ACA Repeal Efforts, Ancillary Services Legislation, CMS Actions Continue
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Latest Republican Efforts on the ACA On April 6, 2017, before Congress left for its spring recess, a new amendment to the American Health Care Act (AHCA) was approved by the House Rules Committee. The amendment was introduced by Reps. Gary Palmer (R-AK) and David Schweikert (R-AZ) and would create a federal “invisible risk sharing program” within the AHCA’s Patient and State Stability Fund (PSSF) program. According to Schweikert, under the amendment, Health and Human Services (HHS) Secretary Dr. Price would establish an “invisible federal high risk sharing program that would offset some of the costs of care for those Americans who have the most expensive, often chronic, medical conditions.” Creating a level of certainty in the health insurance marketplace would immediately, dramatically lower premiums for all Americans, the congressman said.

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New 2017 PSA posters available
 

The Academy recently launched its new public service campaign, on the potential dangers of opioids. This multimedia campaign, includes a display and radio ad, urging doctors and patients to exercise caution in prescribing and taking opioids. The campaign was distributed to hundreds of outdoor media signs and displays and radio stations across the U.S. in an effort to attract attention and awareness of the opioid misuse epidemic. Help us spread the word!

  • We encourage our members to join the conversation by sharing this ad on social media using hashtag #PrescriptionSafety.
  • Order free wall posters for your offices by emailing media@aaos.org
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For more information, visit OrthoInfo.org/PrescriptionSafety
ICYMI: CMS Delays Implementation of Bundled Payment Model On March 21, 2017, the Centers for Medicare & Medicaid Services (CMS) published an interim final rule with comments that delays the Surgical Hip and Femur Fracture Treatment (SHFFT) model from the original implementation date of July 1, 2017 to October 1, 2017. Additionally, CMS is asking for comments to further delay the start date to January 1, 2018. The rule also means that requirements for the Comprehensive Care for Joint Replacement (CJR) model related to becoming an Advanced Alternative Payment Model (APM) will not begin until October 1, 2017. Click here to read more.
Rep. Jackie Speier Introduces IOAS Legislation Reps. Jackie Speier (D-CA) and Dina Titus (D-NV), introduced legislation earlier this month that they say will “close a loophole in Medicare that wastes taxpayer dollars and in some cases harms patients.” H.R. 2066, The Promoting Integrity in Medicare Act (PIMA), would prevent physicians in certain specialties from referring patients to ancillary medical services in which they have an ownership interest and are offered in their offices. AAOS strongly opposes the legislation and believes that the in-office ancillary services (IOAS) exception to the Stark Law is essential to efficiently diagnosing and treating musculoskeletal conditions by allowing orthopaedic surgeons to provide imaging and physical therapy (PT) services in their offices. Congress should oppose any effort to remove the in-office ancillary services exception in the Stark Law. Click here to read more.
Physician-Focused Payment Model Technical Advisory Committee Meets The Physician-Focused Payment Model Technical Advisory Committee (PTAC) this month completed its two-day public meeting to deliberate and vote on three proposals for physician-focused payment models. The full Committee voted to make the following recommendations to the Secretary of the Department of Health and Human Services (HHS):

  • Project Sonar submitted by the Illinois Gastroenterology Group and SonarMD, LLC: recommend for limited-scale testing
  • The COPD and Asthma Monitoring Project (CAMP) submitted by Pulmonary Medicine, Infectious Disease and Critical Care Consultants Medical Group Inc. (PMA): do not recommend
  • The ACS-Brandeis Advanced APM submitted by the American College of Surgeons: recommend for limited scale testing

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State Corner: State Governments, Orthopaedic Societies Respond to Opioid Epidemic State laws with specific-mandates that impact orthopaedic surgeons generally fit within three large buckets: continuing medical education (CME) requirements, querying prescription drug monitoring programs, and quantitative limits to prescriptions. Currently, 15 states have CME requirements for opioid prescribers Though many of these laws vary, with some impacting only pain management clinics, many impact AAOS members. For instance, the New York law requires prescribers who hold a DEA license must take a three hour course on pain management, palliative care and addiction. The New York State Orthopaedic Society has responded to this mandate by creating a webpage at http://www.nyssosorg/education/pmc.html. The information page helps navigate the requirement for orthopaedic surgeons and steers members towards online modules created by the Boston University School of Medicine Safe and Competent Opioid Prescribing Education (SCOPE) and the New York Chapter American College of Physicians. Click here to read more.
What We’re Reading Senior Republicans, Democrats Reach Deal on FDA User Fee Reauthorization, Morning Consult, 4/14/17 Republicans Try To Tame Their Rowdy Town Halls, The Hill, 4/14/17 Trump Administration Makes First Mark on Obamacare with Regulation, Morning Consult, 4/13/17

Trump’s Threat Prompts Democrats to Play Hardball Over Obamacare Payments, Washington Post, 4/13/17 Trump Faces Risky Obamacare Choice, The Hill, 4/13/17 Trump Says Health Care Revamp Still Priority Ahead of Tax Overhaul, The Wall Street Journal, 4/11/17 FDA, Industry Fear Wave of Medical-Device Hacks, The Hill, 4/10/17 Trump Administration to Pay Health Law Subsidies Disputed by House, The New York Times, 4/10/17 GOP Has No Choice But To Keep Pushing Health Care Rock Up The Hill, Kaiser Health News, 4/6/17 Repeal Push Complicates State Efforts to Get Obamacare Waivers, The Hill, 4/6/17 GOP Leaders Add a Carrot to Health Bill, The Wall Street Journal, 4/6/17 Healthcare Executives Eye Improving Access to Outpatient Care in 2017, Modern Healthcare, 4/6/17
CMS Proposes 2018 Payment and Policy Updates The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update 2018 Medicare payment and policies when patients are admitted into hospitals. According to CMS, the proposed rule aims to relieve regulatory burdens for providers; supports the patient-doctor relationship in health care; and promotes transparency, flexibility, and innovation in the delivery of care.

“Through this proposed rule we want to reduce burdens for hospitals so they can focus on providing high quality care for patients,” said CMS Administrator Seema Verma. “Medicare is better able to support the work of dedicated hospitals and clinicians who provide the care that people need with these more flexible and simplified approaches.”

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