Medicare has officially announced changes to its Local Coverage Determination (LCD) that will expand access to microprocessor-controlled knees (MPKs) for lower mobility users. This group is often overlooked as potential users of this groundbreaking technology. Ottobock has played a key role in advocating for the expansion of Medicare coverage for MPKs for low-mobility patients. As the world’s largest manufacturer of prosthetics and orthotics, Ottobock continues its commitment to improving access to advanced prosthetic technology for underserved patient communities.
In 2005, Ottobock initiated the first clinical study involving low-mobility users utilizing MPKs, leading to two important publications. Despite the early evidence, it wasn’t until 2014 that Dr. Andreas Kannenberg published the first systematic review of five MPK studies involving patients with limited mobility. However, this was still insufficient to convince Medicare at that time. Undeterred, Ottobock continued to fund more than 80% of subsequent studies, reinforcing its dedication to this critical research.
By 2021, the cumulative efforts paid off when Dr. Kannenberg and Dr. Andreas Hahn, VP of Clinical Research & Services at Ottobock, published another comprehensive systematic review, encompassing 704 patients across 15 publications and 13 clinical trials. This rigorous scientific groundwork culminated in Ottobock filing a request to reconsider the LCD in March 2022. This request has led to the current revision of the LCD for Lower Limb Prostheses, which, upon finalization, will expand Medicare coverage of MPKs to a whole new demographic of patients who meet specified conditions.
“The journey to expanding Medicare coverage for microprocessor knees to this group of patients has been long and challenging but immensely rewarding. Our extensive research and clinical trials have consistently shown the profound impact that advanced prosthetic technology can have on individuals with limited mobility,” stated Dr. Andreas Kannenberg, the Executive Medical Director of Ottobock North America. “This expansion is not just a testament to the hard work and dedication of our team at Ottobock; it also underscores the importance of innovation and evidence-based practice in transforming healthcare and enhancing patient outcomes. We look forward to continuing our efforts to ensure that every patient, regardless of their mobility level, has access to the best possible care.”
What do the LCD changes mean?
These new Medicare coverage changes will take effect on September 1, 2024. The updated guidelines will provide wider access to advanced prosthetic knees for more patients, ensuring that better technology is available to them. These changes also include specific requirements for claim processing, aiming to improve accuracy and enhance patient care by facilitating access to state-of-the-art prosthetics and streamlining the claims process. There have been no relevant changes compared to the proposed LCD, and the coverage criteria remain unchanged. However, in the connected Policy Article, the DME MACs have adopted a clarification in the criteria for the K-levels that was proposed by an Interagency Workgroup back in 2017. Overall, these changes will make it easier for prosthetists to qualify patients with accepted and published clinical criteria.
Kenevo: The Only MPK Designed Specifically for Low-Mobility Users
In line with Ottobock’s mission to help people maintain and regain their freedom of movement, the global manufacturer recognized the need to support the increasing population of individuals with lower mobility. Ottobock developed the first and only microprocessor-controlled knee (MPK) designed specifically for this patient group. With a strong emphasis on safety, stability, and providing confidence, the Kenevo stands out as a unique knee joint in today’s market. With this Medicare decision, more patients than ever will have access to this groundbreaking product. Learn more about Kenevo here.
