Medicare Proposal Limits “Potential”

To all of you who were among the 100,000+ that joined us in signing the White House petition & reached out to our local congressional members, we thank you!

The article I’m sharing with you today I admit is a bit of a regurgitation of issues I’ve harped on for weeks. However, I share this to highlight a double standard regarding a magical word; ‘potential’.

This word is a potent one & has the power to either enable a new amputee to stand up again & return to being a productive citizen of our great country, or sentence them to life (and what remains of it) in a wheel chair. Keeping the word potential allows for a patient suffering from mental anguish after the loss of a leg some time to get the support & help they need to find purpose in life to fight for it.

Removing the word potential will convey a clear message to the patient they are essentially being stuck on a shelf against their will because they are no longer of use or value to society. Cajoling someone out of benefits they have worked for is despicable at best. This is cruelty & feeds off of those put in a vulnerable position when they need all the help they can get.

I find this word ‘potential’ so very interesting. More so this morning, after I opened my email & found a message from our Medicare jurisdiction contractor alerting me of a quarterly finding on prepayment reviews of codes pertaining to prosthetic feet throughout our entire region. The crux of this message was that the vast majority of claims submitted for particular prosthetic feet were denied at the rate of 70% – 83% due to the POTENTIAL for improper payment.

Huh, will they get to keep the use of the word ‘potential’ in future reviews when they strip that from suppliers?

Further into the article there is a bit of a quote from a TV segment out of Virginia that states: “CMS believes that Medicare beneficiaries will continue to have access to lower limb prostheses that are appropriate & the intent of this proposed LCD is not meant to restrict any medically necessary prosthesis,”

First, believe all you want, but how is this NOT going to adversely impact the industry?! Second, who’s deciding what is appropriate for someone as unique & complex as a human? If you are not face to face with that patient, no amount of words on paper will appease these cubicle tyrants & their crutch they call documentation requirements.

Stepping down from my soapbox now…Be good to one another & do something positive for your fellow man this week! “Local amputee slams Medicare proposal limiting access to high-tech prostheses”