Today’s Top Story
CMS posts 2015 Open Payments financial data.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released 2015 Open Payments (Sunshine Act) data, along with newly submitted and updated payment records for 2013 and 2014. The Open Payments program requires that transfers of value by drug, device, biologic, and medical supply manufacturers to physicians and teaching hospitals be published on a public website. CMS states that, in program year 2015, healthcare industry manufacturers reported $7.52 billion in payments and ownership and investment interests to physicians and teaching hospitals. Total payments in the three major reporting categories are:
- $2.60 billion in general (i.e., non[n-dash]research-related) payments
- $3.89 billion in research payments
- $1.03 billion of ownership or investment interests held by physicians or their immediate family members
DOJ rule will increase penalties for kickbacks and Medicare fraud.
An interim final rule issued by the U.S. Department of Justice (DOJ) calls for sharp increases in penalties for Medicare fraud and kickbacks. Under the rule, minimum penalties for each false claim submitted to government programs such as Medicare will rise from $5,500 to $10,781, with maximum penalties increased from $11,000 per claim to $21,563 per claim. The rule would also increase penalties under the Anti-Kickback law from $11,000 per claim to $21,563 per claim. The Bipartisan Budget Act of 2015 required civil monetary penalties to be increased by August 2016 to account for inflation. DOJ is accepting comments on the rule through Aug. 29.
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Study: Low lean muscle mass linked to risk of incident fracture in older patients.
Data from a study published online in The Journal of Bone and Joint Surgery suggest that low lean muscle mass may be a predictor of incident fractures in healthy older patients. The research team conducted a longitudinal analysis of 913 participants with a mean age of 65.0 years. They found that the prevalence of low lean mass ranged from 3.5 percent to 20.2 percent depending on the threshold applied. At mean 3.4-year follow-up, researchers found that 40 participants (4.4 percent) had sustained at least one low-trauma fracture. After multivariate adjustment, they found that low lean mass, as defined by Baumgartner thresholds, was associated with increased risk of fracture, and added significant predictive value beyond the Fracture Risk Assessment Tool (FRAX). In addition, coexistence of sarcopenia and a T-score <–2.5 at spine or hip was associated with a 3.39-fold increase in low-trauma fracture risk.
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Study: Technical skills checklist may serve as reliable assessment tool for orthopaedic residents, but other methods needed to assess quality of technique.
Findings published online in the Journal of Surgical Education suggest that checklists can be a reliable assessment tool for evaluating a resident’s surgical skills, but documenting adverse events may be necessary to assess quality of technique. The authors tested 23 orthopaedic residents for technical skill in three shoulder surgical approaches using Objective Structured Assessment of Technical Skills (OSATS) checklists, the Global Rating Scale (GRS), and a final pass/fail assessment conducted by three upper extremity surgeons. They found that OSATS checklist scores showed superior interrater reliability compared with GRS and subjective pass/fail measurements. However, the authors note that checklist scores do not measure quality of technique, and recommend that multiple methods of assessing surgical skill be considered when evaluating orthopaedic resident’s surgical performance.
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Off-label prescribing of drugs common, but may be linked to adverse events.
A policy brief published online in the journal Health Affairs examines the issue of off-label drug promotion. The writers note that an estimated one in five prescriptions may be written for an off-label use, and that in some cases, the off-label use is an accepted standard of care and recommended in clinical practice guidelines. However, “off-label use is often not supported by good clinical evidence of effectiveness,” they write. “One study found that 73 percent of medications prescribed for off-label purposes had poor or no scientific support, while another found that 48 percent of off-label prescriptions for critical care patients lacked adequate evidence. […] Off-label use that is not supported by adequate evidence is associated with significantly higher rates of adverse drug reactions. Given the well-known gaps in the postmarket safety surveillance system, the true extent of these adverse events is likely underappreciated.” The writers state that the U.S. Food and Drug Administration has pledged to update its regulations and guidance documents regarding off-label use and recently announced that it would be releasing four guidance documents related to communication practices during 2016.
Study: Proper glove use may help reduce likelihood of HAI.
Findings presented at the annual meeting of the American Society for Microbiology suggest that contaminated gloves may be a vector for healthcare-associated pathogens. The research team quantified the number of viable bacteria transferred to a sterilized polypropylene surface by nitrile examination gloves contaminated with various species of bacteria. They found that all tested microorganisms transmitted 5 percent to 10 percent of inoculation from the gloves to the polypropylene surface immediately following inoculation. All tested microorganisms except Klebsiella pneumoniae and Acinetobacter baumannii decreased dose- and time-dependently and were not detected on the polypropylene surface at 3 minutes after inoculation of groves. K. pneumoniae and A. baumannii. remained approximately 10 colony-forming units on the polypropylene surface at 3 minutes after inoculation of groves. The research team argues that proper glove use may decrease the risk of healthcare-associated infection (HAI).
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Call for volunteers: Bylaws Committee.
July 22 is the last day to submit your application for chair of the Bylaws Committee. The Bylaws Committee makes recommendations to the fellowship on all proposed bylaws amendments to the AAOS Bylaws and Standards of Professionalism. Applicants for this position must be active fellows who are familiar with AAOS decision-making processes and socio-economic activities.
Learn more and submit your application…(member login required)