Today’s Top Story

House leaders release proposal to replace ACA.
Leaders in the U.S. House of Representatives have unveiled the Patient Choice, Affordability, Responsibility and Empowerment Act (Patient CARE Act), which outlines their plan to repeal and replace the Affordable Care Act (ACA). The House proposal advocates the implementation of medical liability reforms, including caps on non-economic damages and limitations on attorney’s fees. In addition, the proposal envisions incentivizing states to adopt a range of tort reform solutions “to provide innovative, results-oriented solutions that offer injured patients the opportunity to receive compensation quickly and fairly without losing their access to the traditional court systems.” The authors state that the plan would also:

  • Ensure no one can be denied coverage based on a pre-existing condition
  • Prohibit insurance companies from imposing lifetime benefit limits on a consumer
  • Require health plans to offer dependent coverage up to age 26, unless a state opts out of this provision
  • Ensure guaranteed renewability for patients to be able to renew their coverage
  • Prevent individuals from being denied health coverage or being forced to pay a higher premium solely because of a pre-existing condition, assuming they have been continuously enrolled in a health plan without a significant break in coverage

Observers note that U.S. Congressional Budget Office will not assess the costs and impact of the Patient CARE Act unless it is introduced as a formal bill, and senior congressional aides say there are currently no plans to hold formal hearings to develop the proposal. Read more…
Read the statement from the House Energy and Commerce Committee…
Read the Patient CARE Act summary (PDF)…
Read the complete Patient CARE Act (PDF)…

Other News

Senator plans to introduce legislation to spin off CMS as an independent agency.
The Hill reports that Sen. Orrin Hatch (R-Utah) has announced his intent to introduce legislation that, if enacted, would make the U.S. Centers for Medicare & Medicaid Services (CMS) an independent agency separate from the U.S. Department of Health and Human Services (HHS). According to Sen. Hatch, CMS consumes about 85 percent of the $1 trillion budget for HHS, and he notes that the Social Security Administration was similarly spun off from HHS in 1994, when it accounted for about 51 percent of the department’s staff and more than half its budget. The senator also cites concerns about the influence HHS and the White House have over CMS operations and policies. Read more in The Hill
Read more in Bloomberg Business

FDA commissioner to step down at the end of March.
Margaret A. Hamburg, MD, commissioner of the U.S. Food and Drug Administration (FDA), has announced her intent to resign from that position at the end of March. President Obama nominated Hamburg to the post in 2009. During her tenure, FDA streamlined the approval process for certain drugs, proposed updates to packaged food nutrition information, required restaurants and retailers to label calories on menus, and won authority to regulate the tobacco industry. Critics say that she did not do enough to combat prescription opioid abuse and claim that the agency has been unduly influenced by industry under her leadership. Read more in The New York Times
Read more in the Baltimore Sun

Study: Surgical treatment of lumbar stenosis and degenerative spondylolisthesis may be effective for older patients.
According to findings published in the Feb. 4 issue of The Journal of Bone & Joint Surgery, there may be a significant benefit to surgical treatment of lumbar stenosis and degenerative spondylolisthesis for octogenarian patients, compared to nonsurgical treatment. The authors conducted an as-treated analysis of 105 patients 80 years and older and 1,130 patients younger than 80 years. They found no differences in rates of intraoperative or postoperative complications, reoperation, or postoperative mortality between the two cohorts. In addition, averaged over a 4-year follow-up period, surgically treated patients at least 80 years of age displayed significantly greater improvement in all primary and secondary outcome measures compared with nonsurgically treated patients. Treatment effects in patients in the older group were similar to those in younger patients for all primary and secondary measures except for the SF-36 bodily pain domain and the percentage who self-rated their progress as a major improvement. Read more…
Read the abstract…

Study: Extending indications for TKA would significantly increase projected costs.
Data published in the February issue of the journal Arthritis Care & Research suggest that expanding eligibility criteria for total knee arthroplasty (TKA) would substantially increase per-patient lifetime costs because more patients would undergo treatment earlier. The research team drew data from the Multicenter Osteoarthritis (OA) Study and used the Osteoarthritis Policy Model to estimate costs. They found that the estimated average discounted (3 percent per year) lifetime costs for persons diagnosed with knee OA of Kellgren-Lawrence grades 3 or 4 were $140,300; direct medical costs were $129,600, with $12,400 attributable to knee OA over 28 years. However, expanding eligibility to include symptomatic OA with a lesser degree of structural damage increased projected costs attributable to knee OA to $16,000. The research team states that the data underscores a need for more effective nonoperative therapies to address knee OA. Read more…
Read the abstract…

Apply now for the 2015 AAOS/OREF/ORS Clinician Scholar Career Development Program.
March 31 is the last day to submit your application to participate in the Clinician Scholar Career Development Program (CSDP). The program is a joint project of AAOS, the Orthopaedic Research and Education Foundation (OREF), and the Orthopaedic Research Society (ORS). CSDP seeks applicants in years PGY2 to PGY5 of orthopaedic residency, fellows, and junior faculty through year 3 who have the potential and desire to become orthopaedic clinician scholars (scientists and investigators). Up to 15 applicants will be selected to participate in the 1.5-day training workshop, with up to 10 additional participants sponsored by orthopaedic specialty societies. The 2015 AAOS/OREF/ORS CSDP will take place Sept. 17-19, 2015, in Rosemont, Ill. Please submit applications, along with curriculum vitae and a letter of support, by 11:59 PM CST on March 31, 2015 to
Learn more and submit your application…

Read the February AAOS Now on your tablet!
The February edition of AAOS Now magazine is now available for electronic devices capable of reading files in ePub format, including the iPhone and iPad, Android devices, and desktop computers (unfortunately, Amazon Kindle does not currently accept ePub files). To download and view the ePub version of AAOS Now, visit the link below and log in using your AAOS username and password. If you have comments or questions about the ePub version of AAOS Now, please email Peter Pollack, electronic content specialist, at
Download and read AAOS Now in ePub format…(member login required)

Last call: Committee positions closing soon!
A number of openings on the AAOS Committee Appointment Program website are closing in the next few days. Act now to apply for the following positions:

  • AAOS Now Editorial Board (one member-at-large—upper extremity focus opening; closes Feb. 13)
  • Commission on Motion Lab Accreditation (CMLA) Board of Directors (one member; Feb. 15)
  • Education Enhancement Fund Governance Committee (one member; Feb. 9)
  • Joint Commission Tobacco Treatment Technical Advisory Panel (one member; Feb. 12)

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