A controversy is brewing over Medicare coverage of prosthetic feet and legs. People who have lost a foot or leg are worried that they will be denied the latest technology for prosthetic legs and feet.
But government investigators are looking at Medicare spending on artificial feet and legs because this spending has soared in the last 10 years while the number of amputees has gone down, largely because of improved diabetes care.
Medicare's billing contractors have proposed closer medical supervision of technicians who sell and fit artificial limbs, as well as tighter rules for patients in order to qualify for advanced devices. Some high-tech prostheses can cost as much as a car. The industry says this would amount to a diminished quality of life for amputees and has launched a protest, which has attracted support from a Boston Marathon bombing survivor, Adrianne Haslet-David, and former U.S. Senator Bob Kerrey, who lost a leg in the Vietnam War.
Haslet-Davis, who lost a leg in the bombing, is too young for the Medicare changes to affect her, but she still feels that the proposals should not go into effect.
Amputees showed up for a protest in front of the Health and Human Services headquarters in Washington. The campaign is being led by the American Orthotic and Prosthetic Association, a trade group. Haslet-Davis and Kerrey said they are not being paid for their support.
A spokesman said that Medicare believes that "beneficiaries will continue to have access to lower-limb prosthetics that are appropriate," and the payment overhaul "is not meant to restrict any medically necessary prosthesis."
Although artificial legs and feet are a small part of Medicare's $600-billion-a-year expenditures, a 2011 inspector general's report found that Medicare spending for lower limb prostheses increased by 27% from 2005 to 2009, as the number of people getting them decreased by about 2,000 people. The report also documented questionable billings.
An industry spokesperson said that if there are problems with billing from certain providers of prostheses, those providers should be kicked out of Medicare, but that policy changes are not needed.
