Congress Repeals IPAB, Passes Budget Deal, Discusses Consolidation and Medical Liability
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Bipartisan Budget Deal Addresses Numerous AAOS Priorities

On January 9, the Centers for Medicare and Medicaid Services (CMS) announced a new voluntary bundled payment model that will qualify as an Advanced Alternative Payment Model (Advanced APM) under the Quality Payment Program. This new model, called “Bundled Payments for Care Improvement Advanced” (BPCI Advanced), requires participants to bear financial risk, have payments under the model tied to quality performance, and use Certified Electronic Health Record Technology. By meeting these requirements, participants can earn the Advanced APM incentive payment.

Mark Your Calendar! Advocacy at Annual Meeting!

As we continue with a new administration and changing Congress, 2018 will be a milestone year for healthcare reform. Many legislative and regulatory issues central to orthopaedic practice and the orthopaedic profession as a whole, including potential Medicare reform, are at stake. Mark your calendars and plan to take advantage of the following opportunities at the AAOS 2018 Annual Meeting.

AAOS Advocacy Booth
Be sure to stop by the AAOS Advocacy Booth to enhance your understanding of the regulatory and legislative issues confronting orthopaedic surgeons. At the booth, you can learn more about the AAOS Office of Government Relations’ (OGR) work to support the orthopaedic specialty in the U.S. Congress and the statehouses. You’ll also have the opportunity to chat with knowledgeable OGR staff and physician advocacy leaders, renew your support in the AAOS Political Action Committee (Orthopaedic PAC), and take action on top legislative issues affecting your patients and practice.

The AAOS Advocacy Booth will be open between 9 a.m. – 5:00 p.m., March 7-8, and between 9 a.m. and 4 p.m., March 9. The booth is located in Hall B, Booth #4343, at the Morial Convention Center.

House Subcommittee Discusses Consolidation

On February 14, 2018, the House Energy and Commerce Subcommittee on Oversight and Investigations convened a hearing titled “Examining the Impact of Health Care Consolidation.” The American Association of Orthopaedic Surgeons (AAOS) appreciates the subcommittee’s focus on this important issue and welcomes an in-depth examination of the consolidation trends in the health care sector, the reasons behind those trends, and the effects they have on the cost and quality of care.

President Trump’s Budget Request

Last week, President Donald Trump unveiled his Fiscal Year (FY) 2019 Budget, which includes proposals affecting defense and non-defense funding for government agencies, tax changes, and funding for social insurance and assistance programs like Social Security, Medicare, and Medicaid. In particular, the proposed 2019 budget requests $68.4 billion for the Department of Health and Human Services (HHS), which is a 21 percent decrease from the 2017 enacted level. According to the White House, the HHS budget makes “thoughtful and strategic investments to protect the health and well-being of the American people, while addressing the opioid crisis, promoting patient-centered healthcare, strengthening services for American Indians and Alaska Natives, encouraging innovation in America’s healthcare future, addressing high drug prices, reforming the Department’s regulations, and generally focusing resources toward proven and effective initiatives.”

Good Samaritan Legislation Passes House Committee

On February 14, the House Energy and Commerce Committee, chaired by Rep. Greg Walden (R-OR), advanced three bipartisan bills to the House of Representatives for consideration. In particular, the committee passed H.R 1876, the Good Samaritan Health Professionals Act of 2017, which helps protect health care professionals who volunteer their services when a major emergency arises. The American Association of Orthopaedic Surgeons (AAOS) has continually advocated for this legislation and applauds members of Congress for advancing this important measure. Specifically, H.R. 1876 provides clear liability protections to licensed health care professionals who volunteer health care services to victims during a declared national disaster. Notably, the legislation respects existing medical liability laws and does not protect providers in cases of willful or criminal misconduct, gross negligence, or reckless misconduct.

Going to the 2018 Annual Meeting? Attend an ICL on Risk Evaluation and Management Strategies for Prescribing Opioids!

On January 8, 2018, the CDC issued a report showing the number one cause of death in adults in the USA is now drug overdose, having passed all other causes including car crashes, cancer and cardiac disease. Attorneys General in both Ohio and Mississippi have filed lawsuits against the top 5 pharmaceutical companies alleging companies’ collusion and negligence that has led to opioid overdose deaths in those states at an ever-accelerating pace. Nationwide, 68 percent of people using pain relievers for non-medical reasons obtained them from a friend or relative. For teenagers, prescription drugs are easier to obtain than beer. Each day, 46 people die from an overdose of prescription painkillers in the US. Each year, health care providers write 259 million prescriptions for painkillers, enough for every American to have a bottle of pills. Meanwhile, the Office of the Surgeon General recently sent a letter on the opioid epidemic to 2.3 million physicians and other healthcare professionals, mandating a call for action on safe prescribing education and access to treatment for opioid use disorders, emphasizing “compassionate care without stigma.”

