AAOS September 5, 2017
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AAOS Comments on CMS Outpatient Rule, TKA Proposal

AAOS Comments on Quality Payment Program Proposed Rule

Webinar on Working with Members of Congress in Their Home District

State Corner – PAs Move to Eliminate Physician Supervisory Relationship Laws

Letter from New Orthopaedic Political Action Committee (PAC) Resident Fellow,
Jacob G. Calcei, MD


ICYMI: CMS Releases Medicare Hospital Inpatient Prospective Payment System Final Rule

Political Graphic of the Week

Quality Payment Program Updates

Don’t Forget! 5 Ways for Healthcare Providers to Get Ready for New Medicare Cards

What We’re Reading

New Resident PAC
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PAC Participation Leader Board by State

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

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AAOS Comments on Medicare Outpatient Rule, Quality Payment Program Changes
 
For questions or concerns on these or other advocacy issues, contact the Office of Government Relations at dc@aaos.org.
 
AAOS Comments on CMS Outpatient Rule, TKA Proposal

ImageOn August 30, 2017, the American Association of Orthopaedic Surgeons (AAOS) submitted comments to the Centers for Medicare and Medicaid Services (CMS) on its “Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems” proposed rule. The comments highlight a number of concerns, including those related to computed/digital radiography changes, social risk factors and risk stratification, physician-owned hospitals, and needed health care system flexibilities. On the radiography changes, AAOS commented that the reduction in payments for services utilizing computed radiography technology is unreasonable; “providers who offer in-office services to improve access and convenience to patients should not be penalized for using this time-tested technology.” AAOS also called for further hardship exceptions in reporting requirements, electronic health records improvements, and increased access to Medicare claims data.

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AAOS Comments on Quality Payment Program Proposed Rule

On August 21, 2017, the American Association of Orthopaedic Surgeons (AAOS) submitted comments to the Centers for Medicare and Medicaid Services (CMS) on its proposed rule that would make changes in the second year of the Quality Payment Program, including participation requirements for 2018. The Quality Payment Program—which replaces the flawed Sustainable Growth Rate (SGR) formula as required by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015—includes two tracks: the Merit-based Incentive Payment System (MIPS) track and the Advanced Alternative Payment Models (APMs) track.

MIPS vs APMs

AAOS has been working closely with CMS to address a number of 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.

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Webinar on Working with Members of Congress in Their Home District

Webinar

If you are a Congressional Ambassador or would like to become one, this webinar is an excellent opportunity to learn the skills you need to push for the policies you want. In 60 minutes, get tips from current AAOS Congressional Ambassadors, who share the simple building blocks of a lasting and successful advocacy effort.

Whether you are a novice advocate hoping to build your skill set, or an experienced ambassador looking to expand your tactics, this live presentation will give you more ways to pursue the advocacy efforts that benefit your practice and your patients.

Register online for this free live event!
Or call AAOS Customer Service at 1-800-626-6726.
 

State Corner – PAs Move to Eliminate Physician Supervisory Relationship Laws


State CornerThe American Academy of Physician Assistants (AAPA) approved a policy in May seeking to remove state regulations that “require a physician assistant (PA) to have and/or report a supervisory, collaborating, or other specific relationship with a physician ... [and seeking to establish] autonomous state boards with a majority of PAs as voting members to license, regulate and discipline PAs, or for PAs to be full voting members of medical boards.” With this move, AAPA is moving forward with its push to eliminate the formal supervisory relationship between physicians and PAs.

The move provoked strong opposition from the American Medical Association (AMA) House of Delegates in June. An AMA committee report labeled this as “anticipated legislation to move PAs into a more autonomous role” since state medical boards currently have authority over PAs.

