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2021 AAOS Advocacy Wins
Mitigated 2021 and 2022 Medicare Pay Cuts to Specialty Care
Just before the 2020 holiday season, the AAOS Advocacy team was successful in mitigating several planned cuts to Medicare reimbursement for 2021. This advocacy against the devaluing of surgical services, especially during the ongoing COVID-19 pandemic, continued throughout 2021 and most recently helped to delay the 10% payment reductions scheduled for 2022. Specifically, the legislation that was signed into law on December 10 delays the 4 percent PAYGO (Pay As You Go) cut until 2023, delays the 2 percent sequester cut until April 2022 (when it will start at 1 percent before going back up to 2 percent in July), and drops the 3.75 percent Medicare fee schedule cut to 0.75 percent. AAOS appreciates that Congress once again heeded the pleas of the healthcare community by averting most of the cuts through year-end legislation, but will continue to advocate for a long-term solution to Medicare’s broken payment system. Learn more…
Passed Law to Protect Patients from Surprise Medical Bills
Following more than two years of tireless Advocacy, a federal law passed that, for the first time at the national level, removes patients from the middle of unanticipated out-of-network medical bills and contains a process for resolving reimbursement disputes between physicians and insurers. Importantly, the law rejects the benchmark approach favored by insurers and instead includes several AAOS priorities such as the preservation of balance billing. In anticipation of rulemaking to implement the new law for 2022, AAOS re-emphasized its policy priorities to the agencies throughout 2021 and is now pushing back on newly released regulations that go against congressional intent. Learn more…
Convinced CMS to Reverse Elimination of the Inpatient Only List
AAOS succeeded in persuading the Centers for Medicare & Medicaid Services to consider patient safety concerns and reverse its elimination of the inpatient only list. This means that the 266 musculoskeletal procedures that were removed from the list on January 1, 2021 will be reinstated on January 1, 2022. Fortunately though, several procedures that AAOS identified—including reconstruction of ankle and shoulder joints, as well as lumbar spine fusion—will remain off the list and continue to be reimbursable in the outpatient setting. Additionally, the 255 procedures that were added to the ASC Covered Procedures List (CPL) in 2021 will be removed, and a new stakeholder nomination process for adding procedures to the list will begin in March 2022. In line with these policy reversals, CMS is returning to a two-year exemption period from medical review activities related to the 2-midnight rule following the removal of a procedure from the IPO list. Learn more…
Celebrated the Repeal on an Exemption For Insurers
AAOS celebrated enactment of a law that removes an exemption that has unfairly protected health insurance companies from federal competition laws for decades. The Competitive Health Insurance Reform Act amends the outdated McCarran-Ferguson Act of 1945 so that the government is empowered to enforce the full range of antitrust laws against insurers who are engaged in anticompetitive behavior such as collaboration on pricing. Ensuring antitrust laws are applied more broadly has been a long-time initiative of the AAOS. Learn more…
OrthoPAC Strengthened by the Support of AAOS Members
The power and influence of the AAOS Orthopaedic Political Action Committee (also known as OrthoPAC), as a driving vehicle for legislative success, was strengthened thanks to the support of more than 2,500 AAOS member contributors in 2021. As the only federal political program dedicated to representing orthopaedic surgeons and their patients, OrthoPAC played a crucial role in advancing the interests of the musculoskeletal community and engaging influential lawmakers on a host of healthcare policy issues, despite a challenging start to the year due to COVID-19 restrictions and the attack on the U.S. Capitol. These relationships helped AAOS fight significant healthcare policy challenges when members needed it the most. Learn more…
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