Legislation

  AAOS Advocacy in Action In May, AAOS staff met with representatives from the CMS Office of Enterprise Data and Analytics to discuss challenges with the ResDAC data acquisition process, as well as new pathways for AAOS registries to access Medicare claims data.         AAOS News Prior Authorization Bill Reaches Important Milestone On May 11, the AAOS-endorsed Improving Seniors’ Timely Access to Care Act—which would reform the burdensome prior authorization process within Medicare Advantage—accumulated 294 [...]

  AAOS Advocacy in Action Sent a letter to Rep. Pete Sessions (R-TX) in support of H.R. 7259, the Medical Controlled Substances Act of 2022.         AAOS News Congressional-led Letter Asks for $35 Million for Research Funds A group of 42 members of Congress—led by Rep. Seth Moulton (D-MA) and Rep. Joe Wilson (R-SC)—sent a letter to the leaders of the House Appropriations Committee requesting that $35 million be appropriated to the Peer Review Orthopaedic Research Program [...]

News Hospice Quality Reporting Program: Key Dates & Measure Change Ambulance Ground Transport: Comparative Billing Report in April Hospices: Aggregate & Inpatient Caps under the Value-Based Insurance Design Model Compliance Medicare Provider Compliance Newsletter DMEPOS Items: Medical Record Documentation Events CMS Health Equity Symposium — April 28 MLN Matters® Articles Update to Publication 100-04, Chapter 18 and Publication 100-02, Chapter 15, Section to Add Data Regarding Novel Coronavirus (COVID-19) and its Administration to Current Claims Processing Requirements and [...]

CMS Proposes Policies to Advance Health Equity & Maternal Health, Support Hospitals On April 18, CMS issued a proposed rule for inpatient and long-term hospitals that builds on the Biden-Harris Administration’s key priorities to advance health equity and improve maternal health outcomes. In addition to annual policies that promote Medicare payment accuracy and hospital stability, the fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) rule includes measures that [...]

  AAOS Advocacy in Action Commented in this letter on the Proposed 2022 Clinical Practice Guidelines for Prescribing Opioids from the Centers for Disease Control and Prevention (CDC) with recommendations for additional components of pain care the association felt were overlooked in the original guidelines. Met with CMS/CMMI representatives to discuss challenges with reporting registry measures as part of the BPCI-A Alternate Quality Measures program. Submitted comments to the FDA on a proposal to amend the device current [...]

News Fiscal Year 2021 Program for Evaluating Payment Patterns Electronic Reports Preventive Services & Health Equity: Improve the Health of Minority Populations Compliance What’s the Comprehensive Error Rate Testing Program? Claims, Pricers, & Codes April 2022 Integrated Outpatient Code Editor (I/OCE) Specifications Version 23.1 Claim Status Category and Claim Status Codes Update MLN Matters® Articles Mental Health Visits via Telecommunications for Rural Health Clinics & Federally Qualified Health Centers Update to Chapter 7, “Home Health Services,” of the Medicare [...]

Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost On April 6, CMS announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna COVID-19 vaccines without cost sharing, as it continues to provide coverage for this critical protection from the virus. People with Medicare pay nothing to receive a COVID-19 vaccine, and there is no applicable copayment, coinsurance, or deductible. People with Medicaid coverage can also get COVID-19 vaccines, including [...]

  AAOS Advocacy in Action Joined a coalition to share feedback and comments on electronic prior authorizations with the Department of Health and Human Services (HHS) Office of National Coordinator of Health IT. Led by new AAOS President, Dr. Savoie, met with CMS to highlight AAOS concerns with the National Correct Coding Initiative. Joined a group of physician associations (led by the American Medical Association) in asking the Centers for Medicare & Medicaid Services (CMS) to reconsider their [...]

News Home Health Providers: Services Provided Data for April 2022 Refresh Continuous Glucose Monitor: Provide Supplies for a Calendar Month Cognitive Impairment: Medicare Provides Opportunities to Detect & Diagnose Claims, Pricers, & Codes Hospice Web Pricer Events Medicare Cost Report E-Filing System: Interim Rate & Settlement Documentation Webinar — April 26 MLN Matters® Articles April 2022 Update of the Ambulatory Surgical Center (ASC) Payment System Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting [...]

IPF & IRF Proposed FY 2023 Payment Rules Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatient Rehabilitation Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 On March 31, CMS issued the fiscal year 2023 inpatient psychiatric facility (IPF) prospective payment system proposed rule to update IPF payments, wage index, and policies. See a summary of [...]