STATE BY STATE
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Updates from California, Colorado, Iowa, and Tennessee
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.
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.
California
Legislation affecting California Medicaid reimbursement rates has been introduced in the State Assembly. AB 1892 requires Medi-Cal reimbursement for O&P appliances to be set at 80% of the lowest maximum allowance for California established by Medicare, with annual adjustments to conform to any changes to Medicare. Currently, reimbursement for O&P appliances in California is prohibited from exceeding 80%. AOPA is tracking this legislation; for the complete text of the bill, visit the California page of the Co-OP.
Colorado
AOPA continues its advocacy efforts related to the Colorado Department of Healthcare Policy and Financing’s (DHCPF’s) rate setting for pediatric custom cranial orthoses (code S1040) following last year’s reimbursement reduction and subsequent reversion back to the original rate. In response to this project, AOPA has sent a comment letter to the DHCPF explaining
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the nature of services related to cranial orthoses and articulating their value.
Iowa
HF 2411 (formerly HSB 668), the bill requiring employers to furnish medically necessary replacement prosthetic devices for workers’ compensation patients, has passed the Iowa House and will now be under consideration in the Senate. AOPA has implemented a grassroots campaign to gather support for the bill in collaboration with members across the state. For updates on HF 2411’s status and more information on this campaign, visit the Iowa page on the Co-OP.
Tennessee
As with other states across the country, Tennessee has introduced coverage mandate legislation. Companion bills SB 2140 and HB 2214 require that insurance providers in the state provide coverage for prosthetic devices that is at least equivalent to the coverage currently provided under Medicare, including repair and replacement. To read the text of the bills, visit Tennessee’s Co-OP page.
To submit an update for publication in the State by State department of O&P Almanac, email awhite@AOPAnet.org. 48
APRIL 2022 | O&P ALMANAC
