New Obstacles in Proposed Rule for Hand Therapists – Jan 25, 2017


Occupational therapists and physical therapists have long been exempt from quality and accreditation standards for furnishing and fabricating prosthetics and custom orthotics for Medicare beneficiaries. On January 12, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule (pdf) would lift that exemption.

The proposed rule would require OTs and PTs to meet Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS) supplier quality and accreditation standards when they furnish and fabricate prosthetics or custom orthotics under the Medicare program. The proposal is an outgrowth of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (“BIPA”). Read a CMS fact sheet about the proposed rule.

In the new proposal, occupational therapists who furnish and fabricate custom orthotics must be “licensed by the state [as a qualified provider of prosthetics and custom orthotics], or…certified by the American Board for Certification in Orthotics and Prosthetics…or by the Board for Orthotist/Prosthetist Certification.”

 AOTA is closely reviewing the Training Licensure and Certification requirements in the proposal to respond to concerns with occupational therapy training set forth by CMS.. In addition, CMS states that it will make changes to the quality standards, which will be handled only through sub-regulatory guidance, by posting on the CMS DMEPOS supplier enrollment website. AOTA will be monitoring any changes regarding orthotics quality standards. The proposed provisions could also have a harmful impact on facility settings, including skilled nursing facilities (SNFs).

CMS is accepting comments on the proposed rule until March 13, 2017. AOTA’s Regulatory Affairs staff will be commenting on the new proposed regulations and welcomes your feedback at You can also submit comments directly to CMS.