Advocacy in Action

AAOS Advocacy in Action

Submitted comments to the regulatory agencies on Part I of the surprise billing rules issued to address implementation of the No Surprises Act.

Action Alert: Protect Access to Specialty Care

Orthopaedic surgeons, along with much of the physician community, are facing imminent cuts to Medicare payment. These cuts, when combined, will amount to an up to 10% reduction and would be significantly damaging to physician practices and access to patient care. The impact of these cuts was mitigated in 2021 thanks to Congress authorizing relief funds, but that congressional relief is set to expire at the end of the year. Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) are working to avert the cuts for 2022 by asking their colleagues, via a congressional sign-on letter, to extend the 3.75% payment adjustment.

Please join AAOS in urging your congressional representatives to sign onto the Bera-Bucshon letter!

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AAOS News

Comments Submitted on Surprise Billing Rule: Part 1

Last week, the AAOS submitted formal comments to the Departments of Health and Human Services, Treasury, and Labor on the No Surprises Act Part I Interim Final Rule. While the rule touches upon many directives of the No Surprises Act, which was passed into law in late 2020, including processes for preventing unexpected out-of-network bills for emergent and scheduled care, the mechanics of the Independent Dispute Resolution (IDR) process will be addressed in a forthcoming Part II rule from the agencies. This first rule comes after more than two years of AAOS advocacy to remove patients from the middle of out-of-network billing disputes and ensure that physicians can access an IDR process for resolving payment disputes as opposed to using a federal rate-setting benchmark. In its comments to the agencies, AAOS stressed the importance of holding patients harmless for true ‘surprise’ bills while also ensuring that physicians are privy to a transparent, fair method for determining the Qualifying Payment Amount that insurers will use in their initial payment offer prior to entering an arbitration process. Read AAOS’ full comment letter…

Nominations Open for 2021 Congressional Bipartisanship Award

All AAOS Fellows are eligible to nominate individuals for the 2021 Congressional Bipartisanship Award before the Friday, September 17 deadline. The award was created by AAOS to honor Members of Congress who consistently work in a bipartisan manner to positively advance policy related to musculoskeletal care. Criteria for award consideration include that the nominee embody the five principles of bipartisanship: 1) demonstrates strong ability to compromise and collaborate with those in the opposing political party, 2) has worked across the aisle on issues related to musculoskeletal physicians, patients and care, 3) embodies the qualities and characteristics of bipartisan cooperation and comradery, 4) puts the duty of their office above partisan politics, and 5) is a leader in working productively with all viewpoints, parties, and policy positions to advance healthcare policy. To nominate a member of Congress for the award, simply submit a form then nominees will be confirmed shortly thereafter. Nominate a member of Congress…

Healthcare Policy News

Congressional Committees Begin Revealing Details of $3.5 Trillion Package

Congressional committees in United States House of Representatives and Senate are busy drafting language for the soon-to-be-revealed $3.5 trillion reconciliation bill. Earlier this week, the House Ways & Means Committee released some of its language relating to paid family and medical leave, retirement, childcare access and equity, health profession opportunity grants, and legislative recommendations relating to Medicare. Today, the House Energy & Commerce Committee released language relating to prescription drug pricing, the Medicaid coverage gap, the Affordable Care Act reinsurance program, and the Children’s Health Insurance Program. The main Medicare proposal intends to expand the program to include dental, hearing, and vision services. It is important to note that Democrats in the House of Representatives are aiming at a “two-track” plan to pass this $3.5 trillion reconciliation bill, which currently has only Democratic support, and the Bipartisan Infrastructure Framework, which has bipartisan support, at the same time and by September 27. The Senate has already passed the Bipartisan Infrastructure Framework and plans to vote on the reconciliation bill before that time. Read more about the package…

Report Finds Medicare Hospital Fund Is Still Projected to Become Insolvent by 2026

Medicare’s Boards of Trustees released their annual report to Congress on August 31 and offered a similar forecast for the Medicare Hospital Fund’s financial status as the 2020 report, which estimated the fund to become insolvent by 2026. The report found that Medicare spent $925.8 billion in 2020 and served 62.6 million people. Additionally, the COVID-19 pandemic had a major impact on the short-term financing for the program but is not expected to significantly impact the fund’s financial status after 2024. For example, payments for inpatient admissions related to COVID-19 increased by 20% while spending for non-COVID-19 care declined dramatically due in part to the postponement of elective procedures. The Social Security Trust Fund is anticipated to deplete by 2034, one year earlier than estimated in last years’ report. Read more about the report…

State News

Health Policy Action Fund Grants Approved for State Advocacy Efforts

In its first in-person meeting since 2019, the AAOS Board of Councilors Committee on State Legislative and Regulatory Issues met last week during the AAOS 2021 Annual Meeting to consider applications for the State Orthopaedic Society Health Policy Action Fund. AAOS established the fund to assist state orthopaedic societies in responding to various legal, legislative and regulatory issues affecting the practice of orthopaedics and patient care on the state-level. From prior authorization reform to efforts to preserve physician-led, team-based care, applications spanned a diverse set of important issues impacting surgeons and the patients they serve. In total, the committee approved requests from eight state orthopaedic societies consistent with the 2021 AAOS United Advocacy Agenda – collectively totaling $60,000 that will go directly to supporting state advocacy efforts. The next application cycle for state orthopaedic societies interested in seeking financial assistance will be in March 2022.

OrthoPAC Corner

Maxwell Courtney, MD, Joins Orthopaedic PAC Executive Committee

The Orthopaedic PAC and the Advisor’s Circle are pleased to announce the newest At-Large Member of the OrthoPAC Executive Committee: Maxwell Courtney, MD, of the Rothman Institute. Dr. Courtney brings to the table a strong background in advocacy, having completed a Health Policy Fellowship with AAHKS, and serving as the current Vice Chair of the AAHKS Advocacy Committee and Chair of the Rothman Institute PAC, both of which have worked very closely with AAOS in developing relationships with members of Congress. He also serves on the CMS Hospital Outpatient Payment Advisory Panel and has helped voice orthopaedic concerns on outpatient reimbursement and the inpatient-only list. The Orthopaedic PAC Advisor’s Circle offers orthopaedic group practices and subspecialties affiliated with AAOS members the ability to bring their particular expertise to the political process and help drive the advocacy agenda of the American Association of Orthopaedic Surgeons. Learn more about the Advisor’s Circle…