- Nearly 2 million Americans are without a limb
- A Medicare proposal would have more stringent requirements to obtain prosthetics
Under the new proposal, Medicare would establish more stringent requirements to obtain advanced prosthetics, reduce the role of the prosthetist who creates and maintains prostheses, and eliminate some of the universal codes that all providers use to cover prosthetic care.
The proposal could affect the 150,000 amputees in the Medicare system, but advocates worry that its influence could set the standard and the U.S. Department of Veterans Affairs and private insurers would follow suit. If that happened, the nearly 2 million Americans without limbs could be affected.
Brian Mast, 35, lost his legs above the knees while serving in the Army in Afghanistan five years ago when an improvised explosive device detonated. He also lost a finger. He was sent to Walter Reed National Military Medical Center in Bethesda, Maryland.
"My oldest was 6 months when I was injured," Mast said, remembering how he cried to his wife, worrying, "I will never be able to walk around carrying my son. I won't be able to stand there and play baseball or catch. I won't be able to play tag or kickball."
But today's technology in prosthetics allows him to do all that with his three children, and much more. He has waterproof legs that allow him to run in the rain and play with his kids at the beach.
"Probably the only thing I can't do is get on my roof and clean my gutters," Mast said.
But he worries it could all go away if the VA adopts the changes made in Medicare.
'As stupid a rule as I've ever seen'
When asked why there was an effort to change the rules, the Centers for Medicare and Medicaid Services said the decision came from the Medicare contractors who administer payment for prosthetic care -- all companies that have ties