State By State

Seeking More Appropriate Reimbursement

Updates from California, New York, Texas, and Washington

Become an AOPA State Rep. If you are interested in participating in the AOPA State Reps network, email awhite@AOPAnet.org.

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.

NEW MEMBER RESOURCE ALERT

AOPA has invested in a new 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.

California

The California Orthotic and Prosthetic Association (COPA) has been working on a budget proposal to address low MediCal reimbursement rates in the state. While the proposal did not make it in this cycle, COPA plans to continue advocating for a Medicaid fee schedule increase and is working with AOPA to develop another advocacy campaign for launch in the coming months. For details, visit the California page on the AOPA Co-OP.

New York

AOPA has been working with the New York State Chapter of the American Academy of Orthotists and Prosthetists to secure a Medicaid fee schedule increase for O&P providers in the state. After two very successful letter-writing campaigns, the groups decided to pursue legislation that would direct the commissioner of health to conduct a study on rate adequacy of orthotics and prosthetics. The bill, S 7023, was introduced May 24 by New York State Sen. John W. Mannion (D). See details on the bill at nysenate.gov/ legislation/bills/2021/S7023.

By taking this multipronged approach, advocates in New York can continue to push the budget proposal forward while simultaneously advocating for an analysis of the existing rates, which will likely produce data that underscores the need for the Medicaid fee schedule increase.

Call to action: If you live or work in New York, please visit the New York page of the AOPA Co-OP to see how you can help.

Texas

Texas HB 2134, Relating to Coverage for Childhood Cranial Remolding Orthosis Under Certain Health Benefit Plans, passed in the Texas House of Representatives, with 113 in favor and 29 opposed. It was referred to the Senate Committee on Business and Commerce, prior to Senate adjournment, but did not receive a vote. In Texas, the legislature is biennial, and no regular session is held during the second year of a biennium.

Washington

HB 1427, a bill to increase insurance coverage of prosthetics and orthotics, gained significant bipartisan support, but unfortunately did not receive a vote during regular session. However, in Washington state, bills introduced in odd-numbered years may carry over to even-numbered years, and this bill is expected to move during next year’s regular session.

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