Medicare Orthotics and Prosthetics Improvement Act of 2015
Latest action. Referred to the subcommitteeA smaller panel inside a standing committee with jurisdiction over a slice of its subject matter. Most hearings and the first markup usually happen here.Read the full definition (opens a new tab) on Health.
Medicare Orthotics and Prosthetics Improvement Act of 2015
This bill amends title XVIII (Medicare) of the Social Security Act to prohibit payment under Medicare part B (Supplementary Medical Insurance) for an item or service furnished: (1) in a state that requires licensure unless the provider or supplier possesses all applicable state licensure, or (2) in a state that does not require licensure unless the provider or supplier meets all qualifications established by the Secretary of Health and Human Services.
The Secretary shall designate and approve independent accreditation organizations that apply quality standards for suppliers only if they are Boards for Orthotist/Prosthetist Certification or essentially equivalent programs.
Special payment rules for certain prosthetics and custom-fabricated orthotics are extended to custom-fitted orthotics. Such rules do not apply, however, to off-the-shelf orthotics furnished on or after January 1, 2016, which are included in a competitive acquisition program.
Decisions about Medicare coverage of orthotics and prosthetics on or after January 1, 2016, must take into account the complexity of the item as well as supplier qualifications (which do not apply, however, to physicians, occupational therapists, or physical therapists state-licensed to provide such items).
Documentation created by an orthotist or prosthetist is considered part of the patient's medical record.
Requirements for suppliers of orthotics and prosthetics are separated from those for suppliers of durable medical equipment.
Orthotists and prosthetists must have a supplier number for Medicare payment to be made.
Patients are not liable for payment of furnished orthotics or prosthetics where payment may not be made or where payment is denied. Only the orthotists or prosthetists are liable in such circumstances.
The Secretary must publish on the Internet website of the Centers for Medicare and Medicaid Services specified performance information about each recovery audit contractor (RAC).
The Secretary is prohibited from recouping more than 50% of any overpayments for qualified providers and hospitals in response to a RAC audit until an administrative law judge has rendered a decision.
The summary continues for 2 more paragraphs. Read it in full on Congress.gov
Written by analysts at the Congressional Research Service and published on Congress.gov, not by Civibrief. Summarized at the "Introduced in House" stage on March 23, 2015. It describes the bill, it is not the legal text.
Where is it in the process, and what happens next?
4 steps remain before this bill could become law.
The record's latest action, on April 7, 2015: Referred to the Subcommittee on Health.
- Clearing the committees it was referred to, and being scheduled for a floor vote
- Passage by the House
- Passage by the Senate
- The President's signature. If the President vetoes it, two-thirds of both chambers must vote to override.
How likely is it to become law?
Civibrief does not forecast outcomes and this page has no opinion about this one. What the record supports is a base rate, which is a fact about the whole pile, not a prediction about this measure.
In the 114th Congress (2015-16), 329 of the 10,233 bills and joint resolutions introduced became law, about 3.2 percent. That count covers every measure at every stage, including the many that never left committee.
This one is not there yet: 4 steps are still outstanding, listed above.
Has anyone actually voted on it?
No. No roll call in this Congress cites this measure. That is the ordinary outcome: most measures never reach a recorded floor vote, and a committee ends most of them simply by not acting.
A vote is not the only thing that happens to a measure. Hearings, markups, and referrals are all recorded actions, and none of them is a vote of the full chamber.
Who is behind it?
Glenn Thompson (R-PA) introduced it on March 23, 2015, and 13 members have since signed on as cosponsors.
They come from both major parties: 5 Democrats, 8 Republicans.
Cosponsoring is a formal signature on the text. It is not a commitment to vote for the measure, it does not bind anyone's party, and a long list of cosponsors is a measure of attention rather than of prospects.
How long has it been in play?
It was introduced on March 23, 2015, 4189 days ago. The most recent recorded action was 4174 days ago, on April 7, 2015.
Measures do not carry over. Anything the 114th Congress has not finished by January 3, 2017 dies when the term ends, and has to be introduced again from the start in the next Congress.
Every answer above is assembled from this measure's own record on Congress.gov and from published counts of what Congress has passed before. Civibrief does not predict outcomes and takes no position on any measure.
Vote history
- HouseIn committee, no floor vote yet
- SenateAwaits House passage
- PresidentAwaits both chambers