Draft Physician Fee Schedule Released, Stark Modernization Discussed, Update on Lower Extremity Advocacy

On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) issued the Medicare Physician Fee Schedule (PFS) Proposed Rule 2019 that includes proposals to update payment policies as well as the provisions of the Quality Payment Program. These updates, if finalized, will come into effect on or after January 1, 2019. AAOS will circulate a summary of the rule and will comment before the deadline of September 10, 2018.

On July 12, 2018, AAOS and AAHKS met with Mr. Adam Boehler, the new Director of the Center for Medicare and Medicaid Innovation (CMMI or the Innovation Center) and CMS Deputy Administrator for Innovation and Quality. This meeting was held at the US Department of Health and Human Services headquarters in Washington, DC. The objective of this meeting was to introduce ourselves to Mr. Boehler and discuss our ongoing concerns with the CMMI payment models including the Bundled Payment for Care Improvement (BPCI) Classic and Advanced models, the Comprehensive Care for Joint Replacement (CJR) model and other related CMS policy. AAOS invited AAHKS to join the meeting since the two organizations have jointly met with CMS in the past and have common concerns and issues. AAOS was led by First Vice-President, Dr. Kristy Weber, and by AAHKS Advocacy Chair, Dr. James Huddleston III.

Late Wednesday night House appropriators voted along party lines to approve a $177.1 billion Labor-HHS- Education spending bill for fiscal 2019. The House Appropriation Committee’s 30-22 vote ended a marathon 1-hour markup that touched on a range of contentious issues including the Affordable Care Act and immigration.

AAOS successfully requested the committee insert report language that clarifies that the Centers for Medicare and Medicaid Innovation (CMMI) may use their funds to support the development and utilization of Qualified Clinical Data Registries (QCDRs) as part of the Innovation Center’s purpose of testing innovative payment and service delivery models.

On Tuesday July 17th, the House Ways and Means Health Subcommittee held a hearing on reforming the Stark Law entitled “Modernizing the Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program”.

The Physician Self-Referral Law, commonly known as the Stark Law, was put in place during the 1980s to protect against inappropriate referrals and waste. The members of Congress and witnesses both recognized the important function the law has served in the fee-for-service context but spoke to the need for reform to support the transition to value based systems.

The American Association of Orthopaedic Surgeons (AAOS), the American Orthopaedic Foot and Ankle Society (AOFAS), and state orthopaedic societies in 2018 continued to advocate that all patients should have access to high quality, comprehensive musculoskeletal care by providers who have met and completed uniform standards for education, licensure, training and certification at state legislatures.

On July 13th, the U.S. Food and Drug Administration announced the agency had approved TPOXX (tecovirimat) the first drug with an indication for the treatment of smallpox. While the World Health Organization declared smallpox eradicated in 1980, there have been long-standing concerns that smallpox could be used as a bioweapon.

FDA Commissioner Scott Gottlieb, MD made the announcement, stating “This is the first product to be awarded a Material Threat Medical Countermeasure priority review voucher. This new treatment affords us an additional option should smallpox ever be used as a bioweapon and ensures that the United States is prepared for any public health emergency with timely, safe and effective medical products.”

On July 11, AAOS Advocacy Resources Committee (ARC) Chair Claudette Lajam, MD and other advocacy leaders held a webinar on in-district congressional advocacy. The webinar covered proven strategies that will help you be an effective advocate at home, without having to travel to DC.  If you weren’t able to make the webinar it’s not too late to learn from these experts, you can view the webinar replay here.

The Orthopaedic PAC recently had a presence at both the American Orthopaedic Society for Sports Medicine (AOSSM) and the American Orthopaedic Foot and Ankle Society (AOFAS) Annual Meetings in San Diego and Boston, respectively. These meetings were great opportunities to educate attendees about the great work that the Orthopaedic PAC, the only federal political action committee solely dedicated to our specialty in Washington, DC, is doing for all orthopaedic surgeons. We are pleased to be offering value to the specialties and are excited to continue to partner with them to advocate on behalf of the house of orthopaedics. If you have any questions about our specialty society partnerships or are interested in having an OrthoPAC presence at your specialty society meeting, don’t hesitate to reach out to pac@aaos.org.