Boehner to Resign While Rep. Price Talks Bundled Payments
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House Speaker John Boehner Retiring From Congress On September 25, 2015, House of Representatives Speaker John Boehner (R-OH) announced he will resign from Congress at the end of October. First elected to the House in 1990, Boehner served as the House Minority Leader from 2007 to 2011 and rose to the speaker position after the 2010 tea party wave. Though his legacy will include repealing the Sustainable Growth Rate (SGR) and attempts at repealing the Affordable Care Act (ACA), much of his speakership was spent attempting to unite a House Republican conference pulled in different directions. Some – like Rep. Tim Huelskamp (R-KS) and Rep. Mark Meadows (R-NC) (who offered a motion to remove Boehner from the speaker’s position in July) – are already preparing for new leadership, while others – like Rep. Lynn Westmoreland (R-GA), Rep. Paul Ryan (R-WI), and Rep. Jeb Hensarling (R-TX) – are calling the move one of the most “selfless acts” they’ve seen.

House Majority Leader Kevin McCarthy (R-CA), the Number 2 Republican in the House and the most likely to replace Boehner as speaker, called Boehner a “leader, mentor, and most of all friend” in a statement. “He will be missed because there is simply no one else like him… Now is the time for our conference to focus on healing and unifying to face the challenges ahead and always do what is best for the American people.”

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Price Leads Letter to CMS on Bundled Payments

FREE WEBINAR – Comprehensive Care for Joint Replacement: Understanding the CMS Proposed Mandatory TJR Bundling Sep 29, 2015 7:15 PM – 8:15 PM Central Join Craig Robert Mahoney, MD; Alexandra E. Page, MD; Timothy Pysell, DrHA; and Michael Suk, MD, JD, MPH, FACS, for a webinar to discuss the impact the proposed payment model would have on you and your practice. Register online by clicking here. Or call AAOS Customer Service at 1-800-626-6726.

More than 50 members of Congress joined Rep. Tom Price, MD (R-GA) and Rep. Phil Roe, MD (R-TN) on a letter urging the Centers for Medicare & Medicaid Services (CMS) to delay the Comprehensive Care for Joint Replacement Model one year. Under the program, CMS will provide fixed payments for knee and hip surgeries to providers in 75 geographic areas over a five-year period. More than 800 hospitals will participate. Read more in AAOS Now online here.

As stated in the letter, the proposed payment model represents a significant change for beneficiaries and providers because it constitutes the first mandatory Medicare episode payment model promulgated under CMS’ CMMI authority. The letter notes that increasing value by means of improved outcomes and reduced costs is a laudable goal, but raises several questions related to the proposal. The general issue areas include: (1) patient choice and healthcare market consolidation, (2) ensuring patients with complex surgeries or chronic conditions have access to care, (3) impact on and safeguards for small and rural hospitals, (4) Electronic Health Records (EHRs), and (5) concerns over gainsharing limitations on providers. The letter concludes by proposing that the changes could have a “negative impact on patient choice, access and quality,” and urges CMS to address the above issues no later than October 1, 2015.

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What We’re Reading GOP Targets Obamacare Taxes in Fast-Track Process, The Hill, 9/28/15 Hensarling Backs Price for Majority Leader, Politico, 9/28/15 CMS Preps for an Upload and a Shutdown, Modern Healthcare, 9/26/15 McCarthy Seen As Favorite to Succeed Boehner, The Hill, 9/25/2015 Bye-Bye Boehner: What Does It Mean for Medicine? MedPage Today, 9/25/15 Government Shutdown Won’t Affect ICD-10 Rollout, CMS Says, Health Data Management, 9/25/2015 Sanders, Top Dems Urge Repeal of Cadillac Tax, The Hill, 9/24/15 IOM: Use EHRs More Efficiently for Patient Safety, Diagnostics, HealthIT Analytics, 9/23/15 Employers Cutting Health Benefits in Preparation for Obamacare’s Cadillac Tax, National Journal, 9/22/15 EHR Interoperability a Top Concern for Medical Students, EHR Intelligence, 9/22/2015 Judge Tells HHS to Revisit Two-Midnight Rule’s Inpatient Pay Cut, Modern Healthcare, 9/22/2015
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AAOS and Others Urge Delay in Meaningful Use More than 40 physician groups, including the American Association of Orthopaedic Surgeons (AAOS), sent letters to the heads of Health and Human Services (HHS) and the White House’s Office of Management and Budget asking for a delay in the final rule for Stage 3 of meaningful use.

