January 23, 2018
CMS Announces New BPCI Advanced Model, Good Samaritan Legislation Moves, and State Orthopaedic Societies Work on CON Laws
For questions or concerns on these or other advocacy issues, contact us at dc@aaos.org.
CMS Announces BPCI Advanced Model On January 9, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary bundled payment model that will qualify as an Advanced Alternative Payment Model (Advanced APM) under the Quality Payment Program. This new model, called “Bundled Payments for Care Improvement Advanced” (BPCI Advanced), requires participants to bear financial risk, have payments under the model tied to quality performance, and use Certified Electronic Health Record Technology. By meeting these requirements, participants can earn the Advanced APM incentive payment.

Write an Ortho-pinion for ANationinMotion.org
Let’s hear your voice! Please submit a short Ortho-pinion to be featured on the homepage of our orthopaedic public awareness campaign website ANationInMotion.org.  Ortho-pinions are patient-friendly bone and joint health columns, covering commonly asked questions from patients or trending information that the public might take an interest in reading. For example, topics might include healing times for fractures, post-surgery expectations, spring sports injury prevention tips and so much more.   The AAOS then promotes this content on social media and encourages you and your practice to do the same. If you’re interested in this free member benefit but need help brainstorming a topic, email Kelly King Johnson at king@aaos.org.

House Subcommittee Advances Good Samaritan Legislation On January 17, the House Energy and Commerce Subcommittee on Health passed H.R. 1876, the Good Samaritan Health Professionals Act of 2017, which helps protect health care professionals who volunteer their services when a major emergency arises. The American Association of Orthopaedic Surgeons (AAOS) has continually advocated for this legislation and applauds members of Congress for advancing this important measure. Specifically, H.R. 1876 provides clear liability protections to licensed health care professionals who volunteer health care services to victims during a declared national disaster. Notably, the legislation respects existing medical liability laws and does not protect providers in cases of willful or criminal misconduct, gross negligence, or reckless misconduct.

State Corner: State Orthopaedic Societies Advocate for Patient Choice, Repeal of Onerous Certificate of Need Regulations State orthopaedic societies are continuing their efforts in 2018 to repeal certificate of need (CON) laws, modernize ambulatory surgical center (ASC) regulations, and create licenses that will enable recovery care centers. The aim of these advocacy efforts is to allow patients and families, with their surgeon, to choose the surgical location most convenient and clinically appropriate for them. Research published in the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) in 2016, found that ASCs decrease the overall cost of health care with a more efficient care model that could help insurance premiums and copayments decrease. [1]Since 2015, the AAOS has supported the Florida Orthopaedic Society’s (FOS) efforts to modernize ASC regulations, repeal the state’s certificate of need law and create a new license to enable the creation of recovery care centers with grants from the State Legislative and Regulatory Issues committee. Florida is one of the few states that require patients to be discharged at midnight – no matter the clinical indications or federal guidelines. The FOS is supporting bills at the state legislature that would adopt the CMS standard for length of stay in an ASC in Florida to a full 24 hours.

AAOS Sends Letter to MedPAC re: Specialty Care On January 10, 2018, AAOS joined a number of surgical organizations in sending a letter to the Medicare Payment Advisory Commission (MedPAC) regarding a discussion on the physician fee schedule (PFS) and primary care services. Specifically, the letter questions the problems that MedPAC describes with the way the PFS pays for primary care, the concerns with income disparities between specialties, and the effectiveness of increasing payment to certain specialties as a means to address workforce issues.

ICYMI: Healthcare Policy in 2017 – the Year in Review Although 2017 was an impassioned and oftentimes highly partisan year for Congress and the Trump Administration, the AAOS Office of Government Relations (OGR) kept legislative and regulatory topics important to orthopaedics front and center.In January, the Sports Medicine Licensure Clarity Act, designed to ensure team providers are properly covered by their professional liability insurance when traveling with athletic teams in another state, was passed by voice vote in the House of Representatives. A Senate companion bill was introduced in April and has 22 cosponsors. Important progress was also made this year toward lifting the moratorium on new or expanded physician-owned hospitals. The House bill, sponsored by Rep. Sam Johnson (R-Texas), has received 64 cosponsors, more than double what it received in past years. Moreover, for the first time, the legislation has a Senate companion, which was introduced by Sen. James Lankford (R-Okla).

Take Action on Physician-Owned Hospital Issue TODAY The government is back open, and we expect a flurry of activity in the coming weeks. Importantly, Congress will need to pass an omnibus appropriations bill to fund the government very soon, and this will be the best opportunity to obtain relief for physician-owned hospitals. H.R. 1156 would repeal the moratorium on expansion and new construction, but we need your help to move this legislation – contact Republican leadership TODAY to urge the inclusion of H.R. 1156 in the omnibus appropriations bill. Click here to act!
Political Graphic of the Week

What We’re Reading Governors Ask Trump, Congress to Do More on Opioid Crisis, The Associated Press, 1/18/18 NIH In A Scramble to Prepare for Any Government Shutdown, Stat News, 1/18/18 Congress Once Again Looking to Kick Health Cost Control Down the Road, Axios, 1/18/18 Senate Dems Push for Health Center Funding in Spending Bill, The Hill, 1/17/18 Senate Committee Advances Trump’s Nominee for HHS Secretary, Politico, 1/17/18 Lamar Alexander to Press for Obamacare Bills in Long-Term Spending Deal, Washington Examiner, 1/17/18 Republicans Lack Votes to Prevent a Shutdown, Politico, 1/17/18 Individual Mandate Now Gone, GOP Targets the One for Employers, The New York Times, 1/14/18 MedPAC Votes to Junk MIPS, Providers Angered, Modern Healthcare, 1/11/18 HHS Nominee Azar Says He Backs Mandatory Pilot Payment Programs, Morning Consult, 1/9/18 Cost of CHIP Renewal Smaller Than Projected, Roll Call, 1/8/18
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-DeliveryReform/.On November 2, 2017, CMS released a final rule with comment period for its Quality Payment Program. 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/comments related to this rule, email macra@aaos.org.

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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.
Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!
To learn more about the Advisor’s Circle, email Stacie Monroe at monroe@aaos.org.
AAOS Orthopaedic PAC Online and Mobile Donations 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!

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