Today’s Top Story
Supreme Court ruling could force Congress to patch or replace ACA.
An article in The New York Times looks at challenges faced by congressional representatives who do not support the Affordable Care Act (ACA), but may be faced with enacting a patch or replacement, depending on the outcome of a case before the U.S. Supreme Court. The plaintiffs in King v. Burwell argue that the ACA authorizes insurance subsidies only to purchasers in states that have set up their own health insurance exchanges. If the Supreme Court agrees and finds the subsidies to be improper, observers say that 5 million consumers could be affected across the 36 states that use the federal healthcare.gov exchange, placing the fiscal structure of the ACA in doubt. Leaders from both the Republican and Democratic parties agree that repeal and replacement of the ACA becomes more difficult as more people have gained coverage under the law and insurers have adapted to its changes. Read more…
On a related note, The Wall Street Journal reports that David King—one of the lead plaintiffs in the King v. Burwell case—served in the U.S. Army, qualifying him for medical coverage through the U.S. Department of Veterans Affairs (VA). Observers say that the fact that this plaintiff could avoid paying a penalty for lacking insurance by enrolling in VA coverage may undermine his standing in the case. Read more…
Other News
Manufacturer to pay $80 million after marketing unapproved orthopaedic cutting guide.
The U.S. Department of Justice (DOJ) and OtisMed have reached a settlement agreement regarding the use of the OtisKnee—a cutting guide designed to assist surgeons performing total knee arthroplasty procedures. The manufacturer initially did not seek clearance from the U.S. Food and Drug Administration (FDA) for marketing the product before it started selling them. Under terms of an acquisition deal, the manufacturer later filed for FDA clearance to market the device, and FDA stated that the manufacturer had not demonstrated that the guides were safe and effective. The DOJ claims that the company sold 18,000 of these devices from 2006 to 2009 without FDA clearance. The manufacturer’s chief executive officer directed employees to continue shipping the device even after the company’s board of directors voted unanimously to halt shipments. This action was reported by a whistleblower, an employee of the company that ultimately acquired OtisMed. In settling the case with the DOJ, the manufacturer paid $80 million in criminal and civil fines, and the executive is to be sentenced on March 18; he faces up to 3 years in prison and $300,000 in fines. The acquiring company was not charged with wrongdoing and has agreed to audit its other devices to ensure that they have proper FDA clearances. Read the FDA statement…
Study: Regional anesthesia during THA associated with reduced complication rates.
According to a study published in the Feb. 4 issue of The Journal of Bone & Joint Surgery, compared with general anesthesia, regional anesthesia for total hip arthroplasty (THA) may be associated with reduced complication rates and shorter hospital length of stay. The authors conducted a retrospective, propensity-matched cohort study of 12,929 THA procedures found in the American College of Surgeons National Surgical Quality Improvement Program database. Overall, 5,103 (39.5 percent) were performed with regional anesthesia. They found that risk of deep surgical site infection was significantly lower in the regional anesthesia group than in the general anesthesia group. In addition, hospital length of stay was decreased by 5 percent with regional anesthesia. Finally, regional anesthesia was associated with a 27 percent decrease in likelihood of prolonged hospitalization. Mortality rates were similar across both cohorts, but the authors noted that the adjusted odds for cardiovascular complication and respiratory complication were lower in the regional anesthesia group. Read the abstract…
Study: Use of a fluorescent probe may help visualize OA progression.
Data from a mouse study published in the February issue of the journal Arthritis & Rheumatology suggest that use of a near-infrared (NIR) fluorescent probe activated by matrix metalloproteinases (MMP) activity may offer a sensitive and consistent visualization of osteoarthritis (OA) progression. The researchers used an MMP-activatable NIR fluorescent probe to assess the up-regulation of MMP activity in vitro by incubating human chondrocytes with the proinflammatory cytokine interleukin-1β (IL-1). In addition, they evaluated MMP activity in βvivo serially in a mouse model of chronic, injury-induced OA. The researchers write that in vitro studies confirmed that NIR fluorescence imaging identified enhanced MMP activity in IL-1β–treated human chondrocytes. In addition, in vivo imaging displayed significantly higher fluorescence intensity in OA knees compared to sham-operated (control) knees of the same mice. They suggest that the approach may have potential for future translation to humans. Read more…
Read the abstract…
Study: Many patients have expectations for physician attire, but attire may not influence perceptions of care.
According to findings published online in the journal BMJ Open, many patients have specific expectations for physician dress, and patient perceptions of attire may be influenced by age, locale, setting, and context of care. The research team reviewed data from 30 studies covering 11,533 patients across 14 countries. They found that preferences or positive influence of physician attire on patient perceptions were reported in 21 studies (70 percent). Overall, 18 studies (60 percent) noted that patients preferred formal attire and white coats, although other attire was not specified. Preference for formal attire and white coats was more prevalent among older patients and in studies conducted in Europe and Asia. In addition, four of seven studies involving procedural specialties reported either no preference for attire or a preference for scrubs, while four of five studies in intensive care and emergency settings also found no attire preference. Only three of 12 studies that surveyed patients after a clinical encounter concluded that attire influenced patient perceptions. Read more…
Read the complete study…
Last call to register in advance for the 2015 AAOS Annual Meeting!
Feb. 10 is the advance registration deadline for the 2015 AAOS Annual Meeting. AAOS members may take advantage of free registration and lower course fees when they register in advance. Register for the Annual Meeting…
An article in the January issue of AAOS Now outlines what participants can expect from the 2015 AAOS Annual Meeting. Read more…
Help build a Safe and Accessible Playground in Las Vegas.
Join the AAOS on Tuesday, March 24, 2015, for the 16th annual Safe and Accessible Playground Build. This year’s project will take place at Palabra Viva Las Vegas church, starting at 8:30 a.m., and concluding with a ribbon-cutting ceremony at 2:30 p.m. Be a playground build sponsor or register as a build day volunteer. No experience is necessary to take part in this fun and rewarding activity! Learn more and register…
Call for volunteers: MedPAC.
AAOS seeks to nominate members to the Medicare Payment Advisory Commission (MedPAC). MedPAC is an independent congressional agency established to advise the U.S. Congress on issues affecting the Medicare program. In addition to advising Congress on payments to private health plans participating in Medicare and providers in Medicare’s traditional fee-for-service program, MedPAC is also tasked with analyzing access to care, quality of care, and other issues affecting Medicare. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must submit 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 relevant subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted by Thursday, March 5, 2015 at 11:59 p.m. CT, to Kyle Shah at shah@aaos.org.
Learn more and submit your application…(member login required)
