Advocacy in Action

• Prior authorization reform
• Payment policy changes
• Safety from workplace violence
• Scope of practice

AAOS News

Prior Authorization Legislation to Receive Committee Vote Next Week

The AAOS-endorsed Improving Seniors’ Timely Access to Care Act (H.R. 3173/S. 3018) will be voted on next week in the U.S. House of Representatives Ways and Means Committee, signifying the most impactful movement prior authorization reform has seen in years. The legislation would improve the burdensome prior authorization process within Medicare Advantage by making the process electronic and transparent. The AAOS Office of Government Relations has been a long-time advocate for this legislation and featured the bill during both Orthopaedic Advocacy Week and the National Orthopaedic Leadership Conference in 2021, which resulted in an additional 85 congressional cosponsors. Support for the legislation reached a peak earlier this year when a report from the Office of Inspector General found that 85,000 prior authorization requests were inappropriately denied by Medicare Advantage plans in 2019 alone. More on AAOS advocacy for prior authorization reform…

AAOS Seeking Volunteers for Open Advocacy Council and Committee Positions
Several positions under the AAOS Advocacy Council are open for application through August 1 (see list below). Members who have an interest in contributing to the mission and vision of AAOS are encouraged to visit www.aaos.org/cap to view and apply (member username and password required).

• Advocacy Council – Chair position
• Coding, Coverage and Reimbursement Committee – Member position
• Health Care Systems Committee – Section Leader position – Practice and Payment
• Health Care Systems Committee – Member positions
• Medical Liability Committee – Member positions
• Political Action Committee of the AAOS – Resident position
• Political Action Committee of the AAOS – Chair position

Volunteers should keep in mind that the Committee Appointment Program is designed so interested members can view only positions for which their membership category is eligible to apply. Learn more and apply…

Healthcare Policy News

Payment Changes Proposed for the 2023 Medicare Physician Fee Schedule
On July 7, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2023 Medicare Physician Fee Schedule (PFS) proposed rule. Proposed changes include a $33.08 conversion factor, which is a $1.53 decrease from the $34.61 conversion factor for 2022. This change and other statutory cuts to physician reimbursement are not sustainable, and AAOS has been advocating for an overhaul of the Medicare physician fee schedule system. CMS is also proposing to expand dental and behavioral health coverage and to update value-based care design in the Medicare program. AAOS will be analyzing the rule, evaluating the impact of proposed changes on musculoskeletal care, and then submitting formal comments to the agency on behalf of members by the September 6 deadline for public comment. Read the AAOS Executive Summary…

Payment Changes Proposed for 2023 Hospital Outpatient and Ambulatory Services
On July 15, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2023 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. CMS is proposing to update both the OPPS and ASC payment rates by 2.7%. These updates are based on the projected hospital market basket percentage increase of 3.1% (reduced by 0.4 percentage point for the productivity adjustment). The agency is also proposing to remove codes 22632 (Arthrodesis, posterior interbody, each additional) as well as code 228XX (Total disc arthroplasty anterior approach second interspace lumbar) from the Inpatient Only list for CY 2023. In addition to proposing payment rates for hospital outpatient and ASC services, the rule includes proposals for advancing health equity in rural areas, promoting competition in the health care system, and prior authorization of an additional service category (facet joint injections and nerve destruction). AAOS will continue to review and submit comments on the proposed changes by September 13. Read the CMS fact sheet…

Democrats Eyeing Healthcare-Focused Reconciliation Bill
As congressional Democrats try to pass a large reconciliation bill, U.S. Sen. Joe Manchin (D-WV) announced that he will only support two provisions: lowering the cost of prescription drugs and extending enhanced Affordable Care Act (ACA) subsidies. Democrats need the support of their entire caucus to pass the package via the budget reconciliation process, which allows legislation to pass in the Senate by simple majority rather than the traditional 60-vote threshold. President Biden has endorsed Democrats moving ahead on the drug pricing and ACA provisions, and Senate Majority Leader Chuck Schumer (D-NY) has said he wants to pass the reconciliation bill by early August. Democrats are currently working with the Senate Parliamentarian to ensure the drug pricing measure complies with the rules of budget reconciliation (only policies that change spending or revenues can be included). September 30 is the hard deadline for Democrats to use the reconciliation process Read more about the bill…

Charity Match, Sweepstakes Being Offered During Orthopaedic Advocacy Week

The countdown is on for the 2022 OrthoPAC Day of Giving on Friday, August 5, as part of the AAOS Orthopaedic Advocacy Week. This year, we are thrilled to announce a new PAC Charity Match benefit. From July 7-August 7, OrthoPAC will match your OrthoPAC contribution to a registered 501c3 of your choice, allowing you to make twice the difference with the same dollar. We will be allocating up to $100,000 for this year’s event. Top three charities thus far: the World Wildlife Fund, RePlay, and the American Osteopathic Academy of Orthopedics Foundation Inc. Add your charity to the list today! Additionally, we will once again be running a Winner’s Choice Sweepstakes. All 2022 contributors will be entered to win (retroactive from Jan. 1, 2022). If you haven’t already done so, we encourage you to get invested with the OrthoPAC and help us amplify our advocacy efforts. Text SWEEPS or PACMATCH to 41444 to donate…

·        Surgeon general: Why fighting burnout is our “moral obligation” (AMA, 7/12)

·        AAOS Advocacy Podcast Spotlights Trends and Regulatory Response to Practice Consolidation in Healthcare (AAOS Now, July)