#NotALuxury,” which sees prosthetic limb users showing the day-to-day activities for which they rely on high-level prosthetics.

A White House petition posted online asking the U.S. government to rescind the proposal attracted more than 107,000 signatures in less than a month.

Anderson said she believes insurance companies view amputees as “an easy group to pick on” because of their limited numbers. There are almost 2 million amputees in the United States, according to the Amputee Coalition.

BELOW: See how several amputees have used the Twitter hashtag "#NotALuxury" to raise awareness about this issue.