LCD Testimony and Rally Reactions

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The following individuals shared their thoughts with The O&P EDGE about the public Open Comment Meeting to discuss the Medicare Draft Local Coverage Determination (LCD) for Lower Limb Prostheses and the rally following it that was held in front of the U.S. Department of Health and Human Services building to protest this set of policies.

TAMMIE HIGGINBOTHAM has a left transtibial amputation, the result of a car accident. She participated in the Open Comment Meeting via teleconference, and shared the story of how she sustained her amputation and what it took for her to receive a well-fitting and comfortable prosthesis and liner.

"How can we do what we do to be productive society members if they cut us back to prehistoric times as far as prosthetics? Are the people deciding this amputees? Would they stand for it? I heard many good people speak that day that were calm, cool, and rational; not blaming, just saying, 'Don't take my leg away. Limbs are not a luxury....'"

BRUCE DAUGHERTY underwent a right transtibial amputation in 2010 at the age of 40-a decision that was made after living with the pain and limitations of a club foot and undergoing multiple surgeries to try to correct it. He drove from Colorado Springs, Colorado, to Washington to participate in the rally.

"If we go backwards to the 1970s way of care, then where is that going to leave me? My whole reasoning for having an amputation was because of the enhancements of technology and the higher functioning prosthetic limb, because I've had to adapt my whole life. That's not the case anymore. Snowboarding and things like that were never on my list of things to do before my amputation. [I]f more Americans would stand up and let their voices be heard, then maybe things can be better when an injustice is done."

JAMES H. CAMPBELL, PHD, CO, FAAOP, AOPA's President Elect, testified at the meeting.

"The O&P community came together in unprecedented fashion to advocate for the patients we serve. I was privileged to testify at the public hearing. Specifically, I addressed the absence of any scientific base and evidence to support the changes in the draft LCD; the articles referenced by CMS claimed to support the changes [but] actually had no bearing on any of the policy changes described within the proposal. In fact, I was able to point out that the evidence that does exist could be used to refute the changes. I stressed that the current standard of practice is fully supported by sound, peer-reviewed scientific evidence."

JEFFREY BRANDT, CPO, CEO and founder of Ability Prosthetics & Orthotics, headquartered in Exton, Pennsylvania, attended the meeting. "I don't know that I've seen the profession more unified than right now, nor as passionate. The hearing was about as raucous as it could be without being unprofessional. To be those medical directors hearing those stories..., listening to professionals and amputees talk about the potential ramifications of the policy in person, they all had to be concentrating pretty hard not to show some emotion.

"We submitted an official comment for the record from our company, [and]...were actually able to supply CMS with real data that we thought they should have looked at before they wrote such a policy...and we were able to show them that...44 percent of our patients would not be in the leg they are currently in; they would not have access to the prostheses they are currently wearing if the policy went into effect. That [policy] would hence move everyone down a functional level, essentially."

THOMAS (TOM) WATSON, CP, owner and president of Tom Watson's Prosthetics & Orthotics Lab, headquartered in Owensboro, Kentucky, spoke at the meeting. He has a transfemoral amputation.

"I've been in the field over 40 years, and I have never been so proud to be an amputee and a prosthetist as I was the morning [of the Open Comment Meeting]. The outpouring of heartfelt testimony from all walks of life was astounding. For so many people to come together for a common goal that being an amputee was not an end but a beginning brought tears to my eyes more than once. The prosthetic industry is a true American success story and should not treated as a luxury. And what was even more astounding was the medical directors present never seemed to take note, make a statement, or ask a question over the entire public comment period. I guess silence can be interpreted as either golden or embarrassment. Hopefully the LCD will be rescinded and we could come together for a common goal to write a policy that could work for all parties."

ADRIENNE WALKER-PITTMAN has a left transfemoral amputation and a traumatic brain injury, which were the result of having been hit by a teenager driving a stolen vehicle. She spoke at the Open Comment Meeting and attended the rally.

"The meeting was so important, and it was amazing to hear the different stories from people and how their devices had impacted and changed their lives. The right prosthetic fit means that physically, medically, and emotionally, it will give an amputee their life back, and that is what my Genium prosthesis by Ottobock does for me. The appropriate prosthetic device allows you to...achieve and inspire and excel despite what you have gone through, so you can get your life back and be an inspiration to others. You cannot fix a problem and be successful with a partial diagnosis. An amputation affects a person's total life as does the right prosthetic device! The family, the caregiver, and community are affected as well!"