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CMS Proposes New Medicare Evaluation and Management (E/M) Visit Documentation

CMS Proposes Major Expansion of Site-Neutrality

Health Savings Account Legislation Passes House

Quality Payment Program (QPP) Feedback Now Available

House Passes ASC Payment Transparency Act

Dr. Julio Gonzalez for Congress Supporters Gather in St. Louis

House Votes to Repeal Medical Device Tax

Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!

AAOS Orthopaedic PAC Online and Mobile Donations

 
 
 
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CMS Proposes New Rules; House Passes HSA Legislation and ASC Payment Transparency Act
 
For questions or concerns on these or other advocacy issues, contact us at dc@aaos.org.
CMS Proposes New Medicare Evaluation and Management (E/M) Visit Documentation

 
   

On July 25, 2018, the Centers for Medicare and Medicaid Services (CMS) released the calendar year 2019 hospital outpatient prospective payment system (OPPS) proposed rule addressing payments to hospital outpatient departments and ambulatory surgery centers (ASCs). Comments on the proposed rule are due by September 24 with a final rule expected by November 1. The AAOS will submit comments to the agency.

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CMS Proposes Major Expansion of Site-Neutrality

On July 25, 2018, the Centers for Medicare and Medicaid Services (CMS) released the calendar year 2019 hospital outpatient prospective payment system (OPPS) proposed rule addressing payments to hospital outpatient departments and ambulatory surgery centers (ASCs). Comments on the proposed rule are due by September 24 with a final rule expected by November 1. The AAOS will submit comments to the agency.One of the major proposals in this rule is the expansion of site-neutrality for outpatient services. Section 603 of the Bipartisan Budget Act of 2015 (BBA) reduced payments to off-campus provider-based hospital departments to the amount paid to physician clinics for the same service, effective January 1, 2017. BBA excluded the grandfathered sites from this requirement. In this proposed rule, CMS aims to extend this site neutrality policy beyond what is required by the BBA, i.e., it would cut payments to currently grandfathered sites for certain clinic visit services. Further, CMS proposes to expand payment cuts for covered outpatient drugs and biologicals acquired by hospitals under the 340B Program to these grandfathered sites as well. The agency would continue to exempt rural community hospitals, children’s hospitals, and certain cancer hospitals.

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Health Savings Account Legislation Passes House

 
   

The U.S. House of Representatives has advanced two bills designed to increase access to Health Savings Accounts (HSAs). Both pieces of legislation contain a package of smaller bills that Republicans say will allow patients to more easily afford health care.

An HSA is a tax-advantaged medical savings account available to patients enrolled in a high-deductible health plan. Money placed into an HSA is free of federal income tax at the time of deposit, is owned by the individual, and can accumulate and roll over each year, unlike a flexible spending account, which must be used each year. Proponents see HSAs as a good solution to help curb the growing cost of health care while giving individual patients more control over their health care dollar spending.

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Quality Payment Program (QPP) Feedback Now Available

The Centers for Medicare and Medicaid Services (CMS) has released feedback reports that will inform eligible physicians and groups on how they performed during 2017, the first full year of complying with the Quality Payment Program (QPP). The reports include their 2017 final score, 2019 Merit-based Incentive Payment System (MIPS) payment adjustment, and final performance category scores and weights, as well as detailed scoring and performance information for each of the performance categories.

To access the report, participants must log into the QPP Portal using their Enterprise Identity Management (EIDM) account, if they have one. If not, CMS strongly encourages people to obtain credentials by July 31. An EIDM User Guide has been posted with more information.

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House Passes ASC Payment Transparency Act

The Ambulatory Surgical Center (ASC) Payment Transparency Act of 2018 was passed by the U.S. House of Representatives on July 25, 2018.  This important piece of budget-neutral legislation would add an ASC representative to the Advisory Panel on Hospital Outpatient Payment and require that CMS disclose criteria used to determine the ASC Procedure List.According to AAOS President David Halsey, MD, “These provisions will help ASCs, specialty societies and other health care stakeholders engage CMS as it considers changes to the ASC Payment System. Further, HR 6138 will support Medicare beneficiaries as they seek the high-quality, efficient and cost-effective community care that ASCs deliver.”

Although a companion bill has not been introduced in the U.S. Senate, AAOS will work with our ASC partners to advocate for the issue this fall.

 
 
Dr. Julio Gonzalez for Congress Supporters Gather in St. Louis

 
  Orthopaedic surgeons with House of Representatives candidate Julio Gonzalez in St. Louis.

On August 2, more than 20 orthopaedic surgeons gathered to support their colleague, State Representative Julio Gonzalez, MD, JD, a practicing orthopaedic surgeon. The St. Louis community was proud to welcome him and support his candidacy. One of the hosts, Dr. John Powell of Signature Orthopaedics, said, “With his unique background, the state of Florida will be well-served, as will the entire House of Medicine.”

Dr. Gonzalez addressed how the number of physicians in Congress has dipped significantly from more than 20 to 13, just a few years ago. He articulated that our Constitutional framers intended adversaries to clash, and the product of that clash is a middle ground solution. However, if the House of Medicine doesn’t show up, the other team can sail to a touchdown.

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House Votes to Repeal Medical Device Tax

On July 24, the U.S. House of Representatives voted to repeal the 2.3 percent medical device tax—a provision that members of both parties have criticized as harming innovation. It voted 283 to 132, with some Democrats joining Republicans to approve the measure.

The vote could help Rep. Erik Paulsen (R-Minn.), the sponsor of the bill, who faces a tough reelection fight this year. “This bill reverses a harmful tax that is hurting job growth and innovation across the country,” Paulsen said.

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Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!
 
 
 
  AAOS Orthopaedic PAC Online and Mobile Donations

Did you know? Supporting our Orthopaedic PAC by phone is easy: simply text AAOS to the number 41444, and follow the link, no log-in required. We encourage our supporters to share this technology with your colleagues who have yet to renew or join and to encourage signing up on a recurring basis. For just $84 a month, or $250 a quarter you can become part of our Capitol Club Program. And don’t forget! The Orthopaedic PAC website features an online contribution center, which can accept contributions via credit card by visiting the site and using your AAOS login credentials. Credit card contributions can also be conveniently scheduled for a monthly, quarterly or yearly recurring donation. Visit www.aaos.org/pac and select Donate to the Orthopaedic PAC for more information or to contribute today.

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