AAOS joined over 70 organizations in sending a funding request letter for the Dr. Lorna Breen Health Care Provider Protection Act
AAOS continues to work with healthcare champions on Capitol Hill to advance musculoskeletal care as Congress returns from recess
The House Energy and Commerce Subcommittee on Health held a hearing on non-opioid pain alternatives, including mention of the AAOS-supported Alternatives to PAIN Act.
AAOS News
AAOS Joins Coalition Letter on Lorna Breen Act
AAOS joined over 70 organizations in sending letters to Apppropriations Committee members in both the House of Representatives and Senate requesting funding for the Dr. Lorna Breen Health Care Provider Protection Act in fiscal year (FY) 2027. The Lorna Breen Act is the first and only federal law dedicated to preventing suicide and reducing occupational burnout, mental health conditions, and stress for healthcare professionals. Through two grant programs, the law and its funding have supported more than 250,000 healthcare workers in 24 states through 44 evidence-informed initiatives to strengthen healthcare workers’ mental health.
Budget Neutrality Legislation Introduced to Stabilize Medicare Payment
Rep. Greg Murphy, MD (R-NC) introduced the Provider Reimbursement Stability Act (H.R. 8163), a bipartisan bill aimed at modernizing the Medicare physician fee schedule to bring greater predictability to physician reimbursement. Key provisions include raising the budget neutrality threshold from $20 million to $54.3 million in 2027 — indexed at five-year intervals thereafter — capping the annual budget neutrality adjustment to the conversion factor at 2.5%, establishing a utilization corrections mechanism, and requiring regular updates to practice expense calculations. The bill was introduced with eight bipartisan original cosponsors from both parties.
CMS Finalizes Rule to Streamline Electronic Transactions
The Administrative Simplification; Adoption of Standards for Health Care Claims Attachments Transactions and Electronic Signatures Final Rule is projected to save the healthcare industry roughly $781 million annually by establishing national standards for the electronic exchange of clinical documentation used to support health care claims. The rule also adopts standards for electronic signatures to ensure secure, authenticated transmission of this information. Historically, providers have relied on outdated manual methods to submit additional claims-related documentation requested by health plans, including medical records, X-rays, clinical notes, telemedicine visit documentation, and laboratory results – all of which cause delays and unnecessary costs. The newly finalized standards establish a consistent, easy-to-use electronic framework for transmitting this documentation, improving efficiency across the entire healthcare system. Compliance with these new rules is required by May 26, 2028.
The House Energy and Commerce Subcommittee on Health held a hearing entitled “Policies to Protect Our Communities from Illicit Drug Threats.” The hearing included witnesses with backgrounds in public health, law enforcement, addiction medicine, and recovery advocacy. The witnesses discussed the impact of funding cuts to the Substance Abuse and Mental Health Services Administration (SAMHSA), the delicate balance between law enforcement and public health approaches to managing the opioid crisis, and the merits of the multiple bills brought before the committee for consideration. The Alternatives to PAIN Act, supported by AAOS, would ensure these nonopioids are as financially and administratively accessible as generic opioids in Medicare Part D plans, creating real choice for the elderly based on their clinical needs. The bill would require such drugs to be covered without a deductible and to be placed on the lowest cost-sharing tier. It would also prohibit the imposition of prior authorization requirements or step therapy for these nonopioid pain management drugs. During the hearing, Rep. John Joyce (R-PA) noted his support for the Alternatives to PAIN Act as it is a viable option to ensure access to these drugs at the lowest possible cost for seniors. When Rep. Mariannette Miller-Meeks (R-IA) questioned witness Dr. Dasgupta about the use of nonopioid drugs in Medicare, he reiterated the importance of having a robust number of alternatives available.
CMS Releases WISeR Updates
The Centers for Medicare & Medicaid Services (CMS) announced that they are delaying the implementation of certain prior authorization (PA) requirements for selected services within the Wasteful and Inappropriate Services Reduction (WISeR) Model to allow additional time for operational readiness. One of the two services that this delay applies to is the Percutaneous Image-Guided Lumbar Decompression for Spinal Stenosis (NCD 150.13). Importantly, CMS notes that should it choose to implement PA for this service, it will be announced via a Federal Register notice. AAOS has previously raised concerns about the WISeR model and appreciates that this has requirement has been delayed.
Political News
Congress Returns to D.C. After Spring Recess
As Congress gears up to return from recess next week, the AAOS Government Relations team has been hard at work scheduling events and meetings to continue highlighting the policies impacting orthopaedic surgeons, practices, and patients. In the upcoming weeks, the AAOS team will meet with:
