CJR Delay Legislation, Access for Athletes During March Madness, MACRA Implementation, and More
For questions or concerns on these or other advocacy issues, contact the Office of Government Relations at dc@aaos.org.
Price, Scott Introduce CJR Delay Legislation

Last week, Reps. Tom Price (R-GA) and David Scott (D-GA) introduced legislation to delay implementation of the Comprehensive Care for Joint Replacement (CJR) model – a bundled payment program mandated by the Centers for Medicare and Medicaid Services (CMS) and set to start on April 1, 2016. The model affects hospitals in 67 geographical areas and targets the most common inpatient surgeries for Medicare beneficiaries: hip and knee replacements, both elective and non-elective, as well as other lower extremity joint replacement procedures and the repair of hip fractures. H.R. 4848, the Healthy Inpatient Procedures (HIP) Act, would delay CJR implementation until January 1, 2018, ensuring that physicians, hospitals, and post-acute care providers have adequate time to prepare for the onset of this complex payment system. Click here to read more.

Free resources for your office
The Academy provides a wide-array of FREE tools and resources to help you promote you, your practice and profession; as well as the latest in musculoskeletal research, tips and trends. Featured this month is the new AAOS public service campaign which focuses on ladder safety, bicycle safety and promoting awareness about spine-related impairment research.

Public Service Advertising (PSA) campaign materials provide an ongoing opportunity to tell the orthopaedic story at the national, state and local levels. Each year, the Academy’s Public Relations Department develops a highly successful, comprehensive, multimedia awareness program aimed at the general public. Each ad includes a call to action for people to visit OrthoInfo.org to learn more.

Order posters or postcards of our latest PSAs for your offices or patient waiting rooms by emailing media@aaos.org, or browse the full catalog at www.aaos.org/PRresources.

The Communications Cabinet will continue to create and produce materials that help our members connect with patients and other key stakeholders. And in the meantime, I welcome your feedback. If there is a topic or idea you think would resonate well with patients, with the media, or with elected officials, or within your local communities, please contact media@aaos.org.

Energy and Commerce Discusses MACRA Implementation

On March 17, 2016, the Energy and Commerce Subcommittee on Health, chaired by Rep. Joseph Pitts (R-PA), held a hearing examining the implementation of Medicare payment reforms. The hearing focused on the repeal of the Sustainable Growth Rate (SGR) formula and the bipartisan and bicameral agreement that replaced the SGR: the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA passed the House of Representatives on March 26, 2015, by a vote of 392-37 and the Senate on April 14, 2015, by a vote of 92-8. The President signed MACRA into law on April 16, 2015 (read more in Advocacy Now).

Click here to read more.

Ensuring Access for Athletes During #MarchMadness

H.R. 921/S.689 was introduced last year by Reps. Brett Guthrie (R-KY) and Cedric Richmond (D-LA), along with Senators John Thune (R-SD) and Amy Klobuchar (D-MN) to preserve the access of athletes and athletic teams to sports medicine professionals who provide high-quality, continuous health care services. AAOS has continued to urge members of Congress to support this legislation, highlighting the issue at the 2015 National Orthopaedic Leadership Conference and submitting a statement at a recent hearing on the legislation. This month, AAOS is tying the legislation together with the NCAA tournaments, calling on legislators to pass H.R. 921/S.689. The following op-ed was published by the Hill’s Congress Blog and can be found online here.

Click here to read more.

House Oversight Debates HIT

On March 22, 2016, the House Oversight Subcommittee on Information Technology and Subcommittee on Health Care, Benefits, and Administrative Rules held a hearing on the opportunities and challenges in health care information technology. Committee members pointed out that numerous health information technology (health IT) innovations exist to monitor health and fitness and improve health outcomes, including electronic health records, wearable devices, apps, and next generation medical devices. Yet, despite the promise of health IT, barriers exist to development and adoption, such as lack of coordination among state and federal regulators, interoperability, and an outdated/inconsistent regulatory framework.

Click here to read more.

Election 2016 Graphic of the Week

Click here to download.

