August 2014

US district court dismisses AOPA suit

In August the US District Court for the District of Columbia issued a decision granting the government’s motion to dismiss the case the American Orthotic and Prosthetic Association (AOPA) filed in May 2013 challenging the Medicare program’s actions relating to prosthetic claims, the August, 2011 Dear Physician Letter, and the exclusion of the prosthetist’s notes from having independent value separate from physician notes as documentation support of claims.

An AOPA statement noted the court granted the government’s motion to dismiss based on the its finding that “AOPA has failed to establish that this Court has jurisdiction over its claims.”

The statement also noted, “The objective of our suit was NOT to have one single claim resolved in favor of a specific O&P firm. Rather, we pursued a course that sought, in essence, to overturn all of the claims in which Medicare utilized the criteria in the Dear Physician letter to claw back money or deny payments. AOPA, being a trade association, doesn’t itself file Medicare claims. Finally, with the devastating impact of losses to O&P providers from these audits and denials, we sought an immediate intervention to reverse the losses that ultimately have put over one hundred O&P facilities out of business.”

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