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Letter from New Orthopaedic Political Action Committee (PAC) Resident Fellow, Jacob G. Calcei, MD

Dear Colleagues,

I am honored and excited to introduce myself as the new Orthopaedic PAC Resident Fellow. First, I would like to congratulate and thank Chad A. Krueger, MD for his service as the prior Orthopaedic PAC Resident Fellow. Working alongside Stacie Monroe and the members of the Office of Government Relations in Washington, D.C., Chad significantly increased resident awareness of and participation in the Orthopaedic PAC. Over the past two years, under Chad’s leadership, the annual resident participation in the PAC has increased from 85 residents in 2014 to 330 in 2016, including 6 programs that reached 100% resident participation last year. Chad has started great momentum and I hope to be able to continue his work.

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ICYMI: CMS Releases Medicare Hospital Inpatient Prospective Payment System Final Rule

On August 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment and polices when patients are discharged from hospitals from October 1, 2017, to September 30, 2018. According to CMS, the final rule relieves regulatory burdens for providers; supports the patient-doctor relationship in healthcare; and promotes transparency, flexibility, and innovation in the delivery of care.

AAOS submitted comments on the proposed rule in June (read them online here), and the final rule reflected many positive developments as a result of AAOS advocacy:

  • Regarding proposed movement of Total Ankle Arthroplasty (TAA) from MS-DRG 470 to MS-DRG 469, CMS announced the agency is reassigning the following procedure codes from MS-DRG 470 to MS-DRG 469, even if there is no major complication or comorbidity reported for FY 2018. CMS is changing the titles of MS-DRGs 469 and 470 to the following to reflect these MS-DRG reassignments:
    • MS-DRG 469: “Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with MCC or Total Ankle Replacement”; and
    • MS-DRG 470: “Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC.”
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Political Graphic of the Week

Political Graphic of the Week

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Quality Payment Program Updates

Quality Payment Program

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/.

     
  On June 20, CMS released a proposed rule that would make changes in the second year of the Quality Payment Program, including participation requirements for 2018. AAOS has been working closely with CMS to address a number of 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. In this proposed rule, CMS has taken significant steps to respond to these concerns, and AAOS will be providing CMS with further comments by the August 21 deadline. For any questions or comments related to this proposed rule, please email macra@aaos.org.
 
     


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Don’t Forget! 5 Ways for Healthcare Providers to Get Ready for New Medicare Cards

Top 5On July 27, two members of the House Energy and Commerce telehealth working group introduced the Evidence-Based Telehealth Expansion Act of 2017, which would encourage the use of telemedicine in the Medicare program. Specifically, the bill, sponsored by Reps. Doris Matsui (D-CA) and Bill Johnson (R-OH), gives the Department of Health and Human Services (HHS) secretary power to waive Medicare restrictions on what telemedicine it covers if the service improves quality of care or reduces costs. Advocates are hoping the bill could be attached to legislation reauthorizing CHIP and certain Medicare programs set to expire at the end of September. Congress is expected to take up such a bill after its August recess. Bill text can be found here.

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NewsWhat We’re Reading

The Odds Are Against a Simple ACA Stablization Bill, Axios, 8/30/17

Pressure Grows to Fund Children’s Health Program, The Wall Street Journal, 8/29/17

State-run Obamacare Exchanges Outline Fixes
, Washington Examiner, 8/29/17

Five State Insurance Commissioners to Testify on Bipartisan Healthcare Bill
, The Hill, 8/25/17

All U.S. Counties to Have an ACA Plan After Ohio Plugs Last Gap
, The Wall Street Journal, 8/24/17

Senate Health Panel Will Hear From Governors, Insurance Leaders
, Roll Call, 8/22/17

Iowa Submits Final Request to Shore Up Obamacare Markets
, The Hill, 8/22/17

Republicans face Looming Deadline on Health Law
, The Wall Street Journal, 8/20/17

Obamacare Survives Its Latest Threat – Bare Counties
, Politico, 8/20/17

Time Crunch Among Hurdles for Bipartisan Senate Push to Bolster ACA
, Morning Consult, 8/18/17
 
 
New Resident PAC One Pager
 
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.

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