“The undersigned medical societies agree that interoperable, useable, and clinically relevant Electronic Health Records (EHRs) are the essential foundation for the implementation of Merit Based Payment System (MIPS) and Alternative Payment Models (APMs),” the letters state. “The physician community, however, is extremely concerned with the current direction of the Meaningful Use (MU) program. To date, 80 percent of physicians are utilizing EHRs, but less than 10 percent of physicians have successfully participated in MU Stage 2. Furthermore, due to the inflexible MU regulations and certification requirements, vendors have created software products that are frequently unusable, administratively burdensome, and in many instances do not promote clinically relevant patient care.”

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PQRS Informal Review Process In 2016, the Centers for Medicare & Medicaid Services (CMS) will apply a negative payment adjustment to individual eligible professionals (EPs) and group practices participating in the Physician Quality Reporting System (PQRS) and group practice reporting option (GPRO) that did not satisfactorily report PQRS in 2014. Individuals and groups that receive the 2016 negative payment adjustment will not receive a 2014 PQRS incentive payment. Click here to read more.
Senate Continues HIT Hearings On September 16, 2015, the Senate Health Education Labor and Pensions (HELP) Committee held a hearing on health information technology (HIT) and improving care through patient access to their records. Legislators stressed the need for better electronic health record (EHR) usability, more patient access to data, and greater interoperability while Chairman Lamar Alexander (R-TN) once again pushed for a delay of Stage 3 of the meaningful use program.

Sens. Susan Collins (R-ME) and Elizabeth Warren (R-MA) led the hearing and focused on the need for a more interoperable, patient-centered healthcare system. They suggested more information would be helpful on how to improve patient access for their own health records and how can EHRs be improved to better serve patients. Sen. Warren specifically addressed concerns surrounding the Health Insurance Portability and Accountability Act (HIPAA) and that she believed there was still work to be done before we achieve an interoperable, consumer-friendly healthcare system.

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Patient and Consumer Stakeholder Meeting – MDUFA Reauthorization, September 15, 2015

The Federal Drug Administration (FDA) is hosting a series of meetings that will be held regarding the reauthorization of the Medical Device User Fee Amendments (MDUFA) IV.  During these meetings, participants will hear updates on the FDA-Industry negotiations and will provide their suggestions for improving the program.

Device user fees were first established in 2002 by the Medical Device User Fee and Modernization Act (MDUFMA). User fees were renewed in 2007, with the Medical Device User Fee Amendments to the FDA Amendments Act (MDUFA II), and 2012 with the Medical Device User Fee Amendments to the FDA Safety and Innovation Act (MDUFA III). In 2015, the FDA is discussing the 2017 medical device user fee program (MDUFA IV) with industry.

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AAOS Orthopaedic PAC Online Contribution Center Starting July 29, 2015, please contact Graham Newson at with any Orthopaedic PAC questions or concerns

The Orthopaedic PAC website features an online contribution center, which can accept contributions via credit card by visiting the site and using your AAOS login credentials. Credit card contributions can also be conveniently scheduled for a monthly, quarterly or yearly recurring donation. Consider joining the Orthopaedic PAC with a monthly contribution of $25 or make a $1,000 contribution manageable through $250 quarterly contributions to qualify for the new “Capitol Club”. Visit and select Donate to the Orthopaedic PAC for more information or to contribute today.

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