CMS Finalizes Rules, Senate Talks 21st Century Cures, and More
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CMS Finalizes Changes to CJR, Cancels SHFFT On November 30, the Centers for Medicare & Medicaid Services (CMS) finalized the cancellation of the mandatory the mandatory Surgical Hip and Femur Fracture Treatment (SHFFT) payment model that was to be operated by the CMS Innovation Center (CMMI) and implemented changes to the Comprehensive Care for Joint Replacement (CJR) model. According to CMS, these changes will offer greater flexibility and choice for hospitals in providing care to Medicare patients. “While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care. We anticipate announcing new voluntary payment bundles soon,” said CMS Administrator Seema Verma.

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Senate Discusses Cures Implementation On December 7, 2017, the Senate Health, Education, Labor and Pensions Committee (HELP) Chairman Lamar Alexander (R-TN) held a hearing “to ensure patients benefit from the 21st Century Cures Act.” The legislation, signed into law on December 13, 2016, was intended to accelerate innovation, boost research, streamline drug and device approvals, and enhance health information technology (HIT) interoperability.

AAOS Signs Letters on Medicare Cuts In a recent letter, AAOS urged Congress not to include Medicare cuts in the tax bill, an end of the year spending package, or other legislation. Specifically, a proposed misvalued codes offset may be included in the legislation to reauthorize the Children’s Health Insurance Program (CHIP) and the annual package of Medicare payment extensions. “We understand the challenge of identifying offsets and appreciate the bipartisan work to advance the Medicare extenders, the Children’s Health Insurance Program (CHIP), and other legislation to improve access to care,” the letter states. “However, we are particularly concerned that the Medicare extenders package identifies an extension of the misvalued code target recapture policy. The effort to ensure the accuracy of values attributed to services received by Medicare beneficiaries is one to which we are firmly committed. But this is also work that has been ongoing for years and reinstating the target recapture policy in the future would likely result in across-the-board cuts given that much of the revaluation that the policy seeks has already occurred or is currently being addressed.”

Senate HELP Hearing on Azar On November 29, 2017, the Senate Committee on Health, Education, Labor, and Pensions (HELP) held a hearing with Department of Health and Human Services (HHS) Secretary nominee Alex M. Azar II, to discuss priority health issues and the nominee’s views and background. Chairman Lamar Alexander (R-TN) chaired the hearing, emphasizing Mr. Azar’s public and private sector experience make him qualified to lead HHS. “You have served in the judicial branch as a law clerk for Justice Antonin Scalia and you know the executive branch, having been HHS General Counsel and Deputy Secretary,” Alexander said. “And you know the private sector. You spent a decade in a leadership position at one of the country’s major pharmaceutical companies, so you know the system of how drugs get from the manufacturer to patients.”

Political Graphic of the Week

What We’re Reading

In Era of Increased Competition, Hospitals Fret Over Ratings, Kaiser Health News, 12/11/17 Hospital Giants in Talks to Merge to Create Nation’s Largest Operator, The Wall Street Journal, 12/10/17 Cadillac Tax is Sticking Point for Congress, The Hill, 12/10/17 Obamacare’s Individual Mandate: On Its Way Out, or Already Gone? The Wall Street Journal, 12/10/17 Collins’ Obamacare Deal Faces Moment of Truth, Politico, 12/8/17 Tax Bill is Likely to Undo Health Insurance Mandate, Republicans Say, The New York Times, 12/6/17 Freedom Caucus Open to Linking Spending Deal to Health Care, Roll Call, 12/6/17 Ryan Says Republicans to Target Welfare, Medicare, Medicaid in 2018, The Washington Post, 12/6/17 Providers See CMS Continuing Value-Based Care Push Despite Project Rollbacks, Morning Consult, 12/5/17 The CHIP Program is Beloved. Why Is Its Funding in Danger? The New York Times, 12/5/17 CVS and Aetna Seek Community-Based Care Model in Giant Healthcare Deal, Modern Healthcare, 12/4/17 Key Lawmaker Seeks Flexibility for States on CHIP, The Hill, 12/1/17

Quality Payment Program Updates The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, and the Centers for Medicare & Medicaid Services (CMS) then replaced it with the Quality Payment Program. Remember – the Quality Payment Program has two tracks you can choose: Advanced Alternative Payment Models (APMs) OR the Merit-based Incentive Payment System (MIPS). AAOS has shared the details of QPP and MIPS, which can be found on our website, here: and here:

On November 2, 2017, CMS released a final rule with comment period for its Quality Payment Program, along with its 2018 physician fee schedule rule. The Quality Payment Program final rule did not differ significantly from the proposed rule released last June. AAOS has been working closely with CMS to address many concerns related to the Quality Payment Program, including the need for additional flexibility and simplification, as well as protection for small, solo, and rural practices. Read the entire proposed rule comment letter submitted by AAOS online here. Find the CMS fact sheet on the final rule here: For any questions or comments related to this proposed rule, please email


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