AAOS Advocacy Now

AAOS Continuing to Urge Congress to Address Pay Cuts in Year-End Package
As an end-of-year spending package comes together in Congress, the entire physician community is scheduled to face a nearly 4.5% Medicare payment reduction starting January 1, 2023, as a result of a recently finalized regulatory rule (see AAOS rule summary). The cut is compounded by the fact that physicians are the only group whose reimbursement is not adjusted for inflation. The Medicare payment system is simply not sustainable and continues to generate significant instability for physicians moving forward, threatening patients’ timely access to essential health care services. Lat month, AAOS and a group of subspecialty organizations sent a letter urging Congress to mitigate the impending Medicare payment cut before the end of the year. Right now, members of the U.S. House of Representatives are signing onto multiple letters asking congressional leadership to stop the entire 4.5% cut. AAOS representatives are encouraging rank and file members to sign onto these letters and telling congressional leadership to #stopthefullcut. Support this advocacy effort..

Healthcare Policy News

MedPAC and CMS Advocating to Increase Physician Pay
Both the Centers for Medicare & Medicaid Services (CMS) and MedPAC are strongly encouraging Congress to address and tackle the looming physician pay cuts, by recommending that Congress increase physician payment rates beginning in 2023. According to CMS, physicians are facing a slew of pay cuts next year, including the 4.5% conversion factor cut under the 2023 physician fee schedule, clinical labor policy cuts, as well as several other priorities that need to be addressed. At its December meeting, MedPAC took the unusual step of endorsing several recommendations to increase physician pay in 2024. Some recommendations include that Congress increase Medicare payments to hospitals by 1%, give an extra increase to safety-net hospitals, and increase pay for providers caring for low-income traditional Medicare patients. MedPAC is set to vote on these recommendations in January and will submit the official recommendation to Congress in March.  Read more…

CMS Proposes Rule to Improve Prior Authorization Process
On December 6, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to streamline the prior authorization process for Medicare Advantage, Medicaid, and CHIP plans by encouraging payers and providers to adopt a transparent, electronic prior authorization platform. The proposed rule closely mirrors the AAOS-supported prior authorization legislation,  called the Improving Seniors’ Timely Access to Care Act of 2022, which passed the US. House of Representatives in September. If finalized, the rule will require payers to improve the transmission of prior authorization-related health data through Application Programming Interface for providers and patients By making this process electronic, patients and their providers will be able to track the status of their request. Additionally the rule would require payers to disclose a specific reason when they deny a request and respond to non-urgent requests with seven calendar days or 72 hours for urgent requests. The AAOS is reviewing the proposed rule and will submit formal comments to CMS ahead of the March deadline. Read more about the proposed rule…

Last Chance for 2022 State Participation Challenge

Has your state reached 20% participation in the OrthoPAC for 2022? Check the map below to see how your state stacks up to others. With just over two weeks left in the year, OrthoPAC needs your help to ensure it has the funds to secure valuable facetime with members of Congress. Medicare payment cuts are on the horizon, and OrthoPAC is playing a critical role in fending them off by obtaining congressional relief. In addition to fighting these healthcare policy battles, the OrthoPAC needs to refill its reserves for building relationships  with the 84 freshman members of the 118th Congress. Help push your state over the 20% threshold by donating to OrthoPAC today. Text ‘AAOS’ to ‘41444’ or visit the webpage…

• Gold Card Legislation Can Aid in Prior Authorization Reform (AAOS Now, November)
• Variability in Medicare direct contracting savings illustrates promises, pitfalls of value-based care (Healthcare Dive, 12/12)