Fall Legislative Preview: Funding Debate, Medical Device Tax, Cadillac Tax and More
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Fall Legislative Preview When Congress returns to Capitol Hill on Tuesday, September 8, legislators will once again find themselves with a full legislative agenda and few days to act. The Senate will likely start the month with work on a measure that would express congressional approval or disapproval of the Iran nuclear agreement. The deadline for action – September 17 – is just 10 calendar days after the Senate is scheduled to reconvene. Then, with government funding set to run out September 30, Congress is considering a stop-gap funding bill – also called a continuing resolution (CR) – to avoid government shutdown (read more in Advocacy Now here). On the Senate side, the full chamber has not taken up any of the bills because of an impasse over spending levels. Democratic senators recently applied new pressure on Republicans to negotiate a deal, sending a letter to Senate Majority Leader Mitch McConnell (R-KY) urging him to schedule talks immediately. Democrats are arguing that the appropriations bills evade the current discretionary spending caps by including almost $40 billion in war funding beyond what President Barack Obama requested to supplement the base defense budget – but without providing additional funds to domestic programs. Click here to read more.
Cadillac Tax Repeal Talks Increase According to reports on the Hill, Republican Senator Dean Heller (R-NV) is planning to introduce legislation to repeal the Affordable Care Act (ACA)’s Cadillac tax after Congress resumes. In the House, two bills have already been introduced aimed at repealing the Cadillac tax: one was introduced by Rep. Joe Courtney (D-CT) and has 132 cosponsors, while a second bill was introduced by Rep. Frank Guinta (R-NH) and has 81 cosponsors. The tax on high-cost health care plans, which goes into effect in 2018, is one of the more controversial provisions of the ACA and has been the subject of much debate within both parties.

“Obamacare continues to overpromise and underdeliver,” said Heller. “This tax is devastating to over 33 million Americans annually relying on [Flexible Spending Accounts] and [Health Savings Accounts] to limit out of pocket costs and lead healthier lives.” Click here to read more.

What We’re Reading Amputees Protest HHS Proposal on Lower-Limb Prosthetics, Morning Consult, August 27, 2015 CMS Says Positive ICD-10 Test Results Prove Agency is Ready for Oct. 1, Modern Healthcare, August 27, 2015 Why Restoring Funding To Medical Research Needs to Be a National Priority, Forbes, August 27, 2015 How Can Healthcare Big Data Analytics Bust Data Silos, HealthIT Analytics, August 27, 2015 The U.S. News Take on ProPublica’s Surgeon Scorecard, U.S. News, August 25, 2015 Surveys Differ on EHR Satisfaction Among Physicians, Medscape, August 25, 2015 Is the Sunshine Act Reducing Clinical Research Spending?, Clinical Leader, August 24, 2015 Voters, Candidates at Odds on Healthcare, Modern Healthcare, August 22, 2015 High Support for Legislation to Curb Drug Costs, National Journal, August 20, 2015
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ICD-10 Updates The Centers for Medicare & Medicaid Services (CMS) recently issued a clarification regarding its “grace period” during the transition to ICD-10 (read more about the implementation changes in Advocacy Now here). The agency has stated that during the 12 months following the Oct. 1, 2015 implementation of ICD-10, contractors would not deny claims based solely on the specificity of the ICD-10 diagnosis code. However, the California Medical Association reports that according to information posted by CMS, claims will be rejected if they do not contain a valid ICD-10 code, with “valid code” defined as one that is coded to the maximum level of specificity. Claims will not be rejected or audited simply because they contain the wrong code—as long as it is a valid code from the right family.

Read the CMS ICD-10 guidance document (PDF) online here.

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ICYMI – IPAB Will Be Triggered in 2017 On July 22, 2015, the Medicare Trustees – a group that oversees the financial operations of the Hospital Insurance and Supplementary Medical Insurance trust funds – released a report that states implementation of the Independent Payment Advisory Board (IPAB) will be triggered for the first time in 2017. The IPAB, opposed by the AAOS, is required to recommend cuts if Medicare exceeds spending growth thresholds. The U.S. House of Representatives passed legislation in June that would eliminate sections 3403 and 10320 of the Affordable Care Act (ACA) and repeal the IPAB before it is activated (read more in Advocacy Now here). The Senate companion version, S. 141, was introduced by Senator John Cornyn (R-TX) in January and it has so far received 41 cosponsors. However, the bill’s fate in that chamber is uncertain as many have argued there is no urgency to pass the legislation. The recent Trustees’ announcement directly refutes this idea and reinforces the need to repeal the IPAB as soon as possible.

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FDA Medical Device Registries Task Force The FDA Center for Devices and Radiographic Health has issued a request for Public Comment in the August 24 Federal Register in regard to a report entitled  “Recommendations for a National Medical Device Evaluation System: Strategically Coordinated Registry Networks to Bridge the Clinical Care and Research” developed by the Medical Device Epidemiology Network’s Medical Device Registry Task Force.

The FDA, working under a cooperative agreement with Duke University, convened the Medical Device Registry Task Force as a part of the Medical Device Epidemiology Network public-private partnership in 2014. The Task Force membership includes representatives from stakeholder groups representing patients, providers, hospitals, health plans, industry, government agencies and academic researchers. Click here to read more.

AAOS Orthopaedic PAC Online Contribution Center Starting July 29, 2015, please contact Graham Newson at newson@aaos.org with any Orthopaedic PAC questions or concerns 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. Consider joining the Orthopaedic PAC with a monthly contribution of $25 or make a $1,000 contribution manageable through $250 quarterly contributions to qualify for the new “Capitol Club”. Visit www.aaos.org/pac and select Donate to the Orthopaedic PAC for more information or to contribute today.

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