Today’s Top Story
CMS issues final rule on 2018 Medicare Inpatient IPPS.
The U.S. Centers for Medicare & Medicaid Services (CMS) has issued the FY 2018 Medicare Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System final rule, which updates 2018 Medicare payment and policies when patients are discharged from hospitals. Among other things, the final rule:

  • Increases the amount of uncompensated care payments made to acute care hospitals by $800 million, raising the total to approximately $6.8 billion for FY 2018
  • Finalizes a 1-year regulatory moratorium on a payment reduction threshold for patient admissions in long-term care hospitals
  • Addresses changes to how the public is notified of Medicare terminations of certain providers

In addition, CMS had originally proposed to revise the application and re-application process for CMS-approved accreditation programs by requiring them to make public provider/supplier survey reports and plans of corrections. However, in the final rule, the agency withdrew that proposal. Read more…
Read the CMS fact sheet…
Read the complete rule…

Other News

Study: Many postoperative opioids go unused and remain accessible.
Findings from a study published online in JAMA Surgery suggest that many postoperative prescription opioids are unused and remain accessible. The research team analyzed six studies covering 810 unique patients. Across all six studies, 67 percent to 92 percent of patients reported unused opioids. Of all opioid tablets obtained by surgical patients, 42 percent to 71 percent went unused. Reasons given for stopping or not taking opioids included adequate pain control and opioid-induced adverse effects. Further, the research team notes that in two studies examining storage safety, 73 percent to 77 percent of patients reported that their prescription opioids were not stored in locked containers. All studies reported low rates of anticipated or actual disposal, but no study reported more than 9 percent of patients who followed U.S. Food and Drug Administration (FDA)-recommended disposal methods. Read more…
Read the abstract…

Study: What morphologic features of the thoracic pedicle may be linked with adolescent idiopathic scoliosis?
A study conducted in China and published online in the journal Clinical Orthopaedics and Related Research attempts to identify morphologic features of the thoracic pedicle associated with adolescent idiopathic scoliosis. The authors conducted a matched cohort study of 60 female patients with Lenke Type 1 adolescent idiopathic scoliosis and 60 matched controls. They used computed tomography to analyze 2,718 pedicles. The authors found no difference across cohorts in pedicle width on the convex side. However, among patients with scoliosis, they found that pedicle width on the concave side was narrower than pedicle width on the convex side and pedicle width in healthy control participants. In addition, dysplastic pedicles were more common in patients with adolescent idiopathic scoliosis compared with controls, and among patients with adolescent idiopathic scoliosis, they commonly occurred on the concave side and on the AV-SC region. Read the abstract…

How much do social risk factors impact quality measures?
A report from the National Quality Forum examines the impact of adjusting health and outcomes measures based on social risk. “There is increasing evidence that social risk factors can influence a person’s health and health outcomes, leading to the question of whether performance measures should account for social risk factors to ensure fair and accurate comparisons of provider performance,” the report reads. “However, some stakeholders have raised concerns that adjusting for social risk could mask disparities in care.” In the wake of a 2-year trial period, during which NQF temporarily changed its policy to allow social risk factors to be considered in NQF-endorsed measures, the agency states that empirical analyses to date “demonstrate a very limited effect of social risk factors” and advocates for further research in this area. Read more…
Read the report (PDF)…

Senate approves bill to finance FDA, Right to Try Act, Surgeon General nominee.
The New York Times reports that the U.S. Senate has passed a bill to help finance FDA by requiring manufacturers to continue to pay for the federal review of prescription drugs and medical devices. The bill was previously passed by the U.S. House of Representatives and President Donald Trump is expected to sign the measure.
In a separate vote, the Senate approved the Right to Try Act. If enacted, it would expand access to experimental treatments for people with terminal illnesses. The bill now goes to the House, where more than three dozen lawmakers have endorsed similar legislation. Read more…
     According to Medscape, the Senate has approved Jerome Adams, MD, as surgeon general, along with four other nominees to the U.S. Department of Health and Human Services. Read more…

New Mexico.
The Associated Press reports that four physicians have filed suit against the New Mexico Insurance Superintendent, alleging that he allowed 16 hospitals and dozens of outpatient care facilities to improperly access an already depleted fund to pay for medical liabilities. The suit seeks to void the superintendent’s actions and reset surcharges in accordance with new studies. The superintendent denies the allegations. Read more…

Call for volunteers: APTA workgroup on TKA guideline.
AAOS seeks fellows to participate on an American Physical Therapy Association (APTA) clinical practice guideline workgroup on Total Knee Arthroplasty (TKA): Pre- and Post-operative Physical Therapist Management for Adults with Osteoarthritis. Workgroup members will be required to complete the AAOS conflict of interest enhanced disclosure form online and attend two mandatory meetings in Alexandria, Va. If you are interested in participating, please contact Mary DeMars by Monday, Aug. 14, at: demars@aaos.org.