AAOS November 14, 2017
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CMS Finalizes Outpatient and ASC Rule, Removes TKA From IPO List

Bonefied News

Quality Payment Program and Physician Fee Schedule Finalized

House Votes to Repeal IPAB

New Advocacy Fellows Program for Residents – Apply or Share!

House Hearing on
MACRA and APMs

House Discusses NIH Funding

Political Graphic of the Week

What We’re Reading

Quality Payment Program Updates

New Resident PAC
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PAC Participation Leader Board by State

Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!

AAOS Orthopaedic PAC Online and Mobile Donations

 
 
 
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House of Representatives Legislative Activities

Senate Legislative Activities
 
 
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CMS Removes TKA From IPO List, House Passes IPAB Repeal, and More
 
For questions or concerns on these or other advocacy issues, contact the Office of Government Relations at dc@aaos.org.
 
CMS Finalizes Outpatient and ASC Rule, Removes TKA From IPO List

On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) finalized the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System rule, which includes updates to the 2018 rates and quality provisions, and other policy changes.

Importantly, the rule finalizes changes to the Medicare inpatient-only (IPO) list for CY 2018. AAOS recognizes CMS for removing total knee arthroplasty (TKA) from the IPO list and for acknowledging this decision should be “made by the physician based on the beneficiary’s individual clinical needs and preferences. AAOS furtheracknowledges CMS for noting that the surgeons, clinical staff, and medical specialty societies who perform outpatient TKA and possess specialized clinical knowledge and experience” are most suited to create guidelines to identify appropriate candidates. AAOS is currently developing measures to assist selection of the ideal candidate for these procedures.

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Talk to your patients about fall-proofing their homes this holiday season

 
   
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With all the holiday cheer and festive activities this season, the last thing most people think about is their risk for falls. But patients should be reminded of the possible dangers lurking in their homes that could put them at risk.  The American Academy of Orthopaedic Surgeons (AAOS) and the Orthopaedic Trauma Association encourage families to make simple changes in their homes by implementing the safety tips from our Falls Prevention and Awareness Guide.  The guide and other fall prevention resources are also available at OrthoInfo.org/falls.

Talk to your patients the next time they visit your office or start spreading the word today by sharing our guideline and infographic on your social media pages using hashtag #HomeSafetyIsBoneSafety.

You may also order free copies of our fall prevention PSA poster by emailing media@aaos.org.

Here are some tips to help you get the conversation started.

  • Reduce clutter - It’s easy to accumulate clutter, such as boxes of décor and stacks of gifts from holiday shopping. Take the time to declutter your home, especially the hallways and stairs.

  • Designate a play area. Children may receive lots of new toys for the holidays and scatter them around the house. It’s important to contain those toys in a dedicated play area and clean up toys after kids are done playing to avoid tripping.
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Quality Payment Program and Physician Fee Schedule Finalized

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2018. The calendar year (CY) 2018 PFS final rule is one of several final rules that reflect a broader Administration-wide strategy to create a healthcare system that results in better accessibility, quality, affordability, empowerment, and innovation.

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House Votes to Repeal IPAB

Last week, the U.S. House of Representatives passed H.R. 849, the Protecting Seniors’ Access to Medicare Act, by a vote of 307-111. The American Association of Orthopaedic Surgeons (AAOS) commends members of the House for passing this important legislation (introduced by Reps. Phil Roe, M.D. (R-TN) and Raul Ruiz, M.D. (D-CA)), which would eliminate sections 3403 and 10320 of the Affordable Care Act (ACA) and repeal the Independent Payment Advisory Board (IPAB) before it is activated. This board – charged with making recommendations to cut Medicare expenditures if spending growth reaches a certain level – threatens the ability of elected representatives in Congress to ensure seniors have access to the health care they need when they need it. The bill now moves to the Senate and AAOS urges quick action on the legislation.

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New Advocacy Fellows Program for Residents – Apply or Share!

The AAOS Office of Government Relations has established a new Advocacy Fellows Program for residents and encourages you to apply or consider sharing this opportunity with residents in your network! Applications are now being accepted for 2018. The goal is to encourage the participation of orthopaedic residents in the national health policy arena. The program seeks to foster the development of orthopaedic surgeons interested in health policy and advocacy who are willing to become key members of the AAOS advocacy team. It offers orthopaedic residents the opportunity to gain a greater understanding of the health policy process and contribute to the development of new policies and programs. Dr. Stuart Weinstein, former Chairman of the AAOS Political Action Committee, is directing the program.

Two fellows will be selected for the calendar year 2018. The deadline for applications is November 15.  A full description and application instructions can be found online here. For more information contact OGR Senior Manager of Government Relations Julie Williams at jwilliams@aaos.org.
 
