Legislation

  AAOS Advocacy in Action Worked with the American Association of Hip and Knee Surgeons on a congressional letter encouraging the Centers for Medicare & Medicaid Services to value pre-optimization time appropriately in its reimbursement of total knee and hip arthroplasty global codes. Shared our positions on the most pressing health policy issues with the Biden-Harris Administration including health disparities, prior authorization, physician-owned hospitals, telehealth, and value-based payment models. Joined with the Surgical Coalition in sending a letter of support [...]

COVID-19 Antibody Treatment and Enforcement Discretion Reminder CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment COVID-19 Vaccines and Monoclonal Antibody Infusion: Enforcement Discretion Relating to SNF Consolidated Billing CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment The U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibody therapy, casirivimab and imdevimab, administered together, for the treatment of mild-to-moderate [...]

CCMS Announces New Model to Advance Regional Value-Based Care in Medicare  Geographic Direct Contracting Model Builds on CMS’ Long-Standing Commitment to Improving Quality and Lowering Costs for Medicare Beneficiaries Today, the Centers for Medicare & Medicaid Services announced a new and transformative voluntary payment model that builds on CMS’ focus to deliver Medicare beneficiaries value through better care and improved quality. The Geographic Direct Contracting Model (the “Model”) will test an approach to improving health outcomes and reducing [...]

CMS Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge Agency outlines flexibilities to maximize Acute Hospital Care at Home, Ambulatory Surgical Centers to decompress hospitals treating COVID-19 patients Today, the Centers for Medicare & Medicaid Services (CMS) outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus disease 2019 (COVID-19) hospitalizations across the country. These flexibilities [...]

News CMS Announces Historic Changes to Physician Self-Referral Regulations Policy Will Increase Number of Lifesaving Organs by Holding OPAs Accountable through Transparency and Competition Prescription Drug Payment Model to Put American Patients First DMEPOS Competitive Bidding Program: Contract Suppliers for Round 2021 Quality Payment Program APMs: Extended Deadline to Update Billing information — December 13 Clinical Laboratory Fee Schedule: CY 2021 Final Payment Determinations Hospice Quality Reporting Program: November Refresh November is Home Care & Hospice Month World [...]

CMS Announces Historic Changes to Physician Self-Referral Regulations Today, the Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based reimbursement. The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from sending a patient for many types of services to a provider that the physician owns, is employed by, or otherwise [...]

News CMS Releases Nursing Home COVID-19 Training Data with Urgent Call to Action Medicare FFS Estimated Improper Payments Decline by $15 Billion Since 2016 CMS Retiring Original Compare Tools on December 1 COVID-19: Health Care Operations Lessons and Fostering Professional Resilience Medicare Diabetes Prevention Program: Become a Medicare-Enrolled Supplier Recognizing Lung Cancer Awareness Month and the Great American Smokeout Compliance Hospice Care: Safeguards for Medicare Patients Events CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management Call — [...]

  AAOS Advocacy in Action In addition to leading a letter of support for H.R. 8702 from the orthopaedic community (see news item below), AAOS signed onto a letter of support from 20+ surgical specialty groups and one from 70+ organizations from the broader medical specialty community.  Asked Congress to pass a statutory delay of the Appropriate Use Criteria program so that stakeholders can reach a better, more feasible and less burdensome approach to encouraging advanced diagnostic imaging. Urged [...]

CMS will retire the original Compare Tools on December 1st. Use Medicare.gov’s Care Compare to find and compare health care providers. In early September, the Centers for Medicare & Medicaid Services (CMS) released Care Compare on Medicare.gov, which streamlines our eight original health care compare tools.  Since then, you’ve had the opportunity to use and familiarize yourself with Care Compare while having the option to use the original compare tools, too.  You’ve also been able to share feedback [...]

COVID-19 Vaccine Codes and PC-ACE Software Update In anticipation of the availability of a vaccine(s), for the novel coronavirus (SARS-CoV-2) in response to the coronavirus disease 2019 (COVID-19), the American Medical Association (AMA), working with the Centers for Medicare & Medicaid Services (CMS), created new codes for the vaccine and the administration of the vaccine.  To prepare for the vaccine administration claims, the PC-ACE software is also updated and ready for providers to download. If you intend to [...]