CMS to work with providers and other agencies to address Stark Law issues
According to HealthLeaders Media, the U.S. Centers for Medicare & Medicaid Services (CMS) is considering the formation of an interagency task force to review the federal Stark Laws. The Stark Laws prohibit referral by a physician of a Medicare or Medicaid patient to another health services entity if the physician or an immediate family member has a financial relationship with that entity. Some providers have complained that the Stark Laws impede the implementation of certain care coordination models.
CMS updates MIPS policy to cover physicians affected by California wildfires
CMS has updated its Extreme and Uncontrollable Circumstances policy for the 2017 Merit-based Incentive Payment System (MIPS) transition year to include counties affected by Hurricane Nate and additional counties affected by the California wildfires. The agency states that MIPS-eligible clinicians in U.S. Federal Emergency Management Agency-designated areas affected by Northern California wildfires and Hurricanes Harvey, Irma, Maria, and Nate will be automatically identified, and no action is required on the part of clinicians. However, providers in those areas who still choose to submit data on two or more MIPS performance categories will be scored on those performance categories and their MIPS payment adjustment will be based on their final score. The data submission period for the 2017 transition year of MIPS runs from Jan. 2, 2018 to March 31, 2018.
Study: WHR proxy scale may offer good predictor of wound complications after pelvis or acetabulum fracture stabilization
Findings from a study published online in the Journal of Orthopaedic Trauma suggest that a surrogate of waist hip ratio (WHR) may be more predictive than body mass index (BMI) of wound healing complication for patients who receive pelvis or acetabulum stabilization. Members of the research team conducted a retrospective review of 161 patients who underwent surgical stabilization of a pelvic ring injury or acetabular fracture. At mean 15.9-month follow-up, 24 patients (15 percent) had developed wound complications. The researchers found that a WHR proxy derived from anteroposterior and lateral computed tomography scout images was more predictive than BMI of wound healing complications.
Study: Joint-calibrated pumps may offer more accurate estimate of surgical site pressure than gravity-equivalent pumps
According to a study published in the January issue of the journal Arthroscopy, joint-calibrated pumps may more closely reflect true surgical site pressure than gravity-equivalent pumps for patients who undergo hip arthroscopy. The authors conducted a prospective, block-randomized study of 37 adult patients treated with arthroscopy for femoroacetabular impingement. They used a spinal needle inserted into the operative field to measure surgical site pressure, and compared displayed pump pressures and surgical site pressures at 30-second intervals for the duration of the procedure. The authors write that either type of pump can be used safely and efficiently, but note that joint-calibrated pumps more closely reflected the true surgical site pressure than gravity-equivalent pumps.
Study: More than one in ten NSAID users may exceed recommended daily limits
Data from a study published online in the journal Pharmacoepidemiology and Drug Safety suggest that many NSAID users exceed the daily recommended limits of such drugs. The research team conducted an online, 1-week diary study of 1,326 ibuprofen users. They found that 90 percent of those surveyed took over-the-counter ibuprofen during the week, and 37 percent also took non-ibuprofen NSAIDs. The researchers found that exceeding the daily limit (EDL) occurred among 11 percent of users for ibuprofen and 4 percent of users for other NSAIDs. Personal characteristics associated with EDL included male sex, ongoing pain, poor physical function, daily smoking, attitudes of “choosing my own dose” and not starting with the lowest dose, and poor knowledge of the recommended 1-time and 24-hour doses.
An article in the Cincinnati Enquirer profiles state efforts to curb opioid addiction. The writer notes that Kentucky was the first state to make its prescription monitoring database mandatory for prescribers, and in 2016 that state saw 301.7 million pain pills prescribed—a reduction of 70 million from 2011 levels. Overall, 16 states require practitioners to check their state’s database before writing an opioid prescription. The American Medical Association Task Force to Reduce Opioid Abuse encourages all physicians to check their state prescription monitoring program prior to prescribing opioids.
AAOS seeks to nominate members to various Patient-Centered Outcomes Research Institute (PCORI) Advisory Panels. Positions are available on the following panels:
Advisory Panel on Clinical Effectiveness and Decision Science
Advisory Panel on Healthcare Delivery and Disparities Research
Advisory Panel on Patient Engagement
Advisory Panel on Clinical Trials
Advisory Panel on Rare Disease
Applicants for these positions must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biography, and a letter of interest highlighting his or her expertise in the subject area and panel of interest. All supporting materials must be submitted to Kyle Trivedi by March 15, 2018, at 11:59 p.m. CT, at:
