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| Ask Your Senators to Support Prior Auth Reform Bill |
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| The Improving Seniors’ Timely Access to Care Act (H.R. 3173/S. 3018) officially has 46 cosponsors in the U.S. Senate. The legislation aims to streamline prior authorization processes within Medicare Advantage plans and passed the U.S. House of Representatives last month, just one day after AAOS members were on Capitol Hill advocating for its passage. Now AAOS and other physician groups are building Senate support with hopes that it will pass before the end of the year.
You can strengthen this advocacy by quickly and easily sending a pre-written letter to your representatives either requesting or thanking them for support! |
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| Reform barriers to timely access to care. |
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AAOS News
AAOS Continuing to Urge Congress to Mitigate 2023 Medicare Pay Cuts
AAOS recently joined a coalition of physicians and other health care professionals in thanking U.S. Representatives Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) for introducing legislation to help mitigate Medicare pay cuts scheduled for 2023. The Supporting Medicare Providers Act of 2022 (of H.R. 8800) would provide a 4.42% positive adjustment to the Medicare conversion factor and is an essential step towards providing physicians with financial stability. In the letter, the coalition emphasized how the drastic cuts would impact patient access to care and emphasized support for a longer-term solution. The AAOS Office of Government Relations is continuing to work with congressional colleagues to ensure that companion legislation is introduced in the Senate before the end of the year and will continue to be a leader in advocating for sensible Medicare payment reform. Read the letter…
AAOS and ASSH Request Coding Changes for Hand Injections
This week, AAOS with the American Society for Surgery of the Hand (ASSH) sent a letter to the Centers for Medicare and Medicaid Services (CMS) regarding issues with the National Correct Coding Initiative (NCCI) program claims edits for injections into the palmar fascial cord. The newest change to the Medical Unlikely Edit (MUE) restricts surgeons’ ability to report more than one injection at the same session. Previous communication with the agency and NCCI indicated that the MUE value would be increased, but the fourth quarter update failed to increase the amount of injections that is reimbursable. AAOS and ASSH are advocating for coding changes to avoid claim denials that surgeons are not able to appeal with the current MUE Adjudication Indicator (MAI) value. Read the full letter… |
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Healthcare Policy News
CMS to Create New, Expedited Pathway for Access to MedTech
The Centers for Medicare and Medicaid Services (CMS) announced this week that a forthcoming proposed rule will aim to create a new, expedited pathway for access to emerging medical technologies for Medicare beneficiaries. The agency outlined four key principles that will guide the rule: 1) device manufacturers may voluntarily participate in the process and it will be limited to devices relevant to the population that Medicare serves; 2) CMS will be permitted to conduct early evidence reviews prior to the device receiving marketing authorization from the Food and Drug Administration (FDA); 3) at the request of the manufacturer, CMS may initiate a coverage review process prior to FDA market authorization, which may subsequently require creating additional evidence development plans and ensuring safeguards for Medicare beneficiaries; and 4) should CMS determine that additional evidence development is the most appropriate coverage pathway, it will explore how to reduce the burden on stakeholders while meeting robust evidence requirements. The proposed rule will be released as an alternative to the Medicare Coverage of Innovative Technologies rule which was finalized by the Trump Administration and later rescinded by the Biden Administration. Read more… |
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OrthoPAC Partners with ASES Foundation to Give Back
The AAOS Orthopaedic PAC (OrthoPAC) recently partnered with the American Shoulder and Elbow Surgeons (ASES) at its annual meeting to offer members a new charity match initiative. Every donation made to OrthoPAC during the meeting was matched with a donation to ASES’s foundation, thereby making twice the difference with the same dollar. The initiative raised more than $7,400 for the foundation and more than $14,000 for OrthoPAC. ASES members who have not already donated are still able to participate in the charity match, which will stay open until Oct. 17, by texting ASES to 41444. Contributions to OrthoPAC help elect and reelect musculoskeletal champions to Congress this November and allows AAOS to be a part of important policy discussions. It looks forward to continuing subspecialty foundation match programs at the upcoming annual meetings for the American Association of Hip and Knee Surgeons and the American Osteopathic Academy of Orthopedics. Learn more about the PAC… |
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