Obama White House Disappoints With Interim Response to “We the People” Petition on LCD


AOPA Reacts
Over 100,000 people took President Obama at his word when they shared their names, email addresses and trust in/commitment to government, signing on in 17 days to surpass the 100,000 signatures required to prompt direct White House intervention and action on the draft lower prosthetic LCD. Others were skeptical, seeing the We the People process as 90% public relations and only 10% substance. Well, the first response from the White House did nothing to dissuade the PR skeptics.

On Friday evening that report did not represent any action by the White House on the petition as had been promised. Rather, it did precisely what the President frequently criticizes Congress for doing–the White House report simply kicks the can down the road. It engages in a pious promise to eventually do what’s right, without giving either a hint of what the substantive action might entail, or when a final substantive decision will be rendered.

The interim We the People report came:

  • exactly 3 months after the LCD was released as a proposal;
  • exactly 60 days after the 100,000th signature on the White House petition;
  • exactly 50 days after the DME MAC public meeting, the amputee rally at HHS HQ, and the date when top CMS and HHS senior officials met with O&P stakeholder representatives and promised a prompt, fair solution that would assure that all Medicare amputees will receive appropriate replacement limbs;
  • it occurs 15 days after the first of an expected stream of commercial payers began embracing this very deficient draft as if gospel, as a premise to invoke the misguided draft’s content as an excuse to cut costs, ramp up profits, and downgrade amputee care. That’s too long! Inaction and failure to rescind this deficient policy now allows it to disenfranchise amputees, sadly in the year when the Administration touted the 25th anniversary of the Americans with Disabilities Act!

While we remain confident that the final resolution of this draft LCD will be a favorable one for the O&P professional and the patients we serve, the question remains… Is the ‘We the People’ promise merely PR fluff, or will it ultimately proves more substantive? Whichever, it clearly does not reflect timely, fairness and responsiveness.

The O&P Alliance and the Amputee Coalition Issue a Joint Statement
The O&P Alliance (AAOP, ABC, AOPA, BOC, NAAOP) and the Amputee Coalition issued a joint statement. Read the entire statement, with excerpts below.

“Rescission of this draft LCD is critical due to the fact that it is out of sync with contemporary prosthetic practice and because private payers like United Healthcare are already adopting elements of this draft LCD as if it were final Medicare policy, inappropriately restricting coverage for amputees covered by private plans.”

“We take CMS and its contractors at their word that they will meaningfully consult with stakeholders before issuing any final coverage policy in this area—including another formal comment period—and we look forward to continuing to work with them to ensure that all individuals with limb loss have access to appropriate prosthetic care.”

Other Reactions
AOPA members and O&P are responding to the interim, non-substantive response from the White House to the We the People petition. Here’s what one member wrote in a letter to his members of Congress:

“Wow! We received overwhelming support to raise awareness and collected 100,000 signatures in 17 days to get a response from President Obama’s administration… and this is what we received… I’m disappointed and concerned! We need your help and influence to ensure that 110,000+ Americans that signed in 17 days and the 200+ demonstrators are heard!”

“People talk about Congress being at a stand-off, but seems like there is a bipartisan consensus in the US House and US Senate and media in opposition to this proposed CMS LCD, both showing more interest and timeliness of response than the current Presidential Administration.”

Read the White House’s response below or on their website:

An initial response to your petition on a Medicare local coverage determination:

Thanks for using We the People, and for sharing your concerns about the local coverage determination for lower limb prostheses proposed by Medicare contractors. In order to get the most up-to-date information concerning your petition, we’ve gone to the Department of Health and Human Services (HHS) — specifically, the Centers for Medicare and Medicaid Services (CMS), and the Administration for Community Living (ACL).

You can learn more about LCDs and how they’re determined here.

The coverage determination process is still ongoing, but CMS wants to make clear that they’re committed to providing high quality care to all Medicare beneficiaries. They also wanted to make sure you know that HHS has met with stakeholders on this important issue, and both CMS and its contractors understand the questions that have been raised about access to the right prosthetic care — including related technologies — for Medicare beneficiaries.

We will be in touch with another update.

–The We the People Team

Tell us what you think about this response and We the People.