Orthopedic Bracing is a Clinical Service, Not a Mail-Order Transaction.
Medicare has proposed Remote Item Delivery (RID) for certain orthopedic braces. This change could reduce Medicare patients’ access to in‑person brace fitting and education.
How In‑Person Bracing Can Support Safer, More Effective Care
Improved Clinical Outcomes
Decreased Returns
Internal data suggests in-person evaluation and clinical fitting expertise can help reduce returns and trial and error shipments.
"Off-the-Shelf" Does Not Mean "Self-Fit."
The term "Off-the-Shelf" (OTS) defines a brace where the services of an orthotist or individual who has specialized training is not needed but many OTS orthotics benefit from supplier in-person fittings3. High-performance back, knee, and upper extremity braces are sophisticated medical tools that often include:
Professional Assessment
Hands-on evaluation of a patient’s mobility, skin integrity, and functional goals for using the device.
Precision Adjustment
Adjusting soft-goods, straps, and hinges to support the patient’s unique anatomy.
In-Person Education
Demonstrating device function, proper use, and how to put the device on (donning) and take it off (doffing) safely.
Under the RID proposal, these essential clinical supplier steps would be removed. A box could arrive at the home of a patient with mobility or health challenges, with no one to ensure proper use of the device.
What Patients Are Asking Policymakers to Consider
We share the goal of reducing fraud and streamlining delivery, but it must not come at the cost of patient health. We propose a four-point plan for policymakers:
Apply a Risk-Based Approach
Immediately remove complex OTS orthotics from the RID program until a thorough evaluation of real-world patient impact is completed.
Create an "OTS+" Category
Redesignate orthotics that require skilled fitting and education as "OTS+," excluding them from the RID bid.
Strengthen Prior Authorization
Use existing oversight tools to target high-risk billing codes without removing in-person fittings and education for the patient.
Conduct a Full Impact Analysis
Delay RID implementation until the economic and clinical effects on marketplace stability and rural access are fully understood.
Help Protect Patient Access
By sharing your voice, you can help ensure that Medicare patients continue to have access to in‑person brace fitting and education. Sending a letter to your elected official helps highlight the importance of in‑person care and why it continues to matter for seniors across the country.
Email Your Representative
References
- Laidler J. L. (2021). The Impact of Ankle-foot Orthoses on Balance in Older Adults: a Scoping Review. Canadian prosthetics & orthotics journal, 4(1), 35132. https://doi.org/10.33137/cpoj.v4i1.35132
- Livesey MG, Weir TB, Addona JL, Curto RA, Apte A, Hughes M, Enobun B, Henn RF 3rd, Hasan SA, Gilotra MN. The Effect of Patients' Understanding of Sling Necessity and Home Assistance on Sling Wear After Shoulder Surgery. Am J Sports Med. 2023 Jan;51(1):179-186. doi: 10.1177/03635465221131984. Epub 2022 Nov 9. PMID: 36349935.
- Centers for Medicare & Medicaid Services. (n.d.). Local coverage article: Billing and coding (Article ID: 52500). U.S. Department of Health & Human Services. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52500
Disclosure & Transparency Statement
This website and the advocacy campaign presented here are operated by DJO, LLC, an Enovis Corporation subsidiary, for-profit company (“Enovis”) a for‑profit company with a direct business interest in the policies and legislation discussed.
The information provided on this site is intended to inform and empower patients, caregivers, and advocates to engage with their elected representatives. Enovis stands to be directly affected—financially and operationally—by the outcomes of the legislative and regulatory actions referenced on this site. In other words, we have a clear stake in the issues being addressed.
We believe transparency matters. While we are committed to sharing accurate, patient‑focused information, visitors should understand that this advocacy effort reflects both:
- Our perspective as a company operating in this space, and
- Our belief that these issues have significant implications for patient access, care quality, and outcomes.
Engaging with policymakers is always a personal choice. We encourage visitors to review multiple sources, consider diverse viewpoints, and decide for themselves whether and how to contact their elected officials.
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