January 7, 2015
Today’s Top Story
1. CMS: 2015 Medicare claims will be held until Jan. 14 to correct technical errors.
The U.S. Centers for Medicare & Medicaid Services (CMS) has announced that Medicare Administrative Contractors (MACs) will hold claims containing 2015 services paid under the CY 2015 Medicare Physician Fee Schedule (MPFS) for the first 14 calendar days of January 2015. CMS states that a series of technical errors were discovered after the Nov. 13 publication of the MPFS rule, and the additional time will allow MACs to process the claims correctly. According to CMS, the hold should have minimal impact on provider cash flow as clean electronic claims are normally not paid sooner than 14 calendar days after the date of receipt. CMS additionally states that MPFS claims for services rendered on or before Wednesday, Dec. 31, 2014, are unaffected by the 2015 claims hold and will be processed and paid under normal procedures and time frames. Read more…
Other News
2. Review study looks at opioid prescribing.
A review study published online in the journal The BMJ looks at the effect of opioid prescribing for low back pain. The researchers note that opioids appear to have short-term analgesic efficacy for chronic back pain, but state that benefits for function are less clear. They examine guidelines and safety strategies for the use of opioids, analyze data from a number of relevant studies, and offer suggestions for future research. “There is no evidence that opioids improve return to work or reduce the use of other treatments,” the researchers write. “They may even limit the effectiveness of other treatments. Clinicians may want to monitor treatment success on the basis of functional ability, in addition to self-reported pain severity.”
Read the abstract…
3. CMS rule changes could affect how ACOs are formed.
An article from Lexology notes that recently proposed regulations from CMS could have implications for entities that wish to form accountable care organizations (ACOs) to participate in the Medicare Shared Savings Program (MSSP). The writers note that existing CMS regulations require an ACO formed by two or more “otherwise independent” participants to be a separate, independent legal entity. However, prospective participants have raised questions as to the exact meaning of “otherwise independent” and the specific parameters of when a separate legal entity is required. The writers state that the proposed regulations appear to resolve these questions by requiring the formation of ACOs as separate legal entities whenever two or more participants are identified by a unique taxpayer identification number. The proposed CMS regulations are currently in a 60-day comment period that will conclude Feb. 6, 2015. Read more…
4. Study examines treatments for knee OA pain.
A meta-analysis published online in the journal Annals of Internal Medicine compares the efficacy of several common drug treatments for knee osteoarthritis (OA) and finds that intra-articular treatments (including an intra-articular placebo) may be superior to NSAIDs. The authors conducted a meta-analysis of 137 studies covering 33,243 participants and found that, for pain, all interventions significantly outperformed an oral placebo, except for intra-articular corticosteroids. Treatments did not significantly differ from one another for reducing stiffness.
Read the abstract…
In an article posted by NBC News, a spokesperson for AAOS notes that AAOS clinical practice guidelines offer a strong recommendation against the use of hyaluronic acid for patients with symptomatic OA of the knee. Read more…
Read the AAOS CPG, “Treatment of Osteoarthritis of the Knee”…
5. CMS to host National Provider Call on 2014 submission process for Medicare Quality Reporting Programs.CMS has announced an MLN Connects™ National Provider Call to provide an overview of the 2014 submission process for Medicare Quality Reporting Programs, including the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier, and the Electronic Health Record (EHR) Incentive Program. The call will take place Tuesday, Jan. 13, from 1:30 p.m. to 3 p.m. ET. The presentation will provide information for eligible professionals (EPs) and group practices submitting 2014 data, and will provide guidance on how EPs and PQRS group practices can earn the 2014 PQRS incentive and avoid the 2016 negative PQRS payment adjustment. To take part, participants must register by 12 noon, Jan. 13.
Register for the call…
6. Connecticut.
A report released by the Connecticut Quality in Health Care Program finds that hospitals in the state reported a record numbers of preventable adverse events in 2013, with increases in the numbers of falls, medication mistakes, and perforations during surgical procedures. The report notes that the most commonly reported events in 2013 were pressure ulcers, which saw an expanded level of reporting with a new category that counted 233 “unstageable” ulcers that were not counted in previous reports. However, even without that category, the number of adverse events increased by 20 percent over the previous year. Overall, there were 277 pressure ulcers accounting for 52 percent of 534 adverse events reported. In addition, there were 90 reports of falls resulting in death or serious injury, 79 reports of perforations during open, laparoscopic, or endoscopic procedures, and 25 reports of retention of foreign objects after surgery or other procedures. Read more…
Read the complete report (PDF)…
7. January AAOS Now is online now and in your mailbox soon!
AAOS members will soon receive the print edition of the January issue of AAOS Now, but the online edition is already available on theAAOS Now website. This month’s issue includes a look at a CMS plan to convert all 10- and 90-day global procedure codes to 0-day global codes, a discussion of price transparency in health care, an examination of new orthopaedic CPT codes, and much more! Read more…
Read “CMS Converting All Global Payments for Procedural Services to Zero Days”…
Read “Price Transparency in Health Care: The Other Half of the Value Equation”…
Read “New Orthopaedic CPT Codes for 2015″…
8. Last call: Patient Safety Committee.
Jan. 8 is the last day to submit your application for a position on the Patient Safety Committee (one member opening). The Patient Safety Committee monitors current trends and educates the fellowship regarding patient safety and infectious disease as they relate to orthopaedic surgery. Applicants for this position must be active fellows with a practice emphasis in spine or adult reconstruction.
Learn more and submit your application…(member login required)