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State By State

Rules and Regulations

Updates From Illinois, Iowa, Kentucky, New York, and Virginia

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Each month, State By State features news from O&P professionals about the most important state and local issues affecting their businesses and the patients they serve. This section includes information about medical policy updates, fee schedule adjustments, state association announcements, and more. These reports are accurate at press time, but constantly evolve. For up-to-date information about what is happening in your state, visit the Co-OP at www.AOPAnet.org/resources/co-op.

Illinois

The Illinois Department of Financial and Professional Regulation (IDFPR) extended the deadline for license renewal requirements, including continuing education (CE) credits and sexual harassment prevention training, to Dec. 31, 2021. The Sept. 30, 2023, license renewal date remains the same. In addition, IDFPR proposed an emergency amendment on Nov. 29, 2021, that would remove the 15-hour limit for online CE credits, allowing practitioners to complete credits in any combination of in-person and online formats. For the full text of the amendment and rulemaking comment guidelines, visit the Illinois page of the AOPA Co-OP.

Iowa

Last year, the Iowa Prosthetic, Orthotic, and Pedorthic Association worked with the state legislature to introduce SF 140, a bill that entitles workers’ compensation patients to more than one replacement prosthetic device over the course of their lifetime. Currently, 18 states have similar entitlements to prosthetic replacement on their books. AOPA is tracking this important state legislation. For the complete bill text, visit the Iowa page of the AOPA Co-OP.

Kentucky

In October 2021, Kentucky Medicaid’s prior authorization contractor began asking O&P practitioners for estimates of fitting and fabrication time, as well as descriptions and cost estimates of materials and labor. The Kentucky Department of Medicaid Services reports that, per state regulations, such a requirement is within the scope of the agency. AOPA is looking into this memberreported issue and is seeking feedback from members in the state. Visit the Kentucky page of the AOPA Co-OP for the full text of the Kentucky regulation.

New York

New York Medicaid has made a change to its prosthetics coverage to not allow for addition/ substitution codes to be added to temporary or preparatory below-knee prostheses. Instead, temporary and preparatory base codes are all inclusive and considered complete items, with add-ons, upgrades, adjustments, modifications, substitutions, etc., not separately reimbursable. AOPA is working to ensure members in New York are aware of this rule, and the association is seeking feedback.

Virginia

Virginia House Bill 2669 received unanimous recommendation from the Virginia Health Insurance Reform Commission. If passed, it would change the existing code of Virginia to require private and employee-sponsored insurance plans to provide coverage for prosthetic care. AOPA has been tracking this legislation and testified in favor of it in January 2020. For the latest information, visit the Virginia page of the AOPA Co-OP.

New Member Resource Alert

AOPA has invested in a resource that allows us to track legislative and regulatory activity related to O&P in every state. We will be updating the state pages on the AOPA Co-OP with alerts as they arise.

Submit Your State News

To submit an update for publication in the State by State department of O&P Almanac, email awhite@AOPAnet.org.

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