Congress Focuses on Rheumatoid Arthritis Therapies

On February 7, 2018, the Senate Special Aging Committee held a hearing titled “Rheumatoid Arthritis Therapies Cost and Competition.” The focus of the testimony centered on the development of new medicines to treat rheumatoid arthritis (RA) – in particular, the development of a class of drugs called biologic disease-modifying antirheumatic drugs, or DMARDS They are called “biologics” because they are proteins made from living organisms, and they are all administered via injection under the skin or by intravenous infusion supervised by a physician. There are only 10 therapies available in this class, and they are costly, marketed at over $50,000 per year.

AMA National Advocacy Conference 2018

The American Medical Association (AMA) National Advocacy Conference was held on February 12-14, 2018 in Washington DC, which brought together physicians, industry experts, political insiders and members of Congress. Keynote speakers included Erik Wahl, an internationally recognized artist, TED speaker and No. 1 bestselling author, and Chris Wallace, an award-winning journalist and host of FOX News Sunday. The AMA president, president-elect, and the chair of the Board of Trustees shared their perspectives on the issues they address daily. Senior advocacy staff from the AMA also provided an overview of the organization’s priority issues. Discussion continued with a panel of congressional staff. Attendees also heard from Rep. Josh Gottheimer (D-N.J.) and Rep. Tom Reed (R-N.Y.) cofounders of the Problem Solvers Caucus, a bipartisan group in Congress that includes approximately 40 members– equally divided between Democrats and Republicans who are committed to forging bi-partisan cooperation on key issues.

ICYMI: AAOS Responds to RFI on Choice and Competition

On January 24, 2018, AAOS sent a letter to the Department of Health and Human Services’ (HHS) regarding their “Promoting Healthcare Choice and Competition Across the United States” Request for Information. In the letter, AAOS notes that it shares the Administration’s desire to see meaningful burden reduction while preserving valuable competition and patient choice and fulfilling statutory obligations. AAOS urged the Department to consider a number of recommendations, which address the needs of our members and the mutual goal of delivering high quality care at affordable prices to patients.

State Corner: Trump Administration Expanding State Waiver Authorities

In January, the Centers for Medicare and Medicaid Services (CMS) issued new guidance for Section 1115 waiver proposals that would allow states to create work requirements for “able-bodied” people in order to be eligible for Medicaid. Since then, Indiana and Kentucky have had Section 1115 waivers approved that create work requirements for Medicaid eligibility. Seema Verma, one of the creators of Indiana’s unique Medicaid program, is the current Administrator of the Centers for Medicare and Medicaid Services (CMS) and approved the waivers. Since 2016, states have also gained authority for Section 1332 waivers. These waivers deal mainly with requirements imposed by the Affordable Care Act.

Take Action on Physician-Owned Hospital Issue TODAY

The passage of the budget deal mentioned above means that the topline spending numbers have been agreed to and work can finally proceed on an omnibus appropriations bill to fund the government for the rest of 2018. This may be our best chance to repeal the harmful restrictions on physician-owned hospitals. We’ve heard positive feedback from congressional leadership that some form of relief for physician-owned hospitals could be included in this bill.  Now is the time to push this important issue over the finish line. Click here to act!
What We’re Reading

HHS May Nix Reporting Requirements for Value-Based Care Program, Morning Consult, 2/15/18

Republicans Who Opposed Obama’s Health Law Now Work to Keep Premiums Down, The Wall Street Journal, 2/15/18

Azar Eyes Relaxing Restrictions on Physician-Owned Hospitals, Modern Healthcare, 2/14/18

Winners and Losers Under Medicare Drug Plan in Trump Budget, Associated Press, 2/14/18

U.S. Healthcare Spending to Climb 5.3 Percent in 2018, Reuters, 2/14/18

Amazon’s Latest Ambition: To Be a Major Hospital Supplier, The Wall Street Journal, 2/13/18

Trump Calls for $18 Billion Cut to HHS Funding, Modern Healthcare, 2/12/18

Pharma Furious After Being “Blindsided” in Budget Deal, Axios, 2/9/18

Brief Government Shutdown Ends as Trump Signs Spending Bill, The Washington Post, 2/9/18

From Clinics to Child Insurance, Budget Deal Affects Health Care, The New York Times, 2/8/18

Democrats Want to Increase ACA Subsidies in Stabilization Bill, Axios, 2/7/18

States Look at Establishing Their Own Health Insurance Mandates, The Wall Street Journal, 2/4/18

Political Graphic of the Week

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:

New Resident PAC One Pager
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PAC Participation Leader Board by State

Click here, to view the interactive version of the map below, which features each state’s PAC support for 2017.

Thank You to Our Current Orthopaedic PAC Advisor’s Circle Members!
To learn more about the Advisor’s Circle, email Stacie Monroe at
AAOS Orthopaedic PAC Online and Mobile Donations

Orthopaedic PAC is now mobile! Supporting 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 and select Donate to the Orthopaedic PAC for more information or to contribute today.

Don’t remember when you last contributed? Log in to the contribution center today to view your complete donation history!