Joint Commission Partnership; AAOS-Backed Bills Near Finish Line

On September 26, the American Academy of Orthopaedic Surgeons (AAOS) and The Joint Commission (TJC) announced a collaborative effort to incorporate AAOS clinical expertise into standards development and performance measurement requirements for Total Hip and Knee Replacement (THKR) Certification. The Joint Commission established this voluntary advanced certification in 2016 for accredited hospitals, critical access hospitals, and ambulatory surgery centers (ASCs) interested in elevating the quality, consistency, and safety of their services and patient care.

Landmark licensure and liability protection for sports medicine professionals advanced again last week, passing the U.S. House of Representatives as part of a larger unrelated bill. The Sports Medicine Licensure Clarity Act (H.R. 302) has already cleared both the House and Senate and received the support of key legislators and committees. The Senate is expected to act on the bill for a final time and send it to the president’s desk before the end of the year.

The final version of the bill ensures that traveling team doctors can appropriately care for their athletes without risking unjust legal or financial penalties. The legislation mandates that liability insurance of a sports medicine professional treating their team in a secondary state should cover that person (subject to premium adjustments) as if treatment was provided in the primary state. Additionally, if two states do not currently have an agreement to provide licensure reciprocity, the sports medicine professional is to be treated in any state as if they’re practicing in the state in which they’re licensed.

The most recent version of a large disaster prevention bill contains initiatives to increase disaster preparedness in trauma care and protect physicians traveling to disaster zones. The Pandemic and All-Hazards Preparedness and Advancing Innovation Act (H.R. 6378) was passed by the House last week before that chamber recessed until after the November midterm elections. The bill includes the MISSION ZERO Act and a modified version of the Good Samaritan Health Professionals Act, two key AAOS priorities.

The MISSION ZERO Act (S.1022, H.R.880) will help maintain military surgical readiness and improve civilian access to trauma care. Introduced by Representative Michael Burgess (R-TX) and Senator Johnny Isakson (R-GA), the legislation establishes a grant program to enable military providers and trauma teams to offer trauma care and related acute care at civilian trauma centers.

On September 28, the House passed a compromise opioid crisis response measure (H.R. 6) which was released last week after months of markups and hearings. The bill includes a wide range of provisions to address the epidemic, including those intended to expand access to treatment for substance use disorder, particularly in local communities, and establish comprehensive opioid recovery centers. It also contains several AAOS-supported initiatives outlined below and is expected to quickly pass the Senate and become law.

On Monday Sept 17, the Centers for Medicare and Medicaid Services (CMS) released the Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction Proposed Rule. CMS has revised the Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) through previous rules in 2012 and 2014, but this is the first such rule released in accordance with the January 30, 2017, Executive Order 13771 entitled “Reducing Regulation and Controlling Regulatory Costs.”

According to CMS, “These proposals would increase the ability of health care professionals to devote resources to improving patient care by eliminating or reducing requirements that impede quality patient care, or that divert resources away from furnishing high quality patient care.”

The American Association of Orthopaedic Surgeons (AAOS) is committed to safe, accessible, cost-effective and quality patient care. However, the structure of the current medical liability system limits the ability of physicians to provide the highest quality patient care, and systematic medical liability reform is needed to improve the overall health care system.

The Arkansas Orthopaedic Society is working on a ballot initiative to set caps on compensation for non-economic damages and on punitive damages. Called Issue I, it limits contingency fees of lawyers to one-third the net amount recovered. The ballot initiative would decrease from 66.67 percent to 60 percent the supermajority vote requirement in the legislature to amend or repeal court rules regarding pleading, practice, or procedure prescribed by the Arkansas Supreme Court. It would also require a two-thirds (66.67 percent) supermajority vote for the legislature to make certain changes to the limits in the amendment. Currently, Arkansas has no limit on non-economic damages and does not set a limit on attorney contingency fees.

Applications are now open for the AAOS Office of Government Relations 2019 Resident Advocacy Fellowship. The program is directed by Dr. Stuart Weinstein, former Chairman of the AAOS Political Action Committee, and seeks to foster the development of orthopaedic surgeons interested in health policy and advocacy who are willing to become key members of the AAOS advocacy team.

Two Fellows will be selected for the 2019 calendar year. Throughout the program, they will gain a greater understanding of the health policy process, contribute to the development of new policies and programs, help develop strategic planning, work on various projects with senior AAOS staff, and develop a strong foundation for leadership in the health care environment. Additionally, Fellows will attend the National Orthopaedic Leadership Conference and various Hill visits in Washington, D.C.

Interested applicants must apply no later than November 15. A full description of the program and application instructions can be found here.

For more information, contact OGR Senior Manager of Government Relations Julie Williams at jwilliams@aaos.org.

• The National Institute on Aging and the American Geriatrics Society are hosting a conference on Osteoporosis and Soft Tissue Disorders March 11-12 in Bethesda, MD. Application (due Oct. 26) and agenda can be found here.

• New Merit-based Incentive Payment System (MIPS) resources are now available in the Quality Payment Program resource library, which can be found here.