AAOS Advocacy in Action

Continued participation in the Surgical Coalition to discuss shared issues and advocacy interests including implementation of the ban on surprise billing, health equity and inclusion, physician wellness, Medicare programs, and prior authorization reform among others.
Urged Congress to pass legislation before April 1 that will eliminate looming Medicare cuts and help ensure that health professionals have what they need to overcome the COVID-19 pandemic.
 
 
 
The Bone Beat More Episodes
Conversations on health policy issues affecting musculoskeletal care…

Episode Library Now Available on AAOS.org

Listening to The Bone Beat podcast has been made easier with a new episode library and dedicated webpages for each topic on aaos.org. Members can tune into new episodes, easily find old ones, or re-listen to their favorite conversations on health policy issues affecting musculoskeletal care. If you are enjoying the show, be sure to leave a review and subscribe for alerts when new episodes air on the last Tuesday of the month.

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AAOS News

Continuing Push to Mitigate Looming Medicare Cuts

This week, Congress is scheduled to vote on a bill that would mitigate Medicare cuts which were recently triggered by passage of the American Rescue Plan and due to the expiring Medicare sequester delay. The bill, H.R. 1868, was introduced by Representatives John Yarmuth (D-KY), Richard Neal (D-MA), Frank Pallone (D-NJ), and David Scott (D-GA) and would extend the temporary delay on cuts through the end of 2021 as well as prevent “budgetary effects” of congressional statute meant to contain budgetary growth. If unsuccessful, the cuts would total 2% and 4% respectively to all providers. The new bill comes in addition to existing legislation in both the House and Senate (H.R. 315/S. 748) that would extend the delay on Medicare sequester cuts until the end of the federally declared public health emergency. The AAOS has expressed support for both legislative solutions and will continue to advocate for mitigating harmful cuts–particularly those which are scheduled to take effect April 1. Learn more and take action on the issue… 

 
 
 

Healthcare Policy News

$1.9 Trillion COVID-19 Relief Bill Signed Into Law

President Joe Biden signed the American Rescue Plan into law on March 11, one day after it narrowly passed Congress with a vote of 220 to 211. The $1.9 trillion COVID-19 economic relief package provides $1,400 direct payments to qualifying individuals, extended temporary federal unemployment benefits, increased premium support for Affordable Care Act (ACA) plans, and continuation of COBRA health coverage subsidies for 2021 and 2022. The Congressional Budget Office estimates that the ACA provisions could extend coverage to 2.5 million uninsured consumers at a cost of $34 billion. Notably for AAOS members, the law does not provide additional funding for the Provider Relief Fund or a delay in the 2 percent Medicare sequester cut that is scheduled to take effect March 31. It does however give rural providers $8.5 billion and offers additional funding to states that expand Medicaid to cover low-income adults. Learn more about the COVID-19 relief package…

 

Coverage of Breakthrough Devices Delayed Until May

The Centers for Medicare & Medicaid Services (CMS) announced last Friday that it will be delaying implementation of the Medicare Coverage of Innovative Technology (MCIT) and Definition of ‘Reasonable and Necessary’ rule until May 15. The delay is part of the Biden Administration’s regulatory freeze of Trump-era rules that have not yet taken effect. If implemented in its current form, the MCIT rule would create a voluntary pathway of up to four years of national Medicare coverage for newly FDA market-authorized breakthrough devices. The delay allows additional time for stakeholders to weigh in on some questions left unanswered in the original final rule, including coding and reimbursement and how the breakthrough devices may affect older populations. CMS also believes the number of devices that will initially be approved for coverage through the MCIT pathway was underestimated in the original rule and is seeking public feedback on the consequences of potential growth. As a reminder, the AAOS offered comments when the change in coverage was being proposed and will continue to monitor its implementation. Read more about the delayed rule…

 

