Today’s Top Story
DEA changes registration renewal process; eliminates grace period, will send only one renewal notice.
The U.S. Drug Enforcement Administration (DEA) has announced significant changes to its registration renewal process. Beginning Jan. 1, 2017, the agency will only send out one renewal notification. The renewal notification will be sent to the “mail to” address for each DEA registrant approximately 65 days prior to the expiration date. No other reminders to renew the DEA registration will be mailed. Paper renewal applications will not be accepted the day after the expiration date. If DEA has not received the paper renewal application by the day of the expiration date, mailed in renewal applications will be returned and the registrant will have to apply for a new DEA registration. This eliminates an informal grace period that the agency has previously allowed for registrants to renew their registrations. Read more…

Other News

President signs 21st Century Cures Act.
President Obama has signed the 21st Century Cures Act into law. Among other things, the act allocates $4.8 billion for biomedical research over a decade and includes provisions to streamline the U.S. Food and Drug Administration (FDA) drug and device approval process. Supporters of the legislation say that it will enhance the federal drug regulatory structure to keep up with advances in biotechnology and medical research. Read more…
Read the bill…

Study: Immediate ROM protocol linked to rapid return of function following TSA, but may lower healing rate of lesser tuberosity osteotomy.
Findings published in the December issue of the Journal of Shoulder and Elbow Surgery suggest that implementation of an immediate range of motion (ROM) protocol may be associated with more rapid return of function following total shoulder arthroplasty (TSA) compared to a delayed ROM protocol, although immediate ROM may reduce the healing rate of a lesser tuberosity osteotomy. The authors conducted a randomized, controlled trial of 60 TSA patients who participated in an immediate motion (IM) or delayed motion (DM) protocol. At 1-year follow-up, they found no significant difference between cohorts in final ROM or functional healing scores. The authors noted that patients in the IM group displayed higher functional outcome scores initially, but noted no difference across groups at 3 months. Further, the rate of osteotomy healing was 81 percent in the IM group and 96 percent in the DM group. Read the abstract…

Study: Despite similar training, trauma surgeons demonstrate wide range in surgical material costs.
A study published in the December issue of the Journal of Orthopaedic Trauma suggests wide variation in surgical material cost among trauma surgeons, despite similar specialty training. The researchers retrospectively reviewed medical records on 88 bimalleolar ankle and 46 bicondylar tibial plateau fractures treated by six fellowship-trained trauma surgeons at a single, academic, level 1 trauma center. For bimalleolar ankle fracture, they found that the mean case cost per surgeon ranged from $613 to $2,243. For bicondylar tibial plateau fracture, the mean intraoperative material cost per surgeon ranged from $1,839 to $4,088. The researchers write that use of bone void fillers, locking plates, adjunctive external fixators, mini-fragment locking plates, cannulated screws, single-use taps, guidewires, and drill bits all substantially increased costs. Read the abstract…

Do apology laws reduce risk of medical liability suits?
A research paper posted through the Social Science Research Network suggests that enactment of so-called “apology laws”—which prohibit certain statements, expressions, or other evidence related to disclosure from being admissible in a lawsuit—may not effectively limit risk of medical liability for healthcare providers. The research team reviewed data from a single, national medical liability insurer, covering 90 percent of all physicians practicing in a single specialty from 2004 through 2014. They found that in general, apology laws increased the probability of medical liability lawsuits, but reduced the average payment per case. However, they note that the decrease was primarily the result of an increase in the number of cases involving no payment to a claimant, as opposed to a decrease in the amounts that claimants actually received. “…the evidence presented here strongly suggests that apology laws are not substitutes for specific physician disclosure programs…,” the research team writes, “and that the experiences of these types of programs are not generalizable to the physician population at large. In other words, simply being allowed to apologize is likely not enough to reduce malpractice risk. Physicians benefit from being trained when to apologize and what to say when apologizing as part of a specific physician disclosure program. Therefore, while apology laws may facilitate the introduction of these programs, the programs themselves are likely necessary to achieve actual decreases in malpractice liability risk.” Read the research paper (PDF)…

Report estimates impact of ACA repeal on patients with pre-existing conditions.
A report released by the non-profit Kaiser Family Foundation examines medical underwriting practices by private insurers in the individual health insurance market prior to implementation of the Affordable Care Act (ACA). The researchers estimated rates for various health conditions based on data from the National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System, and consulted field underwriting manuals used in the individual market prior to ACA passage as a reference for commonly declinable conditions. They project that 27 percent of adult Americans under the age of 65 have health conditions that would likely leave them uninsurable based on underwriting practices that existed prior to implementation of the Affordable Care Act. The organization notes that many of those are currently insured through an employer or public coverage, under which they do not face medical underwriting. However, the researchers note that the extent to which people with pre-existing health conditions may be affected “is likely to be a central issue in the debate over repealing and replacing the ACA.” Read more…
Read the report (PDF)…

Last call: committee positions closing soon!
A number of openings on the AAOS Committee Appointment Program website are closing Dec. 21. Act now to apply for the following positions:

  • Adult Reconstruction Hip Instructional Course Committee (chair, two members)
  • Adult Reconstruction Hip Program Committee (chair, 11 members)
  • Adult Reconstruction Knee Instructional Course Committee (two members)
  • Adult Reconstruction Knee Program Committee (seven members)
  • Biological Implants Committee (one member)
  • Bylaws Committee (two members)
  • Hand & Wrist Instructional Course Committee (one member)
  • Hand & Wrist Program Committee (chair, one member)
  • Musculoskeletal Tumor & Metabolic Disease Program Committee (chair, two members)
  • Pediatrics Instructional Course Committee (two members)
  • Pediatrics Program Committee (chair)
  • Political Action Committee of the AAOS (treasurer)
  • Practice Management Instructional Course Committee (one member)
  • Practice Management/Rehabilitation Program Committee (five members)
  • Spine Instructional Course Committee (four members)
  • Spine Program Committee (four members)
  • Trauma Program Committee (chair, three members)
  • Tumor Instructional Course Committee (two members)

Learn more and submit your application…(member login required)