NAAOP held its second annual Congressional Fly-In. The policy fights driving it have been building for years.

The National Association for the Advancement of Orthotics and Prosthetics held its second annual in-person Congressional Fly-In to advance O&P policy, according to reporting by The O&P EDGE.

A fly-in, in legislative terms, is when an organization brings its members to Capitol Hill for scheduled meetings with legislators and their staff. The point is presence. Hill offices track who shows up in person and who sends emails, and organizations that can demonstrate geographic breadth and sustained interest tend to get heard differently than those that do not.

Making this an annual event matters as a signal. The second installment suggests NAAOP is investing in a sustained advocacy posture, not a one-time push tied to a single vote.

What NAAOP represents and why it matters to patients

NAAOP represents orthotists and prosthetists as a profession. That is distinct from representing patients, but the two interests overlap significantly when the conversation turns to coverage policy.

When a Medicare contractor declines to cover a microprocessor knee for a patient whose clinical team supports the device, that is a reimbursement problem for the prosthetist and a care problem for the patient at the same time. When CMS changes the functional classification criteria used to assign K-levels, every affected patient finds out through their clinic, not through a policy newsletter. The regulatory environment for O&P practitioners and the coverage environment for patients are, in most practical respects, the same environment.

NAAOP has been consistent about showing up on Capitol Hill to make that case. The fly-in is one way they do it. Their August informational luncheon on transitions of care for Medicare amputees is another.

The legislative landscape they are walking into

Several active issues have occupied O&P advocates in recent months.

Medicare lower-limb prosthetic policy. CMS has been revising its coverage framework for lower-limb prosthetics, including the K-level functional classification system that determines which components a beneficiary can access. The patients most affected by changes in this area tend to be those at the borderline between functional classifications, where coverage decisions turn on how clinical documentation is read by a contractor whose clinical context is limited.

Prior authorization requirements. CMS expanded prior authorization requirements for O&P services in 2026. Prior authorization adds a procedural layer between a clinical decision and device delivery. When it functions as designed, it catches errors before they become expensive. When it does not, it delays care. NAAOP and other O&P groups have argued that for this population, delays carry functional and wound-healing consequences that are difficult to reverse. The expanded CMS prior authorization rules have been a consistent source of friction in the sector.

DMEPOS enrollment. The CMS enrollment moratorium for durable medical equipment suppliers expired in August 2026. Moratoriums affect who can enter the market. Their effects on patient access in specific regions become visible slowly, often through wait times and in-network availability rather than through a clear announcement.

Prosthetic parity in private insurance. Most working-age amputees are not on Medicare. They are on employer or marketplace plans, and their coverage floor is set by state prosthetic parity laws. Most of those laws carry an ERISA exemption that excludes self-insured employer plans, which is to say most large-employer plans. The gap between what a state parity law says and what a large-employer plan is required to do is significant. Federal legislation to address that gap has been introduced across multiple Congresses without passing. It is a persistent item on NAAOP’s agenda. The state-by-state picture of prosthetic parity law coverage is a separate layer from any federal fix.

What a fly-in actually accomplishes

Congressional fly-ins do not pass legislation. What they build is a record of constituent interest that informs whether and how a bill advances. Staff track volume and specificity. Organizations that show up repeatedly, with practitioners and patients from multiple states, with concrete examples of how policy gaps land in clinical practice, develop a different kind of relationship with committee offices than those that engage only when a vote is already imminent.

The outcomes are also rarely visible immediately. A fly-in in September 2026 might show up in committee markup language in 2027, or it might not show up anywhere. The alternative, not going, produces a cleaner outcome, just not the one advocates want.

What this means for patients

Nothing immediate. No new coverage rules follow from a fly-in.

But the conversations happening in NAAOP’s Hill meetings are upstream of the coverage decisions that arrive in appointment rooms. If prior authorization has created delays in your care, if a Medicare K-level assignment did not match what your clinical team recommended, or if a private insurer has denied a device your physician prescribed, those outcomes have policy explanations. They are not purely administrative accidents.

If any of those situations are current for you, the relevant resources are:

• The Amputee Coalition’s federal advocacy page for current legislation tracking
• CMS’s coverage determination database for the Medicare policies currently in effect
• Your state insurance commissioner’s office if you believe a state-regulated plan is not following the parity law in your state