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Healthcare Policy News
Payment Changes Proposed for the 2024 Medicare Physician Fee Schedule
On July 13, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Physician Fee Schedule (MPFS) proposed rule. Proposed changes include a $32.75 conversion factor, which is a $1.14 decrease from the $33.89 conversion factor for 2023. CMS is also proposing to implement an add-on code G2211 beginning January 1, 2024, but with reduced utilization estimates given concerns raised by AAOS and the subsequent Congressional delay in implementation. Additional noteworthy proposals of the rule include expansion of telehealth services, further delay in implementation of the 2017-based Medicare Economic Index that was finalized in CY 2023, and an indefinite pause in implementation of the Appropriate Use Criteria program for advanced diagnostic imaging services. AAOS will be analyzing the rule and submitting comments. Learn more using CMS’ MPFS factsheet…
Payment Changes Proposed for 2024 Hospital Outpatient and Ambulatory Services
Also on July 13, the Calendar Year (CY) 2024 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule was issued by the Centers for Medicare & Medicaid (CMS). Proposed changes include increasing 2024 payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPDs) and at ASCs to 2.8%. CMS is also proposing to adopt the Risk-Standardized Patient-Reported Outcome-Based Performance Measure (PRO-PM) for elective total hip and knee arthroplasties in the HOPD setting. AAOS is working to summarize the rule and will submit formal comments to the agency on behalf of its members ahead of the deadline. Learn more using CMS’ OPPS/ASC factsheet…
Congress Takes Steps to Reauthorize the Pandemic & All-Hazards Preparedness Act
Last week, the House Energy and Commerce Health Subcommittee held a markup to discuss reauthorizing the Pandemic and All-Hazards Preparedness Act (PAHPA) which expires on September 30. The subcommittee voted along party lines and is advancing the bill to the full Energy and Commerce Committee for markup on July 19. The Senate Health, Education, Labor, and Pensions (HELP) Committee held a markup the bill today. The AAOS submitted comments in March regarding considerations for hospital preparedness and enhancing situational awareness for any future health emergencies, and will be monitoring developments throughout the ongoing reauthorization process. Watch the House E&C hearing…
CMS Innovation Center Releases Episode-Based Payment Model RFI
On July 14, the Center for Medicare & Medicaid Innovation released a request for information (RFI) to gather feedback regarding the design of a new episode-based payment model that seeks to improve beneficiary care while lowering Medicare expenditures and increasing care coordination across healthcare settings. The agency wants to create a pathway for specialists to participate in population-based Medicare Accountable Care Organizations and is especially interested in feedback from participants of previous models such as the Comprehensive Care for Joint Replacement and the Bundled Payment for Care Improvement Classic and Advanced models. The RFI contains a broad range of questions that fall into six foundational components: 1. clinical episodes; 2. participants; 3. health equity; 4. quality measures, interoperability, and multi-payer alignment; 5. payment methodology; and 6. structure model overlap. AAOS will be commenting on the RFI ahead of the August 17 deadline. View the official RFI… |
