Today’s Top Story
Providers who failed to revalidate may have lost eligibility for Medicaid reimbursement.
An analysis by Modern Healthcare finds that more than 65,000 providers in 15 states may be ineligible for reimbursement under Medicaid under an Affordable Care Act provision that requires certain providers to revalidate their eligibility. Under the initiative, providers that enrolled in Medicaid prior to March 25, 2011, were required to submit revalidation notices to the U.S. Centers for Medicare & Medicaid Services (CMS) by Sept. 25, 2016, or risk being dropped. There is no national database of Medicaid providers, but the publication reviewed data from 15 state Medicaid agencies, and notes that Texas alone cut more than 28,000 of its 298,000 Medicaid providers. The provision is designed to curb fraud and abuse in Medicaid programs. Read more…(registration may be required)

Other News

Patient non-compliance could affect provider reimbursement under MACRA rule.
An article in USA Today looks at the potential impact patient non-compliance may have on providers under a Medicare Access and CHIP Reauthorization Act (MACRA) rule. The writer notes that the rule is designed to improve quality and reporting by reimbursing providers for quality outcomes. However, some healthcare providers may be subject to payment penalties under Medicare if too many patients experience negative outcomes due to non-compliance with the provider’s advice. Read more…

Study: Patients with moderately higher BMI may not be at increased risk of meniscus repair failure.
According to a study published online in The Journal of Knee Surgery, patients with moderately increased body mass index (BMI) may not be at increased risk of short-term meniscus repair failure compared to patients with a lower BMI. The research team conducted a retrospective study of 216 patients who underwent meniscus repair at a single center. Overall, 100 patients (46.3 percent) had BMI <25 and 116 patients (53.7 percent) had a BMI ≥25. At mean 19-month follow-up, they found that 20 patients (20 percent) in the normal BMI group and 14 patients (12 percent) in the increased BMI group had required further surgery for repair failure. The research team writes that “surgeons should not consider moderately increased BMI as a contraindication to meniscal repair.” However, they note that the effect of BMI greater than 35 on meniscal repair outcomes remains unclear and warrants further study. Read more…
Read the abstract…

Study: DAIR may offer efficacy for certain patients with PJI.
Findings from a study published online in The Journal of Arthroplasty suggest that débridement, antibiotics, irrigation, and implant retention (DAIR) may be an option for treatment of hip periprosthetic joint infections (PJI) in certain patients, especially during the early postoperative period. The authors reviewed data on 122 DAIRs performed over a 16-year period. Overall, 67 percent of DAIRs were of primary arthroplasties, and 60 percent were performed within 6 weeks of the index arthroplasty. They found that infection eradication was achieved in 104 cases (85 percent) using a single or multiple DAIR approach, and 10-year implant survivorship was 77 percent. In 32 cases, more than one DAIR was required. “Early PJI and exchanging modular components at DAIR were independent factors for a four-fold increased infection eradication and improved long-term implant survival,” the authors write. They also caution that DAIR is associated with increased morbidity, and a risk of further surgery and instability. Read the abstract…

Study: Few patients aware of information on CMS Open Payments website.
A study published online in the Journal of General Internal Medicine suggests that few patients may make use of publicly available information on industry payments to physicians via the CMS Open Payments website. The researchers surveyed a nationally representative pool of 3,542 adults, and found that, of 1,987 respondents who could be matched to a specific physician, 65 percent saw a physician who had received an industry payment during the previous 12 months. They state that only 12 percent of survey respondents knew that physician payment information was publicly available, and only 5 percent knew whether their own physician had received payments. Read more…
Read the abstract…
Visit the Open Payments site…

Call for volunteers: Panel to develop AUC on surveillance of metastases after surgical treatment of sarcoma.
The Musculoskeletal Tumor Society (MSTS) seeks AAOS and MSTS fellows to participate on the writing panel for the Surveillance of Local Recurrence and Distant Metastasis after Surgical Treatment of Bone and Soft Tissue Sarcomas Appropriate Use Criteria (AUC); a project led by MSTS with the AAOS Evidence-Based Medicine Unit. The writing panel will be responsible for constructing a comprehensive patient indications list and a treatment list for the indicated condition. Writing panel members will be required to construct and review materials, correspond with AAOS staff electronically, and participate in approximately five to 10 conference calls that over a period of 1 to 3 months, and to produce the AUC materials. Members should have experience monitoring and treating patients after treatment of bone and soft tissue sarcomas. Nominees for the writing panel may have relevant conflicts, but will be required to complete the AAOS conflict of interest enhanced disclosure form online. To participate, please contact Mary DeMars by Monday, April 3, 2017, at: demars@aaos.org.

Call for volunteers: Health Care Systems Committee.
March 31 is the last day to submit your application for a position on the Health Care Systems Committee. The Health Care Systems Committee helps orthopaedic surgeons develop and improve relationships with other healthcare stakeholders. The following openings are available:

  • Member-at-large—health information technology (one opening)
  • Member (two openings)

Applicants for these positions must be active fellows with knowledge of healthcare system mechanisms, payment, and policies that impact quality, access, and resources for musculoskeletal conditions and disorders. Learn more and submit your application…(member login required)