September 18, 2017

Today’s Top Story
HHS activates disaster program to assist providers with Irma patients.
The U.S. Department of Health and Human Services (HHS) has activated the National Disaster Medical System Definitive Care Reimbursement Program to help hospitals and medical facilities providing care to people affected by Hurricane Irma. Under the program, HHS reimburses medical facilities and hospitals for care provided to people who became injured or ill as a result of natural disasters, if medical care is no longer available in their local area after the disaster. Covered services include medically necessary hospital care, which can extend beyond the typical 30-day stay, as well as home care, rehabilitation, physical therapy, and primary care.
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Other News

CMS payment update will increase reimbursement for TAA.
An article in HealthLeaders Media notes that a recently released update to the Inpatient Prospective Payment System by the U.S. Centers for Medicare & Medicaid Services (CMS) will in FY 2018 increase the reimbursement bundle for primary total ankle arthroplasty (TAA) procedures, by moving these procedures from the lower-paying Medicare Severity Diagnostic Related Group (MS-DRG) 470 to MS-DRG 469.
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Read the update (PDF)…
The American Association of Orthopaedic Surgeons (AAOS) advocated for this change.
Read more in AAOS Advocacy Now

Study: Higher BMI can result in worse perioperative outcomes and higher costs in ASD surgery.
Data from an online study published in the journal Spine suggest higher body mass index (BMI) may negatively affect perioperative outcomes and cost for patients who undergo adult spinal deformity (ASD) surgery. The researchers conducted a retrospective study of 244 patients undergoing spinal arthrodesis, who were categorized by BMI groups: nonobese (BMI <30), class I obesity (BMI 30-34.99), or class II/III obesity (BMI ≥35). They used multivariate logistical regression to determine odds of prolonged intensive care unit (ICU) stay (>2 days), prolonged total length of hospital stay (LOS) (>1 week), and high-stay costs (>$80,000), among other factors. Compared with nonobese patients, they found that patients with class I obesity were at increased risk of prolonged ICU stay, while patients with class II/III obesity had greater odds of prolonged total LOS and high-stay costs.
Read the abstract…

CMS to host provider call on 2018 PQRS payment penalties.
An upcoming CMS provider call will discuss Physician Quality Reporting System (PQRS) penalties, PQRS feedback reports, and the informal review process for program year 2016 results and 2018 payment adjustment determinations. Although 2016 was the last program year for PQRS, some providers may see a penalty in 2018 if they did not meet 2016 PQRS quality data reporting deadlines. The call is scheduled for Tuesday, Sept. 26, 2017, from 1:30 p.m. to 3 p.m. ET.
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Register for the call…

Do insurance company approvals impact the opioid epidemic?
An article from ProPublica and The New York Times suggests that insurer approval policies may play a role in the opioid epidemic. The writers state that a number of health insurance companies have limited patient access to pain medications that may carry a lower risk of addition or dependence, while encouraging the use of cheaper generic opioid medications. The publications analyzed Medicare prescription drug plans covering 35.7 million people in the second quarter of 2017 and found only one-third of the people covered had access to a painkilling skin patch containing a less risky opioid. Patients were required to obtain prior approval for the nonaddictive but more expensive patches, while almost every plan covered common opioids and very few required any prior approval.
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FDA considering revamp of compounding pharmacy rules to increase participation in oversight program.
Reuters reports that the U.S. Food and Drug Administration (FDA) is working on a new policy to encourage more compounding pharmacies to register under a law enacted in the wake of a 2012 meningitis outbreak linked to 76 deaths. In 2013, the Congress passed the Drug Quality and Security Act, which created a category of “outsourcing facilities” that could register with FDA, allowing them to sell products in bulk to hospitals and physician practices without requiring individual prescriptions, in exchange for following federal manufacturing standards and subjecting themselves to routine inspections. Only about 70 firms out of an estimated 7,500 compounders have registered. To increase participation, FDA plans to release draft guidance on gradation of enforcement priorities based on the size of registered compounders and the riskiness of their products.
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Last call: United States Pharmacopeia Opioid Roundtable.
AAOS seeks to nominate members to the United States Pharmacopeia (USP) Opioid Roundtable. USP is a nonprofit, standard-setting organization that strives to improve global health through public standards and related programs that help ensure the quality, safety, and benefit of medicines and foods. The organization is creating an opioid roundtable to support mitigation of the opioid epidemic. Applicants for this position 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 and a current curriculum vitae. All supporting materials must be submitted to Kyle Trivedi by Sept. 20, 2017, at 11:59 p.m. CT, at trivedi@aaos.org.
Learn more and submit your application…(member login required)

 

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