Regulatory Update:

CMS Withdraws Restrictive Orthotics and Prosthetics Rule

Issued October 10, 2017

On October 4, 2017, the Centers for Medicare and Medicaid Services (CMS) posted a Federal Register notice to announce the withdrawal of the January 2017 proposed rule regarding the "Medicare Program; Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom-Fabricated Orthotics."  

There has been a long-standing exemption that acknowledged the qualifications and standard training of physical and occupational therapy practitioners, and allowed them to furnish and fabricate custom orthotics and prosthetics without requiring additional accreditation, credentialing, and regulatory burdens.  The January 12, 2017 proposed rule included provisions to discontinue this exemption, potentially restricting access to needed care.  With the withdrawal of that proposed rule, the exemption will remain in place at this time.  As per CMS: “In light of the cost and time burdens that the proposed rule would create for many providers and suppliers, particularly the cost and burden for those providers and suppliers that are small businesses, and the complexity of the issues raised in the detailed public comments received, we are withdrawing the January 12, 2017 proposed rule in order to assure agency flexibility in re-examining the issues and exploring options and alternatives with stakeholders” (Withdrawal Notice, p. 46181).

The American Physical Therapy Association (APTA) and the American Occupational Therapy Association (AOTA) credit professional advocacy of the associations’ staff and members as a significant influence in the CMS’ decision to withdraw the proposed rule.  Genesis Rehab Services collaborated with APTA and AOTA on this issue and also submitted comments to CMS in support of a continued exemption for physical and occupational therapy practitioners. 


The Regulatory Administration department of GRS/RHS closely monitors legislative and regulatory notices, and continues to work with Congress, CMS and industry leaders regarding changes in government regulations that may impact patient care and service delivery.