State By State

Moving Forward

Updates from Colorado, Pennsylvania, South Dakota, and Texas

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 AOPAnet.org/resources/co-op.

Colorado

In December, a team of advocates led by Angela Montgomery, CPO, and the Rocky Mountain Orthotic & Prosthetic Coalition presented the So Kids Can Move initiative at the Colorado State Capitol in Denver as part of the Disability Rights Conference hosted by Rep. David Ortiz (D-38). So Kids Can Move is working to expand access to prostheses and orthoses utilized for physical activity as medically necessary healthcare for children and youth.

Colorado was the first state to enact a fair coverage law for prosthetics in 2000, thanks in part to the assistance of long-time Coloradan and limb loss advocate Jeffrey Cain, MD. Since then, 20 additional states have followed Colorado’s example over the past 22 years.

Pennsylvania

In September, many O&P licensure applicants in Pennsylvania experienced denials stemming from a section of the Medical Practice Act requiring accreditation from the National Commission for Certifying Agencies, a voluntary status that both the American Board for Certification in Orthotics, Prosthetics, and Pedorthics (ABC) and the Board of Certification/Accreditation (BOC) have chosen not to maintain.

With the help of the Pennsylvania Orthotic and Prosthetic Society, ABC, and BOC, HB 2800, the bill removing this requirement, quickly moved through the legislature and was signed into law Nov. 3 by Gov. Tom Wolf. Applicants who experienced denials previously due to this issue will now be reconsidered.

South Dakota

During the Nov. 8 midterm elections, South Dakotans voted to expand their Medicaid program to thousands of additional low-income residents, becoming the seventh state to do so via the ballot box. With 56% approval from voters, South Dakota brings the total number of Medicaid expansion states up to 39. Under the expansion, it’s estimated that more than 50,000 new enrollees will join the program once it is implemented, starting in 2024.

Texas

HB 134, which was pre-filed Nov. 14 for the 2023 legislative session, mandates coverage of cranial remolding orthoses (CROs), code S1040, in certain individual and group health insurance plans, as well as Texas’s Medicaid and child health plan programs. AOPA has engaged its CRO Intervention Workgroup and CRO providers in the state to assess the bill’s coverage language and develop an evidence-based advocacy approach.

HB 134 has been previously introduced during the 2013, 2015, and 2021 sessions. If passed, HB 134 would take effect starting September 2023. To stay updated regarding this bill, check the Texas page of the AOPA Co-OP.

For more information on these and other state developments, visit the AOPA Co-OP or contact Sam Miller at smiller@AOPAnet.org.

So Kids Can Move

So Kids Can Move is a new policy and advocacy initiative working to expand access to prostheses and orthoses utilized for physical activity as medically necessary healthcare for children and youth on a state-by-state basis. It is the result of a collaboration between AOPA, the National Association for the Advancement of Orthotics and Prosthetics, the Amputee Coalition, and the American Academy of Orthotists and Prosthetists.

To learn more or inquire about bringing the initiative to your state, contact Sam Miller, AOPA state and federal advocacy manager, at smiller@AOPAnet.org.

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