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Healthcare Policy News
Legislation Introduced to Reform Prior Authorization
On May 13, champions in the U.S. House of Representatives introduced legislation that would streamline and add transparency to the prior authorization process under the Medicare Advantage program. The Improving Seniors’ Timely Access to Care Act was introduced by Reps. Ami Bera, MD (D-CA), Suzan DelBene (D-WA), Larry Bucshon, MD (R-IN), Mike Kelly (R-PA), and has 88 additional original cosponsors. Similar legislation gained immense support during the 116th Congress with 280 congressional supporters and the endorsement of more than 400 organizations. The AAOS will continue to make reforming these burdensome processes a top priority and is advocating for passage of the new legislation as part of the upcoming Orthopaedic Advocacy Week. Read the press release…
Changes Finalized for CJR, Joint Replacement Medicare Model
The Centers for Medicare & Medicaid Services (CMS) recently released the much-anticipated final rule which makes changes to the Comprehensive Care for Joint Replacement (CJR) Model. The agency extended the model an additional three performance years through December 31, 2024, but excluded v oluntary participants from the change. It also modified the episode definition to include outpatient lower extremity joint replacement trigger procedures and made several modifications to the target price calculation and reconciliation process. Improvements to the program include elimination of the 50 percent cap on gainsharing payments, distribution payments, and downstream distribution payments when the recipient of these payments is a physician. CMS will also now count beneficiary age, dual-eligibility status, and CMS-Hierarchical Condition Category as episode-level risk adjustment factors and changed the reduction to the discount factor for good quality performance to 1.5 percent and to 3 percent for participants with excellent quality scores. Read AAOS’ summary of the final rule…
House Bill Introduced to Protect Physicians During the Pandemic
This week, the Coronavirus Provider Protection Act was introduced in the U.S. House of Representatives by Reps. Lou Correa (D-CA) and Michael Burgess, MD (R-TX). The bipartisan legislation, which AAOS supports and previously backed in the 116th Congress, would provide limited liability protections for health care responders and facilities who face litigation related to services offered during the COVID-19 public health emergency period or within 60 days of its termination. The services must also be within scope of licensure/certification and provided in good faith. The AAOS has signed onto a letter of support for this key legislation and will continue to promote these common-sense, limited protections in its advocacy efforts. Learn more about the new bill…
HHS Confirmations Continue with New Deputy Secretary
On Tuesday, the Senate confirmed Andrea Palm as Deputy Secretary of the U.S. Department of Health and Human Services (HHS). Prior to her confirmation, Palm was the leader of Wisconsin’s Department of Health Services as well as chief of staff at HHS during the Obama Administration. Though Palm’s confirmation hearing received bipartisan support in April, the vote itself was delayed several weeks before she was ultimately confirmed by a 61-37 majority. In her new role, Deputy Secretary Palm will oversee the management of the department including the approval of rules coming out of the agency. However, the Senate has yet to bring a floor vote on the confirmation of Chiquita Brooks-LaSure for Administrator of the Centers for Medicare & Medicaid Services (CMS). While her confirmation hearing was largely uneventful, the recent recall of Texas’ Medicaid expansion waiver approved by the Trump Administration has all but brought the CMS confirmation to a halt. Yet other key positions including Food and Drug Administration Commissioner and Director of the White House Office of Management and Budget are still awaiting nominees. Read more about Palm… |
