Today’s Top Story
Senate Committee moves forward on Tom Price nomination to HHS secretary.
U.S. News and World Report writes that Republican legislators on the U.S. Senate Finance Committee have advanced the nomination of Tom Price, MD, as secretary of the U.S. Department of Health and Human Services (HHS), despite a boycott of the vote by Democratic legislators. Committee rules generally require at least one member from each party to be present at such a vote, but committee members voted to temporarily suspend that rule due to the boycott. The committee advanced Dr. Price’s nomination by a vote of 14-0. The nomination now moves to the Senate floor. Read more…

Other News

Study: Alpha-defensin assay may help identify PJI.
Findings from a study published in the February issue of the journal Clinical Orthopaedics and Related Research (CORR) suggest that the alpha-defensin assay may be a reliable diagnostic tool for the identification of periprosthetic joint infection (PJI). The authors conducted a prospective study of 156 patients who underwent total joint arthroplasty (65 knees, 91 hips), 29 of whom received a confirmed diagnosis of PJI. They found that the alpha-defensin immunoassay produced a sensitivity of 97 percent, specificity of 97 percent, positive predictive value of 88 percent, and negative predictive value of 99 percent. Among four false-positive patients, the authors note that two had metallosis and one had polyethylene wear, and the false-negative case presented with a draining sinus. They argue that follow-up evaluation should be conducted to estimate longer term performance of the test. Read the abstract…

Study looks at natural history of pseudotumors following MOM THA.
A study published in the February CORR examines the natural history of asymptomatic pseudotumors in metal-on-metal (MOM) total hip arthroplasty (THA). The research team reviewed information on 71 patients who underwent MOM THA, 23 of whom (32 percent) had a positive ultrasound scan for pseudotumor at early follow-up. Of those, eight patients underwent revision THA (35 percent of those with a positive scan). Of the remaining 15 patients, 12 had persistent pseudotumor, two resolved, and one was lost to follow-up. Six patients (13 percent) who had a normal early ultrasound scan showed new ultrasound findings at delayed follow-up, and of those, four were conclusively diagnosed as pseudotumor, and one was revised. Of five patients in whom the volume of pseudotumor decreased on ultrasound at mid-term follow-up, three showed a decrease in serum trace ions levels and two showed an increase. In two of six cases, new-onset pseudotumors at mid-term follow-up were linked to an increase in serum trace metal ions at mid-term follow-up. Read the abstract…

Study: Sarcopenia linked to increased complications, mortality rates for older patients.
According to a study published in the Feb. 1 issue of The Journal of Bone & Joint Surgery, sarcopenia may often be associated with acetabular fractures in older patients, and is linked to increased complication and mortality rates. The research team reviewed data on 99 patients with acetabular fracture and recorded body mass index (BMI) and adequate CT scans from the Rhode Island Hospital Trauma Database. Of those, 42 patients had sarcopenia and 57 did not. They found that sarcopenia was more common in male patients and in patients with lower BMI. Overall, fractures in patients without sarcopenia were generally associated with a higher-energy mechanism of injury than among patients with sarcopenia. Compared to no-sarcopenia, the research team found that sarcopenia was significantly associated with increased 1-year mortality and likelihood of anterior column fracture. Read the abstract…

GAO says CMS needs more progress in reducing improper Medicaid payments.
Findings from a report from the U.S. Government Accountability Office (GAO) suggest that further efforts may needed by the U.S. Centers for Medicare & Medicaid Services (CMS) to reduce the number of improper Medicaid payments. GAO notes that CMS has taken steps to improve Medicaid program integrity and reduce improper payments, but recommends additional actions to help further prevent improper payments. The agency identifies four key program integrity issues for the Medicaid program:

  • Enrollment verification
  • Oversight of Medicaid managed care
  • Provider eligibility
  • Coordination between Medicaid and Affordable Care Act healthcare exchanges

Read more (PDF)…
Read the complete report (PDF)…

CMS call to discuss data reporting for global surgery initiative.
The 2017 Medicare Physician Fee Schedule (PFS) final rule adopted a data reporting requirement, effective July 1, 2017, for practitioners furnishing specified global procedures in nine states: Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island. Practitioners who only work in practices with fewer than 10 practitioners and those who furnish services in other states are not required to report, but may report voluntarily. CMS plans to use the reported data to help establish payment rates under the PFS. On Tuesday, April 25, from 1:30 p.m. to 3:00 p.m. EST, representatives from CMS will discuss the new requirements and reporting resources available to providers. A question and answer session will follow the presentation. Call participants must register in advance. Learn more and register…

Last call: ACR Appropriateness Criteria Expert Panel on Musculoskeletal Imaging.
AAOS seeks to nominate two members to the American College of Radiology (ACR) Appropriateness Criteria Expert Panels on Musculoskeletal Imaging. The criteria are evidence-based guidelines designed to assist providers in making the most appropriate imaging decision for a specific clinical condition. Applicants for this position must be active fellows. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted by Feb. 7, 2017 at 11:59 p.m. (CT), to Kyle Shah at: shah@aaos.org.
Learn more and submit your application…