Advocacy in Action

AAOS News

Comments Submitted on Proposed Changes to Interoperability and Prior Authorization
On February 21, AAOS submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its Interoperability and Prior Authorization proposed rule. Plans include establishing a system to decrease physician burden, improve electronic exchange and healthcare data, and advance operations around prior authorization Specifically, AAOS encouraged CMS to reduce prior authorization for routine procedures and services which AAOS members have communicated is a barrier to efficient and effective patient care.  AAOS also highlighted utilizing APIs to enhance the exchange of health information, as well as patient satisfaction and care, but acknowledged that the success of interoperable systems depends on data exchange being secure, useful, and valuable.  Read AAOS’ full comments…

Bill Reintroduced to Repeal Ban on Physician-Owned Hospital Expansion
Senator James Lankford (R-OK), Representative Michael Burgess, MD (R-TX) and colleagues recently reintroduced the Patient Access to Higher Quality Health Care Act, which removes the Affordable Care Act’s ban on the creation and expansion of new physician-owned hospitals and allows them to participate in Medicare and Medicaid. Physician-owned hospitals run efficiently and contribute to both diversity and increased access in the healthcare marketplace. They comprise less than five percent of hospitals nationwide but have a successful track record of providing individualized and innovative quality care. AAOS supported the bill in the 117th Congress and advocated for its passage. Read Senator Lankford’s op-ed on this issue…

Surprise Billing Arbitration Paused after Texas Court Decision
The Centers for Medicare & Medicaid Services are asking parties involved in surprise billing disputes to put payment determinations on hold following a Texas court’s decision last week. The federal judge ruled in favor of the Texas Medical Association and organizations like AAOS supporting the lawsuit, saying that the arbitration process established under the No Surprises Act “continues to place a thumb on the scale” in favor of insurers. Along with pausing new determinations, arbiters should recall any determinations made after Feb. 6 but can continue working through other parts of the dispute resolution process as they wait for further guidance from federal regulators. Read more…

Application Now Open for BPCI-A Extension
This week, the Centers for Medicare & Medicaid Services (CMS) released the application for the Bundled Payments for Care Improvement Advanced (BPCI-A) model extension. Medicare-enrolled physicians, suppliers, and Medicare Accountable Care Organizations (ACOs) can apply to participate in the upcoming two-year extension of the model, which will allow for participation through 2025. The model extension will offer participants modifications and improvements intended to help inform the structure of future bundled payment models. Changes for the BPCI-A extension include greater technical assistance with model requirements and adjustments to the payment methodology. Also new in the extension is the requirement that first-time Convener Participants must be Medicare providers or suppliers, or Medicare ACOs. The deadline for applications to the model extension is May 31, 2023. Attend a webinar to learn more..

PAC Contribution Criteria Updated for 2024 Election Cycle

At the beginning of every election cycle, the Orthopaedic PAC Executive Committee reevaluates its contribution criteria for federal candidates and legislators Recently, it made two changes to its 2023-24 criteria including adding the House Rules Committee to Tier Two and moving the House Small Business Committee from Tier Two to Tier Three. The remaining factors are the same as the 2021-22 cycle. OrthoPAC contributes to candidates based on their character, integrity, and respect for human dignity as supported in the AAOS Code of Ethics and Core Values of Leading to Serve, Shaping our Future, and Excellence Together. Additional factors can be viewed on aaos.org.  Learn more about OrthoPAC’s Criteria for Giving…

• End ObamaCare’s Ban on Physician-Owned Hospitals (Wall Street Journal, 2/20)
• Just a quarter of hospitals fully compliant with price transparency rule: report (The Hill, 2/6)