Congressional Hearing on Telehealth Hints at Bipartisan Opportunity

A key congressional committee recently held the first 2021 hearing on telehealth, as Congress looks to extend some of the flexibilities granted during the COVID-19 public health emergency (PHE). Members of the Subcommittee on Health of the Committee on Energy and Commerce were in widespread bipartisan agreement that telehealth use during the PHE was a positive outcome and had “opened a door” that could not be entirely closed again. Subcommittee members did raise concern about fraud and abuse being enabled by loose telehealth restrictions as well as the possibility of “lower value” care. Most, however, acknowledged the significant benefits of telehealth including patient convenience, improved access for rural or underserved areas, and greater physician visibility into the social determinants of health. Some of the most likely long-term policy changes discussed were a permanent waiver of the origination site and rural requirements to provide telehealth services in Medicare as well as the continued expansion of services allowed based on clinical benefit. The House Ways and Means Committee, which shares jurisdiction over Medicare policy, is expected to hold its own hearing on telehealth in the coming weeks. Read more about the hearing…

 
 
State News

Momentum for Prior Authorization Reform Continuing to Build

Reducing unnecessary delays in care by reigning in health insurers’ prior authorization policies remains a top priority for orthopaedic surgeons at the state and federal level. Building on the passage of legislation in Minnesota last year, several states are actively considering measures aimed at reducing the harmful impact of burdensome utilization management programs. Connecticut, Florida, Illinois, New Jersey, Pennsylvania and Texas are among several states taking up the issue during their current legislative sessions. In fact, the AAOS Board of Councilors (BOC) Committee on State Legislative and Regulatory Issues approved a State Orthopaedic Society Health Policy Action grant last week to support the Pennsylvania Orthopaedic Society’s focus on prior authorization reform, in particular bolstering its communications, media and lobbying efforts. As more states work to advance meaningful prior authorization reform, the momentum will only reinforce ongoing AAOS efforts nationally to reform similar policies within Medicare Advantage. Read a recent editorial about efforts in Pennsylvania….. 

 
 
OrthoPAC Corner

PAC Contribution Criteria Updated for 2021

At the beginning of every election cycle, the Orthopaedic PAC Executive Committee reevaluates its contribution criteria. It took special consideration during the process for 2021, given the Jan. 6 attack on the U.S. Capitol and subsequent pause of political giving during Q1. The newly approved criteria for contributing to federal candidates and legislators is as follows:

 

The AAOS Orthopaedic PAC (OrthoPAC) makes political contributions 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 are listed below. Learn more about the new criteria… 

  1. Views on issues of importance to the care of musculoskeletal patients and the maintenance and betterment of the profession of orthopaedic surgeons
  2. Positive input from the AAOS OrthoPAC members and stakeholders (BOC, BOS, State Societies, Capitol Club Members, Advisors Circle) in the specific district or state
  3. Position on a committee with jurisdiction over policy issues important to the care of musculoskeletal patients and betterment of the profession of orthopaedic surgeons
  4. Members in elected leadership position
  5. History of working well with the AAOS Office of Government Relations (OGR) staff and sponsoring or co-sponsoring legislation deemed important to AAOS
  6. Fellow orthopaedic surgeons and physicians running for office
  7. Electability to the specified office
 
 
 
 
What We’re Reading

·         Federal Surprise Medical Billing Law Enacted Following Years of Influential AAOS Advocacy (AAOS Now, February)

·         New Law Repeals Antitrust Exemption for Health Insurers (AAOS Now, February)

·         ONC chief Micky Tripathi talks public health data systems and ‘health equity by design‘ (Healthcare IT News, 3/12)

·         Two-thirds of largest hospitals aren’t complying with price transparency rule (Modern Healthcare, 3/16)

 
 
 
 
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QUESTIONS

For questions or concerns on these or other advocacy issues, contact us at dc@aaos.org.

 
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Did you know? Supporting our Orthopaedic PAC by phone is easy: simply text AAOS to the number 41444. Learn more about OrthoPAC.


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