Advocacy in Action | October 7, 2021

Physician Groups Respond to Regulators’ New Surprise Billing Rule

The AAOS, along with other organizations representing over 140,000 physicians, expressed opposition to the recently released second interim final rule to address surprise medical billing. The new rule establishes a process to settle out-of-network costs between providers and payers but fails Congress’ impartiality test by requiring that a certified independent dispute resolution entity look first to the qualifying payment amount. In the press release issued Oct. 1, the physician coalition denounced the rule and encouraged regulators to revisit congressional intent to protect patients and doctors. U.S. Representatives Richard Neal (D-Mass) and Kevin Brady (R-Texas) also accused the administration of straying from congressional statute in a letter they sent this week. The administration is currently accepting comments regarding this interim rule, which is expected to be enacted Jan. 1, 2022. Read the press release…

Winners Announced for 2021 Congressional Bipartisanship Award

During this year’s Combined National Orthopaedic Leadership Conference (NOLC) and Fall Meeting, AAOS awarded four members of Congress with the inaugural Congressional Bipartisan Award: U.S. Senators Joseph Manchin III (D-WV), Susan Collins (R-ME), and US. Representatives Ami Bera, MD (D-CA), and Fred Upton (R-MI). All AAOS Fellows were eligible to nominate individuals until the Sept. 17 deadline. Criteria for award consideration include that the nominee embody the five principles of bipartisanship: 1) demonstrates strong ability to compromise and collaborate with those in the opposing political party, 2) has worked across the aisle on issues related to musculoskeletal physicians, patients and care, 3) embodies the qualities and characteristics of bipartisan cooperation and comradery, 4) puts the duty of their office above partisan politics, and 5) is a leader in working productively with all viewpoints, parties, and policy positions to advance healthcare policy. Learn more about the new award…

Healthcare Policy News

Good Samaritan Health Professionals Act Introduced in the Senate

On Oct. 6, Senators Bill Cassidy, MD (R-LA) and Angus King (I-ME) introduced the Senate version of the Good Samaritan Health Professionals Act of 2021. The House bill was introduced last month by Raul Ruiz, MD (D-CA) and Larry Bucshon, MD (R-IN). This legislation would ensure that disaster victims have access to medically necessary care by providing volunteer health professionals with the same level of civil immunity that they would receive in their home state during a federally declared emergency. Due to inconsistent state laws and a lack of federal policy, it is often unclear whether protections against unnecessary lawsuits exist for medical volunteers who cross state lines. This uncertainty disincentivizes physicians from volunteering, and in some cases has resulted in trained and qualified professionals being turned away. The AAOS has signed onto two Health Coalition on Liability and Access-led letters thanking sponsors of the legislation for their leadership on the issue. Read the letter here…

Applications for COVID-19 Provider Relief Funding Are Now Open

The Department of Health and Human Services (HHS) announced that the applications for both Provider Relief Fund (PRF) Phase 4 and American Rescue Plan (ARP) Rural payments are now open. PRF Phase 4 is available to a broad range of providers who were financially impacted by the COVID-19 pandemic. ARP Rural is available to providers serving rural Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP) beneficiaries. Providers can apply for both programs in a single application until the deadline on Oct. 26 at 11:59 p.m. ET. There are a series of validation checks required before the application is accepted, so HHS recommends beginning the application as soon as possible. Apply through the PRF Application and Attestation Portal…

CMS Updates 2020 MIPS Performance Feedback and 2022 MIPS Payment Adjustments

The Centers for Medicare & Medicaid Services recently announced revisions to the Performance Year (PY) 2020 Merit-Based Incentive Payment System (MIPS) final scores and the associated 2022 MIPS Payment Adjustments for some participants. The revisions stem from two recently discovered errors in MIPS scoring logic. One issue occurred in applying the complex patient bonus to Medicare Shared Savings Program eligible clinicians and the other happened when CMS’s system did not recognize patient-reported outcome measures as outcome measures. Revised performance feedback was posted to the Quality Payment Program (QPP) website on Sept. 27, and MIPS participants are encouraged to log into the QPP website as soon as possible to review their performance feedback.  Download the announcement for more detail…

Health Provisions Advance in $3.5 Trillion Reconciliation Bill

On Sept. 25, the House Budget Committee favorably marked up and reported the proposed $3.5 trillion reconciliation package also known as the “Build Back Better Act.” The legislation is currently awaiting consideration before the House Rules Committee, where further changes are anticipated. If agreed to, it will then be considered on the House floor. In the Senate, Joe Manchin (D-WV) and Kyrsten Sinema (D-AZ) continue to oppose the overall size of the package, creating a math problem for Senate Majority Leader Chuck Schumer (D-NY). As it currently stands, the package includes significant changes to and investments in health care. Key proposals would extend enhanced marketplace subsidies authorized under the American Rescue Plan Act, improve marketplace affordability, close the Medicaid coverage gap through short-term subsidized coverage and a new long-term federal Medicaid program, expand Medicare benefits to include vision, hearing, and dental services, as well as provide investments in the health care workforce and infrastructure. Read more about the bill… 

Capitol Club Hosts 40 Members of Congress at Combined NOLC/Fall Meeting

During the AAOS Combined National Orthopaedic Leadership Conference (NOLC) and Fall Meeting, OrthoPAC hosted a Capitol Club reception at La Vie on the evening of Sept. 28. Not only did Capitol Club members (those who contribute $1,000 or more annually to OrthoPAC) take in sweeping rooftop views of the Potomac River and the U.S. Capitol, they also enjoyed the company of more than 40 members of the U.S. House of Representatives and two U.S. Senators. Twenty-three of those congressional attendees are also members of the Problem Solvers Caucus – a bipartisan group that is equally divided between Democrats and Republicans who are committed to working together across party lines to solve the nation’s toughest challenges through commonsense solutions. AAOS Capitol Club Members were able to meet with congressional representatives and chat about the pressing legislative concerns facing orthopaedic surgeons, including scheduled Medicare payment cuts, prior authorization reform, and orthopaedic research funding. Become a Capitol Club member today by texting AAOS to 41444.  Learn more about the Capitol Club…

·        Anthem running billions of dollars behind on payments to providers (Modern Healthcare, 10/6)

·        Op-Ed: VA’s Supremacy Project threaten vets’ health care (Stars and Stripes, 10/5)

·        Francis Collins to step down as NIH director by year’s end (Politico, 10/4)