I 
119TH CONGRESS 
1ST SESSION H. R. 4475 
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 pros-
thetics, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 17, 2025 
Mr. THOMPSON of Pennsylvania (for himself, Mr. THOMPSON of California, 
Mr. BILIRAKIS, and Mrs. DINGELL) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Ways and Means, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to protect 
beneficiaries with limb loss and other orthopedic condi-
tions 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Orthotics and 
Prosthetics Patient-Centered Care Act’’. 
SEC. 2. INCREASING PROTECTIONS FOR MEDICARE BENE-
FICIARIES RECEIVING ORTHOTIC AND PROS-
THETIC CARE. 
(a) PROHIBITION ON PAYMENT FOR ITEMS DELIV-
ERED BY DROP SHIPMENT.—Section 1834(h)(1) of the 
Social Security Act (42 U.S.C. 1395m(h)(1)) is amended 
by adding at the end the following new subparagraph: 
‘‘(I) PROHIBITION ON PAYMENT FOR CER-
TAIN ITEMS FURNISHED USING A DROP SHIP-
MENT.— 
‘‘(i) IN GENERAL.—No payment may 
be made under this subsection for an item 
described in clause (ii) furnished to an in-
dividual via a drop shipment on or after 
the first day of the first year beginning 
after the date of the enactment of this sub-
paragraph. 
‘‘(ii) ITEMS
DESCRIBED.—The items 
described in this clause are orthotics and 
prosthetics, not including supplies for such 
orthotics and prosthetics, that are identi-
fied by HCPCS codes for which payment is 
not made under section 1847. 
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‘‘(iii) DROP SHIPMENT DEFINED.—In 
this subparagraph, the term ‘drop ship-
ment’ means, with respect to an item de-
scribed in clause (ii), the direct shipment 
of such item to an individual who has not 
received training or education from a 
qualified practitioner (as defined in sub-
paragraph (F)(iii)) on the fitting and ad-
justment, care, and use of such item.’’. 
(b) ADDITIONAL PRACTITIONERS EXEMPT FROM 
COMPETITIVE ACQUISITION.—Section 1847(a)(7)(A)(i) of 
the Social Security Act (42 U.S.C. 1395w–3(a)(7)(A)(i)) 
is amended— 
(1) by inserting ‘‘, physical therapist, occupa-
tional therapist, orthotist, prosthetist,’’ after ‘‘by a 
physician’’; and 
(2) by striking ‘‘the physician’s’’ each place it 
appears and inserting ‘‘such physician’s’’ in each 
such place. 
(c) ENSURING BENEFICIARY ACCESS TO REPLACE-
MENT CUSTOM-FITTED ORTHOTICS AND CUSTOM-FAB-
RICATED ORTHOTIC DEVICES.—Section 1834(h)(1)(G) of 
the Social Security Act (42 U.S.C. 1395m(h)(1)(G)) is 
amended— 
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(1) in the heading, by inserting ‘‘, CUSTOM- 
FITTED
ORTHOTICS, 
CUSTOM-FABRICATED 
ORTHOTICS,’’ after ‘‘REPLACEMENT OF PROSTHETIC 
DEVICES’’; and 
(2) in clause (i), by inserting ‘‘replacement of 
custom-fitted orthotics, replacement of items of cus-
tom-fabricated orthotics described in subparagraph 
(F)(ii),’’ after ‘‘which are artificial limbs,’’. 
(d) REGULATIONS.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall promulgate final regulations to 
implement the amendments made by this section. 
Æ 
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