 
House Hearing on MACRA and APMs

On November 8, 2017, the House Energy and Commerce Subcommittee on Health held a hearing titled “MACRA and Alternative Payment Models: Developing Options for Value-based Care.” Subcommittee Chairman Michael C. Burgess, M.D. (R-TX) convened the hearing to discuss the implementation of one of the two tracks eligible professionals can be reimbursed under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – Alternative Payment Models (APMs). The committee reviewed Medicare payment reforms, including models that are already under way and those that are returning savings to the program while improving outcomes.

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House Discusses NIH Funding

The House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, chaired by Tom Cole (R-OK), held a hearing on October 24, 2017 to discuss the recently proposed budget costs regarding NIH funding. The current proposal is to cap NIH Indirect Cost Reimbursement at 10% of total research costs in FY 2018, a large reduction from the 28% spent by NIH in FY 2017. Not only would this proposal adversely affect researchers and doctors in all arenas, but the proposal would also inspire the trend to keep diminishing NIH research appropriations from Congress. Decreased funding for NIH research has been a major burden for the orthopedic community over the last several years, and AAOS is working with Congress and the orthopedic community to put money back in the hands of researchers, all with the goal of improving the quality of life for Americans suffering from unfortunate musculoskeletal conditions.

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Political Graphic of the Week

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NewsWhat We’re Reading

Trump to Nominate New HHS Secretary Alex Azar, Roll Call, 11/13/17

Key Republican Senators Ready to Move Trump’s Health Secretary Nominee, Washington Examiner, 11/13/17

Trump Health Agency Challenges Consensus on Reducing Costs, The New York Times, 11/12/17

Unsure of CMS’ Strategy, Providers May Retreat on Risk Models, Modern Healthcare, 11/11/17

Trump May Use Executive Power to Weaken Obamacare’s Individual Mandate, Politico, 11/10/17

Senate Keeps Medical Expenses Deduction in Break with House, The Hill, 11/9/17

Individual Mandate Repeal Likely Off Table for House Tax Bill, Roll Call, 11/9/17

Elections Results Suggest GOP Lost Edge on Health Care, The Wall Street Journal, 11/9/17

CBO: Repealing Obamacare Mandate Saves $338 Billion, The Hill, 11/8/17

Using Tax Legislation to Overhaul Obamacare Still Being Discussed, The Washington Post, 11/5/17
 
 
Quality Payment Program Updates

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, and the Centers for Medicare & Medicaid Services (CMS) then replaced it with the Quality Payment Program. Remember – the Quality Payment Program has two tracks you can choose: Advanced Alternative Payment Models (APMs) OR the Merit-based Incentive Payment System (MIPS). AAOS has shared the details of QPP and MIPS, which can be found on our website, here: www.aaos.org/MACRA_QualityPaymentProgram/ and here: www.aaos.org/MACRA-DeliveryReform/.

Quality Payment Program

     
  On November 2, 2017, CMS released a final rule with comment period for its Quality Payment Program, along with its 2018 physician fee schedule rule. The Quality Payment Program final rule did not differ significantly from the proposed rule released last June. AAOS has been working closely with CMS to address many concerns related to the Quality Payment Program, including the need for additional flexibility and simplification, as well as protection for small, solo, and rural practices. Read the entire proposed rule comment letter submitted by AAOS online here. Find the CMS fact sheet on the final rule here: https://www.cms.gov/Medicare/Quality-Payment-Program/resource-library/QPP-Year-2-Final-Rule-Fact-Sheet.pdf. For any questions or comments related to this proposed rule, please email macra@aaos.org.  
     

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New Resident PAC One Pager
 
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Resident Pac Participation

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PAC Participation Leader Board by State

Click here, to view the interactive version of the map below, which features each state’s PAC support for 2017.
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Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!

PAC Advisor's Circle
 
 
 
  AAOS Orthopaedic PAC Online and Mobile Donations

image Orthopaedic PAC is now mobile! Supporting by phone is easy: simply text AAOS to the number 41444, and follow the link, no log-in required. We encourage our supporters to share this technology with your colleagues who have yet to renew or join and to encourage signing up on a recurring basis, for just $84 a month, or $250 a quarter you can become part of our Capitol Club Program. And don’t forget! The Orthopaedic PAC website features an online contribution center, which can accept contributions via credit card by visiting the site and using your AAOS login credentials. Credit card contributions can also be conveniently scheduled for a monthly, quarterly or yearly recurring donation. Visit www.aaos.org/pac and select Donate to the Orthopaedic PAC for more information or to contribute today.

Don’t remember when you last contributed? Log in to the contribution center today to view your complete donation history!