CMS Alters MACRA Rules to Add Advanced Alternative Payment Models (APMs)
For questions or concerns on these or other advocacy issues, contact the Office of Government Relations at dc@aaos.org.
 
AAOS Comments on CMS Proposed Rule for Physician Reimbursement On July 25, 2016, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) released a new proposed rule which supplements the recent proposed Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rule (read more in Advocacy Now online here). The proposed rule includes new cardiac care bundled payment models and incentives to increase cardiac rehabilitation usage, but also alters the Comprehensive Care for Joint Replacement (CJR) bundled payment model to remove hip fracture procedures and creates new pathways for CJR and additional models to qualify as Advanced Alternative Payment Models (APMs). Click here to read more.
Cycling safety tips for your patients

Cycling is a pastime that people of every age can enjoy, but without taking proper precaution, can lead to fractures, muscle strains and sprains.  Help your patients reduce their risk for injury and enjoy the bone building benefits of cycling with these safety tips.

  • Remind them to stay safe by directing them to the bicycle safety page at OrthoInfo.org/bikesafety.
  • Order the new bike safety PSA posters or postcards for your office wait room in the “Store” at aaos.org. Once you click on the red “Store” tab, in the upper right hand corner of the home page, simply type in “riders” to order the posters and postcards.
  • Link to the AAOS Bicycle Safety page on your practice website and social media pages, along with the tagline @AAOS and #bikesafety.
  • Write a letter to your local newspaper on bike safety, especially if you can include a personal anecdote on an incident you witnessed, or if you’re seeing an increase in fractures and other bike-related injuries. A sample letter to the editor is available in the AAOS newsroom at: newsroom.aaos.org/member-resources.

If you’re riding, set a good example by wearing a helmet and following the rules of the road. And when driving, walking or running, remember that the bicyclist sharing the road or sidewalk with us has more than 200 bones, and as orthopaedic surgeons, we’re committed to keeping all of them safe and in one piece.
Please Take the Global Surgery Payment Survey Today! On July 15, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a unilateral decision to implement a new sweeping mandate to collect data about global surgery services (read more in Advocacy Now online here). According to the proposal (pp. 46192-46200), beginning just five months from now on Jan. 1, 2017, surgeons providing 10- and 90-day global surgery services to Medicare patients will be required to report a whole new set of codes to document the type, level and number of pre- and post-operative visits furnished during the global period for every global surgery procedure provided to Medicare beneficiaries. Under this system, surgeons would be required to use a new set of G-codes to report on each 10-minute increment of services provided. Click here to read more.
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What We’re ReadingZika Spending Stalemate in Congress Spills Over Into Campaigns, Roll Call, 8/15/16

Few Docs Ready for Risk Under MACRA, Modern Healthcare, 8/13/16

Medicare Changes Fiercly Resisted, The Hill, 8/12/16

Cardiac Bundled-Payment Program Will Likely Penalize High-Spending Hospitals, Modern Healthcare, 8/12/16

CMS Suggests New Obamacare Exchange Rule is Coming, Morning Consult, 8/11/16

More Tweaks Coming for Value-Based Medicare Advantage Project, Modern Healthcare, 8/11/16

Should Big Insurance Become Like Walmart To Lower Health Costs? Kaiser Health News, 8/11/16

How a Clinton Adminsitration Would Reshape Healthcare Wars, Washington Examiner, 8/10/16

AMA Piloting Program With 2 States Aimed at Reversing Opioid Crisis, Morning Consult, 8/10/16

Vexing Question on Patient Surveys: Did We Ease Your Pain? The New York Times, 8/4/16
Senate Discusses Stark LawThe Senate Finance Committee recently held a hearing on July 12, 2016 entitled “Why Stark, Why Now? Suggestions to Improve the Stark Law and Encourage Innovation Payment Models.”Though there are numerous political distractions this summer in Washington, DC, the hearing demonstrates the importance of the Stark Law issue with members of Congress. The hearing was called by Chairman Orrin Hatch (R-UT) to again take a look at the entirety of the Stark law and the complexities of what it has entailed over 25 years. The bulk of the hearing focused on the larger issues associated with the law, particularly ways it might be unintentionally impeding the development of value-based health care models that call for greater integration of services.  Chairman Hatch reiterated that the law was designed in an era when fee-for-service was Medicare’s primary payment model while now, as providers are moving towards alternative payment models, the law presents some practical and some outdated barriers in need of updating.

“The strict liability regime, huge penalties, and the breadth, complexity, and ambiguities of the Stark law and its regulations have created what is often referred to as a minefield for the health care industry,” wrote a recent Senate report.

Click here to read more.
An Expanded Definition of Women’s HealthKimberly Templeton, MD, past vice-chair of the Women Physician Section and current American Medical Association (AMA) Orthopaedic Section Council Chair wrote, introduced, and championed a resolution for the 2015 AMA annual meeting that has ultimately resulted in the AMA’s new policy that recognizes an expanded definition of women’s health. With the support of the AAOS delegation, the resolution was referred for further study last year. The resulting report – adopted by the AMA during the annual meeting in 2016 – outlines the role that sex and gender play in health and supports application of evidence-based information to practice. As an orthopaedic surgeon, Dr. Templeton ensured the importance of sex and gender in musculoskeletal diseases were highlighted in the policy. Click here to read more.
Election 2016 Graphic of the Week Click here to dowload graphic.
Two-Midnight Rule Update On August 2, 2016, the Centers for Medicare and Medicaid Services (CMS) published a final rule that eliminates the agency’s two-midnight policy, which cut Medicare inpatient reimbursements. The policy has been the subject of a number of legal challenges and continued industry criticism, including a September 2015 ruling by U.S. District Court Judge Randolph Moss that set the wheels in motion for modification of the rule. Judge Moss sided with the American Hospital Association (AHA) in Shands Jacksonville Medical Center v. Burwell and agreed that the payment reduction was put forward without adequate notice and a limited amount of time for meaningful comment. As an AHA statement explained, the new finalized rule “is a mixed bag for hospitals and the patients they serve. On the one hand, we are pleased CMS reversed the effects of the 0.2 percent payment reduction that was part of the original ‘two-midnight’ policy, and restored the resources that hospitals are lawfully due.” Click here to read more.