| House Passes HEROES Act, Opens Debate on Next Phase of Relief Efforts
On May 15, the U.S. House of Representatives voted to pass the HEROES Act, opening debate on the next phase of coronavirus relief efforts from Congress. The legislation includes more than $3 trillion in funding for state and local governments, hospitals and physicians, payments to individuals, and other assistance. Most relevant to orthopaedics is that the bill includes an additional $100 billion in grants for healthcare providers as a fix for the currently suspended Medicare Accelerated and Advance Payment Program, as well as adjustments to repayment timelines for Paycheck Protection Program loans. The HEROES Act has been criticized as being too expansive and overreaching and is unlikely to see quick consideration in the Senate as currently written. That being said, formal negotiations on the next phase with the White House and Congress are not expected to begin until June, so this process will be significantly slower than the Coronavirus Aid, Relief, and Economic Security (CARES) Act and previous stimulus bills. The Office of Government Relations continues to advocate for AAOS priorities including support for physician practices, preservation of reimbursement levels, reduced administrative burden, and protection from infection and other liability claims. Read AAOS’ summary of the bill…
Orthopaedic Practices Receive $208 Million in Relief Funds
The Department of Health and Human Services (HHS) recently published a list of provider organizations that received payments from the Coronavirus Aid, Relief, and Economic Security (CARES) Act’s Provider Relief Fund general distribution.These grants were earmarked for COVID-19 providers, and there was some initial confusion as to whether orthopaedic surgeons would qualify that has since been clarified. According to an AAOS analysis of the data, approximately $208 million has already been delivered to more than 1,200 orthopaedic practices across the U.S. The money, which is a direct grant that was automatically sent to practices which treat Medicare patients, was calculated as roughly one-twelfth of the individual practices’ 2019 Medicare payments. The amount represents the reimbursement surgeons would have collected from Medicare if they had been allowed to treat patients and is considered budget neutral, since the federal government is still collecting Medicare premiums. See HHS Provider Relief Fund data…
CMS Proposes Changes to IPPS and Long-term Care Hospital PPS
On May 11, the Centers for Medicare & Medicaid Services (CMS) unveiled recommendations to update Medicare payment policies for hospitals paid under the Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital Prospective Payment System (PPS) for fiscal year 2021. The changes would create a separate hospital payment category for chimeric antigen receptor T-cell therapy, as well as make new antimicrobials more accessible through changes to the new technology add-on payment. The proposed rule would also add additional reporting requirements for hospitals’ Medicare cost reports including: (1) the median payer-specific charge that the hospital has negotiated with all Medicare Advantage (MA) organizations (also referred to as MA organizations), by Medicare Severity-diagnosis Related Group (MS-DRG); and (2) the median payer-specific charge the hospital has negotiated with all third-party payers, which would include MA organizations, by MS-DRG. CMS believes the new rule would be less burdensome for hospitals because hospitals are already obligated to report payer-specific negotiated charges. AAOS is analyzing the rule and will provide both a summary and comments in the coming weeks. Check out CMS’ fact sheet…
Dr. Knute Buehler Vies for U.S. House in Oregon’s May 19 Primary
Knute Buehler, MD, FAAOS, is running for Congress in the historically Republican seat left open by the retirement of Congressman Greg Walden. Dr. Buehler invented globally used knee replacement technology and has served on the board of his local hospital and many community organizations. In 2014, Dr. Buehler was elected to State Representative in a majority Democrat district and won re-election in 2016. As a private practice owner, he is passionate about physician-ownership issues and protecting fair physician payment. AAOS, along with other national medical associations like the AMA, ACEP, ADA, and the AAO, have endorsed Dr. Buehler. While he is the leading candidate, as of May 14, 30 percent of voters remain undecided in this 11 candidate race. Dr. Buehler has a great shot of winning this race and becoming the only orthopaedic surgeon in the U.S. House of Representatives. Learn more about Dr. Buehler… |
