Legislation

  AAOS Advocacy in Action Discussed the next generation of value-based care models in a meeting with the CMS Innovation Center led by AAOS Advocacy Council Chair Douglas Lundy, MD, MBA, FAAOS. Expressed support for legislation that would allow physicians with a 90% prior authorization approval rating to be exempt from prior authorization requirements under Medicare Advantage plans.       Ongoing Event Focuses on Economic Impact of Orthopaedic Surgeons         Source: 2018 AMA Economic [...]

  AAOS Advocacy in Action Expressed support for the bipartisan Meaningful Access to Federal Health Plan Claims Data Act of 2021, which would link clinician-led clinical data registries to Medicare claims data Urged Congress to invest resources into studying the effect of post-acute sequelae of SARS-CoV-2 infection (PASC), also called “Long COVID.” Asked Congress to address high student loan debt and consider the “Resident Education Deferred Interest (REDI) Act” (S. 3658/H.R. 4122).         The 2nd [...]

  AAOS Advocacy in Action Joined neurosurgery and spine surgery specialist groups in developing and endorsing a position statement on image requirements for prior authorization (read more below).             2nd Annual Orthopaedic Advocacy Week The AAOS leadership, in conjunction with the Office of Government Relations, is hosting the second annual Orthopaedic Advocacy Week August 1-5. The completely virtual event is designed to offer members simple, minute-long opportunities to advocate for priority healthcare policy issues including [...]

News CMS Issues Significant Updates to Improve the Safety and Quality Care for Long-Term Care Residents & Calls for Reducing Room Crowding COVID-19: Pfizer-BioNTech Vaccines for Children as Young as 6 Months — New Codes New Model to Improve Cancer Care for Medicare Patients: Apply by September 30 Internet-Only Manual Update to Publication 100-04, Chapter 16, Sections 70.5, 70.8, and 70.9 to Remove References to the Clinical Laboratory Improvement Amendments (CLIA) Files Provide Ostomy Supplies Promptly Events Cancelled [...]

  AAOS Advocacy in Action Sent a letter of support for the Safety from Violence for Healthcare Employees Act of 2022, which would establish legal penalties for assaulting or intimidating hospital employees (read more below). Joined several physician groups in sending a letter to the Centers for Medicare & Medicaid Services highlighting inappropriate use of local coverage articles by Medicare payment contractors.       The Bone Beat New Episode Conversations on health policy issues affecting musculoskeletal care... Orthopaedic [...]

  AAOS Advocacy in Action Joined the American Association of Hip and Knee Surgeons (AAHKS) to provide feedback to the Centers for Medicare & Medicaid Services (CMS) on MIPS electronic quality measures for functional status assessment prior to elective total knee and hip replacement procedures. Along with the Council of Medical Specialty Societies (CMSS), AAOS is raising concerns about the scope of practice expansion for non-physician practitioners' recommendations from the National Academy of Medicine. Subsequently, these recommendations were [...]

  AAOS News   A Win for AAOS Advocacy on Guidelines for SI Joint Fusion AAOS became aware of a policy created by AIM Specialty Health on minimally invasive sacroiliac joint fusion, exclusive to the use of the triangular iFuse Implant System. The policy, which was then adopted by Anthem and United Healthcare, restricted the use of other sacroiliac joint fusion devices. AAOS expressed concern regarding the practice of granting exclusive coverage, which would severely affect the surgeon’s [...]

  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 [...]