Advocacy in Action

2022 Midterm Election and Supported Candidate Recap

The 2022 midterms turned out to be another interesting election, baffling political pundits. The Senate majority still hangs in the balance with 48 Republicans and 48 Democrats. All eyes are on Nevada and Arizona where the races are too close to call, while Georgia will head into a runoff on Dec. 6 between U.S. Senator Raphael Warnock and Herschel Walker. In the House of Representatives, Republicans currently hold 209 seats and need only 218 to take the majority. The AAOS OrthoPAC invested in a number of races and is hovering at a 98% win rate of supported candidates elected to office with 23 races yet to be called. We are excited to welcome OrthoPAC-supported Rich McCormick (R-GA-06) to Congress, who is another physician. Five other races with physician candidates have yet to be called: U.S. Reps. Ami Bera, MD (D-CA-06) and Kim Schrier, MD (D-WA-08); and open seat/challenger candidates Kermit Jones, MD (D-CA-03), Asif Mahmood, MD (D-CA-40) and Yadira Caraveo, MD (D-CO-08). The AAOS Office of Government Relations and OrthoPAC are looking forward to engaging with the new freshman class to advance bipartisan musculoskeletal issues.

AAOS News

AAOS Responds to Questions on MACRA Implementation, Payment Mechanisms
The AAOS recently responded to a request for information from eight bipartisan members of the U.S. House of Representatives on ways to improve implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) and associated payment mechanisms. The law was established in 2016 to incentivize the shift of U.S. healthcare spending and delivery from a fee-for-service model to a value-based care model. In its response, t he AAOS highlighted the need to address the sustainability of the Medicare Physician Fee Schedule, improve qualified clinical data registries, and develop physician-led novel alternative payment models. The request from Congress on improvement ideas comes on the heels of continued conversation about needed Medicare reimbursement reform, while the AAOS is continuing to push for oversight of MACRA implementation in the 118th Congress. Read the letter…

AAOS Backs Amicus Brief in Support of Lawsuit Challenging No Surprises Act Rule
Several physician groups, including the AAOS, are supporting a second lawsuit brought by the Texas Medical Association against the federal departments responsible for implementing the No Surprises Act. In an amicus brief filed recently with a federal court in Texas, the groups warned that the August 2022 final rule on the Qualifying Payment Amount used to resolve unanticipated medical bills creates a de facto out-of-network rate that governs the relationship between health insurers and providers and will greatly diminish patient access to care. A second amicus brief was filed earlier in the year for a separate lawsuit led by the American Medical Association and the American Hospital Association, which was later dismissed. Read more…

Healthcare Policy News

Senators Urging Congress to Mitigate 2023 Physician Medicare Cuts
Forty-six senators have signed a letter to Senate leaders Charles Schumer (D-NY) and Mitch McConnell (R-KY) asking that they address impending cuts to physician reimbursement in Medicare. Without congressional action before years end, physicians will face a cumulative Medicare payment reduction of approximately 8.5% starting January 1, 2023–4.47% stemming from changes to the Medicare Physician Fee Schedule Conversion Factor, and 4% stemming from a budgetary mechanism known as Statutory Pay‐As‐You‐Go. If enacted, these cuts will continue to drive hospital consolidation, limit patient access, and harm physicians’ ability to run their businesses. The AAOS is aggressively advocating for Congress to pass the Supporting Medicare Providers Act of 2022 (H.R.8800) before the end of the year, which would halt the 4.47% cut, and eliminate all impending cuts to physician reimbursement. Read the letter from the senators…

CMS Finalizes 2023 Medicare Payment Changes
The Centers for Medicare & Medicaid Services (CMS) have released the 2023 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) final rules. Key changes to the MPFS include a 4.47% decrease in the conversion factor due to budget neutrality requirements, the temporary extension of telehealth services, and delayed implementation of the split/shared visits policy. In its comments when the changes were being proposed, AAOS strongly urged the agency to apply updates to the evaluation and management component of the global codes to maintain relativity of the Fee Schedule. CMS agreed to examine whether it is still necessary to package postoperative care for all procedures. In the OPPS final rule, CPT code 22632 is removed from the inpatient-only list, and CMS are adding facet joint interventions to the list of outpatient services that require prior authorization, effective July 1, 2023. Learn more from AAOS’ MPFS final rule summary here and the  AAOS OPPS final rule summary here…

CDC Updates Guideline for Prescribing Opioids for Chronic Pain
The Centers for Disease Control and Prevention (CDC) has replaced its 2016 opioid guideline for chronic pain. Published in Morbidity and Mortality Weekly Report, the guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. The guideline addresses four key areas, including initiating opioids for pain, selecting opioids and dosages, deciding duration of initial opioid prescription and conducting follow-up, and assessing risk and potential harms of opioids. “This voluntary clinical practice guideline provides recommendations only and is intended to support, not supplant, clinical judgment and individualized, person-centered decision-making,” the CDC stated. Read the guidelines…

• Medicare Doctor Payment Cuts Spur Calls to Congress for Relief (Bloomberg Law, 11/10)
• Medical groups support No Surprises Act lawsuit (Healthcare Finance, 10/28)