Today’s Top Story
CMS withdraws proposed prosthetics and orthotics rule.
The U.S. Centers for Medicare & Medicaid Services (CMS) has officially withdrawn a proposed rule that would have revised the standards for qualifications that providers and suppliers must meet in order to furnish, fabricate, or bill for prosthetics and custom-fabricated orthotics under the Medicare program. The agency states that the proposed rule is being withdrawn due to the cost and time burdens it would create and the complexity of issues raised by stakeholders.
AAOS had communicated to CMS serious concerns with the proposed rule. Wilford K. Gibson, MD, chair of the AAOS Council on Advocacy, states that the proposed rule would have “moved in the opposite direction from CMS’s stated objectives” by decreasing coordinated care and reducing alignment of incentives and regulations. “With this withdrawal, we look forward to properly addressing the coordination of high-quality, integrated and seamless orthotic and prosthetic management care.”
Read the notice in the Federal Register
Read the AAOS statement…

Other News

Still time to gather MIPS data to avoid 2019 payment penalty.
An article in HealthLeaders Media notes that Oct. 2, 2017, was the deadline for practices to begin 90-day data collection for one of the CMS “pick your pace” options under the Merit-Based Incentive-Payment System (MIPS) track of the Medicare Access and CHIP Reauthorization Act (MACRA). Providers that submit 90 days of 2017 data to Medicare may earn a neutral or small positive payment adjustment. However, practices can begin data collection as late as Dec. 31, 2017, to submit a minimum amount of data and still avoid a payment penalty in 2019. In 2019, CMS will cut Medicare pay 4 percent for providers who do not submit any 2017 MIPS data.
Read more…
Learn more about MIPS…

Study: Hamstring autograft with preserved insertions linked to improved outcomes compared to free autograft for ACL patients.
A study published online in the journal Arthroscopy compares differences in short-term outcomes for patients who undergo anterior cruciate ligament (ACL) reconstruction using a graft with preserved insertions and those treated with a free hamstring graft. The researchers conducted a prospective, randomized trial of 110 adult professional athletes, of whom 55 were treated with hamstring autograft with preserved insertions and 55 were treated with a free hamstring graft. At 2-year follow-up, the researchers found that, compared with free autograft, hamstring autograft with preserved insertions was associated with statistically superior anterior stability, better functional outcome, and closer return to preinjury level of sports activity.
Read the abstract…

Study: Operative and nonoperative treatment of Achilles tendon rupture may offer similar functional outcomes.
Data from a study published online in the journal Foot & Ankle International suggest no significant difference in Achilles tendon total rupture score (ATRS) for patients treated operatively or nonoperatively. The researchers analyzed 132 patients (62 surgical, 70 nonsurgical) with minimum 2-year follow-up. They found no significant difference in ATRS between the surgical and nonsurgical management cohorts (mean 84.8 and 85.3, median 90 and 91, respectively) with identical rehabilitation programs of functional bracing. They also noted no significant difference in ATRS across treatment cohorts based on patient sex or age at time of injury.
Read the abstract…

Study: Online physician ratings may not indicate actual performance.
Findings from a study published online in the Journal of the American Medical Informatics Association suggest that online ratings of specialist physicians may not objectively correlate with quality of care or peer assessment of clinical performance. The authors conducted an observational study of 78 physicians and assessed the association of consumer ratings with specialty-specific performance scores, primary care physician peer-review scores, and administrator peer-review scores. They found no significant association across the five most popular online platforms, although patient ratings of physicians tended to be consistent across all platforms.
Read more…
Read the abstract…

AMA Wire reports that the Wisconsin Supreme Court is considering whether to accept a case that could determine the constitutionality of the state’s medical liability cap. At issue is a case in which a woman visited two separate hospital emergency departments within 2 days and ultimately suffered organ failure plus gangrene in all her limbs, which eventually had to be amputated. A jury ruled that clinicians who treated here were not negligent but found that both failed to provide proper informed consent. The patient was awarded $15 million in noneconomic damages, and her husband was awarded $1.5 million for the loss of his wife’s companionship. Both the trial court and an appeals court ruled that the state’s $750,000 medical liability cap was unconstitutional. If the state Supreme Court chooses not to take up the case, the appellate court ruling will stand.
Read more…

Call for volunteers: Biomedical Engineering Committee.
Oct. 11 is the last day to submit applications for a position on the AAOS Biomedical Engineering Committee (two member openings). This committee monitors and reviews scientific and regulatory developments in the field of biomedical engineering as they relate to orthopaedic surgery. Applicants for these positions must be active fellows, candidate members, or candidate member applicants for fellowship with a practice emphasis on either adult reconstruction or spine.
Learn more and submit your application…(member login required)