HHS and CDC on Opioids

On March 18, 2016, the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health released a National Pain Strategy that outlines actions for improving pain care in America. According to an agency press release, the Strategy is a roadmap toward achieving a system of care in which all people receive appropriate, high quality and evidence-based care for pain. The plan was developed by the HHS Interagency Pain Research Coordinating Committee (IPRCC), which is composed of representatives from the Department of Defense, Department of Veterans Affairs, Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention (CDC), Food and Drug Administration, National Institutes of Health and members of the public, including scientists and patient advocates.

Click here to read more.

What We’re Reading

Bill to Delay Bundled Joint Replacement Payments Introduced, Modern Healthcare, 3/24/16

Medicare to Unveil Overhauled Requirements for Doctor Pay Soon, CQ Roll Call, 3/21/16

No End in Sight for GOP Budget Stalemate, National Journal, 3/22/16

GOP Panel Delays Tort Reform Bill After Conservative Backlash, The Hill, 3/22/16

In-State Hospital Mergers Can Lead to Higher Costs, Research Shows, Morning Consult, 3/21/16

CMS Mulling Quality Measure Reporting Period, Congress Told, MedPage Today, 3/18/16

Will Your Team Have Their Team at the NCAA Tournament? The Hill, 3/17/16

Alexander, Murray Unveil Bill For Next Medical Innovation Markup, Morning Consult, 3/17/16

SCOTUS Pick Has History in Healthcare-Related Cases, Modern Healthcare, 3/16/16

Patients in Pain, and a Doctor Who Must Limit Drugs, New York Times, 3/16/16

House 10-Year Budget Plan Would Eliminate Subsidies, Modern Healthcare, 3/16/16

The Economics of Paying For Value, Health Affairs, 3/15/16

Finding Value in Unexpected Places, New England Journal of Medicine, 3/9/16

MedPac March Report The Medicare Payment Advisory Commission (MedPAC) released its March 2016 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s analyses of payment adequacy in fee-for-service (FFS) Medicare and provides a review of Medicare Advantage and the prescription drug benefit, Part D. MedPAC is an independent congressional agency established by the Balanced Budget Act of 1997 to advise the U.S. Congress on issues affecting the Medicare program. In addition to advising the Congress on payments to private health plans participating in Medicare and providers in Medicare’s traditional fee-for-service program, MedPAC is also tasked with analyzing access to care, quality of care, and other issues affecting Medicare. Click here to read more.

On January 10, 2016, leaders of the AAOS, AAHKS, Hip Society, and Knee Society distributed a letter on new pre-certification procedures for total joint arthroplasty.

“We understand the goal of eliminating unnecessary health care costs, but these methods must be balanced with independent clinical judgment, patient preference, best levels of evidence and preservation of timely appropriate patient access to care,” the letter states. “We will continue to bring our combined resources and expertise to bear to address and resolve the problems associated with the activities of these insurance plans. If our constructive engagement falls short of achieving the necessary results, we are prepared to bring additional pressure to bear and seek alliances with other affected stakeholders such as patients and employers.”

Click here to read more.

2015 EHR “Meaningful Use” Hardship Exemption Information

Note: visit www.aaos.org/advocacy/HIT/ for all the latest updates on health information technology and meaningful use, including information on applying for a 2015 exemption.

In an effort to allow physicians to avoid a potential 3 percent meaningful use penalty in 2017, a law was passed by Congress that allows the Centers for Medicare & Medicaid Services (CMS) to consider hardship exceptions for categories of eligible professionals (EPs) and hospitals in a new, more streamlined process. Physician groups, including the American Association of Orthopaedic Surgeons (AAOS), lobbied for the legislation because the delayed release of modifications to the Stage 2 of the program left physicians with insufficient time to report under the modified requirements (read about the changes in an earlier Advocacy Now article here).

If you or your organization did not successfully meet meaningful use for an electronic health record (EHR) reporting period in 2015 and would like to apply for a hardship exception, the deadline is July 1, 2016.

Click here to read more.