The Lower Limb LCD Policy Proposal, despite being just a draft proposal, is now being felt in the private sector: United Health Care has now deemed vacuum pumps as not medically necessary, effective October 1, 2015. Read the policy now.
AOPA is pursuing a two part strategy: (a) AOPA partnered with a congressional representative in UHC’s state, who contacted UHC requesting that they set up a high level meeting with AOPA reps; and (b) AOPA is joining in a letter of objection to the policy from the O&P Alliance, together with the Amputee Coalition, due for release this week, challenging the assertion that there is no scientific evidence to support this treatment, and seeking a meeting with UHC’s Medical Director. We believe the results can be additive and symbiotic, not divisive, in bringing attention to the problem from multiple directions.
We promise to continue to keep you posted on the UHC issues, but we have also received an early indication about another mischievous outgrowth of the commercial sector jumping on the draft LCD as an opportunity for cutbacks–this time from one of the state BCBS plans. We are waiting to see documentation, but if this proves correct, we will again communicate with the insurer AND communicate to CMS (as we did when the UHC policy first arose) underscoring yet again the need for a quick decision to rescind the draft LCD. Read this news article published in the Minnesota Star Tribune.