HR4475-119

Introduced

To amend title XVIII of the Social Security Act to protect beneficiaries with limb loss and other orthopedic conditions by providing access to appropriate, safe, effective, patient-centered orthotic and prosthetic care, to reduce fraud, waste, and abuse with respect to orthotics and prosthetics, and for other purposes.

119th Congress Introduced Jul 17, 2025

Legislative Progress

Introduced
Introduced Committee Passed
Jul 17, 2025

Mr. Thompson of Pennsylvania (for himself, Mr. Thompson of California, …

Summary

What This Bill Does

This bill amends Medicare payment rules (Title XVIII of the Social Security Act) to regulate how orthotics and prosthetics are delivered to beneficiaries. Key provisions:

  1. Prohibits Drop Shipments: Bans Medicare payment for orthotics/prosthetics that are directly shipped to patients without the patient first receiving training from a qualified practitioner on fitting, adjustment, care, and use of the device.

  2. Expands Qualified Practitioners: Adds physical therapists, occupational therapists, orthotists, and prosthetists to the list of practitioners who can provide required certification for durable medical equipment.

  3. Enhances Replacement Coverage: Extends replacement coverage rules (previously just for prosthetic devices) to include custom-fitted and custom-fabricated orthotics.

  4. Regulatory Mandate: Requires the Secretary of HHS to issue final regulations within 1 year of enactment.

Who Benefits and How

  • Medicare beneficiaries with limb loss/orthopedic conditions: Improved quality of care through mandatory in-person fitting and training; safer device use through proper education
  • Orthotists and Prosthetists: Practice protection through recognition as qualified practitioners; increased patient volume as drop-ship model is banned
  • Physical Therapists and Occupational Therapists: Expanded scope as authorized practitioners for O&P certification
  • Quality O&P Providers: Competitive advantage as drop-ship competitors are eliminated from Medicare reimbursement

Who Bears the Burden and How

  • Drop-ship O&P Suppliers: Loss of Medicare reimbursement for their business model; must shift to practitioner-based service delivery
  • CMS/HHS: Administrative burden to create new regulations and enforce drop shipment prohibition
  • Some Medicare beneficiaries: May face reduced convenience or longer wait times if they previously used drop-ship services

Key Provisions

  1. Section 2(a): Prohibits Medicare payment for orthotics/prosthetics delivered via drop shipment
  2. Section 2(b): Expands definition of qualified practitioners to include PTs, OTs, orthotists, prosthetists
  3. Section 2(c): Extends replacement coverage to custom-fitted and custom-fabricated orthotics
  4. Section 2(d): Mandates HHS regulatory implementation within 1 year
Model: Not recorded
Generated: Not recorded

Evidence Chain:

This summary is derived from the structured analysis below. See "Detailed Analysis" for per-title beneficiaries/burden bearers with clause-level evidence links.

Primary Purpose

Reforms Medicare coverage of orthotics and prosthetics (O&P) to ensure beneficiaries with limb loss receive quality patient-centered care through qualified practitioners, while reducing fraud by prohibiting drop shipments and requiring proper fitting education.

Policy Domains

Healthcare Medicare

Medicare Orthotics and Prosthetics Patient-Centered Care Act

Likely Beneficiaries
  • Medicare beneficiaries with limb loss
  • Orthotists and Prosthetists
  • Physical Therapists
  • Occupational Therapists
  • Quality O&P providers
Model: claude-opus-4-5-20251101 | Version: bill_summary_v2 | Source: ih
Physical Therapists:
Quality O&P providers:
Occupational Therapists:
Orthotists and Prosthetists:
Medicare beneficiaries with limb loss:
Likely Burden Bearers
  • Drop-ship O&P suppliers
  • CMS/HHS
Model: claude-opus-4-5-20251101 | Version: bill_summary_v2 | Source: ih
CMS/HHS:
Drop-ship O&P suppliers:

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Healthcare Medicare
Actor Mappings
"cms"
→ Centers for Medicare & Medicaid Services
"the_secretary"
→ Secretary of Health and Human Services

Key Definitions

Terms defined in this bill

2 terms
"drop shipment" §2

The direct shipment of orthotics or prosthetics to an individual who has not received training or education from a qualified practitioner on the fitting and adjustment, care, and use of such item

"qualified practitioner" §2_qualified_practitioner

Expanded to include physician, physical therapist, occupational therapist, orthotist, or prosthetist who can certify the need for durable medical equipment

We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.

Learn more about our methodology