Advocacy in Action

AAOS News

AAOS Urging Congress to Repeal Ban on Physician-Owned Hospital Expansion
The AAOS recently wrote a letter to Senator James Lankford (R-OK), Representative Michael Burgess, MD (R-TX) and colleagues in support of their newly introduced Patient Access to Higher Quality Health Care Act (H.R. 977/S. 470). The legislation, which AAOS also supported in the 117th Congress, removes the Affordable Care Act’s controversial ban on the creation and expansion of new physician-owned hospitals and allows them to participate in Medicare and Medicaid programs. In the letter, AAOS noted that 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 higher quality care. AAOS is urging Congress to put patients first and pass the new bill.  Read the full letter of support…

AAOS Supporting Bill That Would Tie Physician Pay to Inflation-based Index
A bipartisan coalition of doctors in Congress recently introduced the Strengthening Medicare for Patients and Providers Act (HR. 2474). The bill follows the recent recommendation of the independent Medicare Payment Advisory Commission and would change the physician payment rate above the current law by providing an annual Medicare physician payment update tied to inflation, as measured by the Medicare Economic Index (MEI) Healthcare organizations, including AAOS, view the move as a critical first step toward reforming Medicare to address payment uncertainty affecting participating physicians and to ultimately serve patients better. Read more about the bill here…

Efforts to Fund Ortho Research Program Continue With Congressional Letter
A group of 46 members of Congress—led by Rep. Seth Moulton (D-MA) and Rep. Joe Wilson (R-SC)—sent a letter to the leaders of the House Appropriations Committee requesting that $35 million be appropriated to the Peer Review Orthopaedic Research Program (PRORP) in 2024 as part of the Department of Defense’s Congressionally Directed Medical Research Program. PRORP has typically received $30 million in funding every year, but additional funds are needed to ensure continuity of care for the patient. Over half of all combat injuries sustained during our most recent conflicts involved extremity injuries and orthopaedic-specific conditions secondary to battle injury. Studies funded by PRORP will lead to major improvements in surgeons’ abilities to care for these devastating injuries. AAOS has been intimately involved in ensuring this program continues to receive proper funding since its inception in 2008. Read the congressional letter…

Healthcare Policy News

CMS Makes Changes to Prior Authorization Rules Under Medicare Advantage
On April 5, the Centers for Medicare & Medicaid (CMS) issued the 2024 Medicare Advantage and Part D Final Rule. This rule aims to ensure that Medicare Advantage (MA) enrollees have access to the same healthcare as they would in Traditional Medicare. AAOS is encouraged by the prior authorization requirements finalized, including the requirements for MA plans to follow Medicare’s National Coverage Determinations and Local Coverage Determinations where relevant. MA plans are required to establish a Utilization Management Committee so that enrollees have consistent and transparent access to medically-necessary care without unreasonable barriers. CMS indicated that it will consider “gold carding” of prior authorization requirements in the MA program in the future. AAOS also appreciates the regulations to shield Medicare enrollees from deceiving marketing practices to guarantee accurate information is disseminated across all platforms and help enrollees make informed decisions for selecting MA plans  Learn more about the final rule…

CMS Proposes Updates to Medicare Inpatient Payment
On April 10, the Centers for Medicare & Medicaid Services (CMS) published the fiscal year 2024 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system proposed rule. Among the changes which will update fee-for-service payment rates and policies for inpatient hospitals, CMS is proposing a 2.8% increase in payments for hospitals that meet all quality and electronic health records reporting requirements in 2024. The agency is also proposing to clarify the factors that will be considered to determine physician-owned hospital expansion requests, and modifications to the process for requesting an expansion exception. With respect to the Hospital-level Risk-standardized Complication Rate Following Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty measure, CMS is proposing the addition of mechanical complications ICD-10 codes starting with the FY 2030 program year. AAOS will be providing more details to members and formally commenting on the rule. Read more about the rule…

DEA Offers Guidance and Proposes Changes On Opioid Use
The Drug Enforcement Administration (DEA) continues to provide guidance for safe practices around opioid use. As of December 29, 2022, the Consolidated Appropriations Act of 2023 requires all DEA-registered practitioners, except veterinarians, to complete a one-time eight-hour training course. This training is designed to assist practitioners in better understanding appropriate measures with prescribing practices and other treatment options for patients with substance use disorders. DEA practitioners registering or renewing with the DEA will have to verify that they have satisfactorily completed the eight-hour training requirement starting June 27, 2023. Separately, the DEA has proposed several new provisions aimed at preventing the illegal dispersal of controlled substances through the Internet. This proposed rule outlines the key provisions. Read more about the proposed changes…

First Quarter Update for 2024 Election

The 2024 Election Cycle is well under way, and the AAOS political program has a goal of raising $4 Million. Thanks to its generous donors, OrthoPAC closed out the first quarter of 2023 raising $743,599. This has allowed the PAC to help many allies in Congress by disbursing just over $23,000 to U.S. Senate candidates and $130,000 to U.S. House candidates, with a nearly 50/50 split between Republicans and Democrats. It also enables the PAC to keep building relationships so that it has a seat at the table when policy decisions are being made that impact musculoskeletal care AAOS Office of Government Relations staff attended more than 100 events with members of Congress in Q1. With 34 seats up for re-election in the U.S. Senate, 2024 will be another vital election for reelecting members of Congress who understand and support priority healthcare issues. AAOS members can request support for candidates by contacting the OrthoPAC.  Learn more about OrthoPAC’s contribution criteria…

• Several personal, professional factors may contribute to burnout among orthopedic surgeons (Orthopedics Today, 4/11)
• CMS proposes 2.8% hospital inpatient reimbursement hike (Modern Healthcare, 4/10)
• Docs Support Bill to Reform Medicare Payments (MedPage Today, 4/6)
• Surprise Medical Bill Disputes Spur Lawmakers to Seek Changes (Bloomberg Law, 4/3)