SGR Repeal Passes House, Meaningful Use Proposed Rule, Opioid Abuse, and More For questions or concerns on these or other advocacy issues, contact the Office of Government Relations at dc@aaos.org
SGR Repeal Sees Strong House Vote The House of Representatives last week overwhelmingly passed H.R. 2, the Medicare and CHIP Reauthorization Act, by a vote of 392 to 37. AAOS commends House members for passing the legislation, which will permanently repeal the Sustainable Growth Rate (SGR), ending the threat of substantial payment cuts in physicians’ Medicare reimbursement. The bill now goes to the Senate where they have adjourned for a 2-week recess. As a result, Senators will not consider the measure until they return on April 13. Further, this means the scheduled 21 percent reduction in Medicare payments will go into effect, but the Centers for Medicare and Medicaid Services (CMS) will delay processing Medicare payments for at least 14 days, giving the Senate time to act when it returns. President Obama has voiced support for SGR repeal and is expected to sign the legislation, should it pass the Senate. Senate Majority Leader Mitch McConnell (R-KY) promised that the chamber would take up the House-passed SGR repeal package “very quickly” when they get back. Click here to read more.
CMS Releases Meaningful Use Stage 3 Proposed Rule The U.S. Centers for Medicare & Medicaid Services (CMS) released draft regulations to add a third and final stage to the agency’s meaningful use of electronic health records (EHRs) program. The new rule maintains current payment adjustments and hardship exemptions, and in most instances, all physicians and other eligible professionals will be required to conform to the rules by 2018 regardless of the level of their previous participation. According to CMS, however, these proposed rules will give providers additional flexibility, make the program simpler, and drive interoperability among electronic health records, and increase the focus on patient outcomes to improve care. “This Stage 3 proposed rule does three things: it helps simplify the meaningful use program, advances the use of health IT toward our vision for improving health delivery, and further aligns the program with other quality and value programs,” said Patrick Conway, CMS acting principal deputy administrator and chief medical officer. “In an effort to make reporting easier for health care providers, we will be proposing a new meaningful use reporting deadline soon.” Click here to read more.
Energy and Commerce, HHS, Address Opioid Abuse The House Energy and Commerce Subcommittee on Oversight and Investigations last week held a hearing to discuss the growing problem of prescription drug and heroin abuse from state and local perspectives. The hearing, entitled “Examining the Growing Problems of Prescription Drug and Heroin Abuse: State and Local Perspectives,” built on last year’s subcommittee hearing that brought together several representatives from federal agencies to discuss this issue. According to a committee memo, one year later the problem has continued to grow with drug poisoning (overdose) being the leading cause of death from injury, surpassing motor vehicle accidents, suicide, firearms, and homicide. Last week’s hearing brought together a number of experts from across the country who confront this growing crisis in their communities and who were able to provide insight into the issue at a state and local level, review what steps are being taken, what has and hasn’t worked, and how to improve federal efforts to address the crisis. Click here to read more. Follow Our New Twitter Account @AAOSAdvocacy
What We’re Reading Medicare pay fix sails through House, Politico, March 27, 2015

Reid Plans Senate Exit: Not Running for Re-Election, Roll Call, March 27, 2015

Schumer’s Path to Leader Looks Clear, National Journal, March 27, 2015

CMS issues draft Stage 3 rules for EHR incentive program, Modern Healthcare, March 20, 2015

Cleveland Clinic Grapples With Changes in Health Care, New York Times, March 17, 2015

Republican-Controlled Senate Clears Budget Plan, Wall Street Journal, March 27, 2015
Senate Hearing on Health IT On March 17, 2015, the Senate Health Education Labor and Pensions Committee held its first Senate health committee hearing on Health IT since the 2009 passage of HITECH Act to examine why goals for “meaningful use” program have not yet been reached. The committee’s chairman, Sen. Lamar Alexander (R-TN), noted that a Medical Economics survey last year found nearly 70% of physicians say their Electronic Health Records (EHR) systems have not been worth it. He also emphasized that half of physicians have not met the requirements of the “meaningful use” program and are now facing penalties. “Transitioning to electronic health records requires a real transformation in how physicians practice medicine,” Sen. Alexander stated. “They must implement pricey systems, learn how to use them, ensure their staff is trained, and pay annual licensing fees and for hardware and associated services. The administration seems to have complicated the process by rushing ahead with penalties for those who don’t adopt EHR systems.”  Click here to read more.
2015 Physician Quality Reporting System (PQRS): CAHPS for PQRS Requirements Meeting A meeting was held at the American Medical Association (AMA) DC office on March 19, 2015, hosted by the Centers for Medicare and Medicaid Services (CMS), to discuss Consumer Assessment of Healthcare Providers and Systems (CAHPS) for Physician Quality Reporting System (PQRS) requirements.  PQRS uses incentive payments and payment adjustments to promote the reporting of quality information by eligible professionals (EPs).  CAHPS for PQRS is the collection and reporting of quality data in the form of a patient experience of care survey. The meeting focused on who can participate in CAHPS for PQRS, the CAHPS reporting requirements, the sampling and exclusion criteria, data collection, scoring and reporting, survey and vendor selection and an overview of the survey itself was provided. For performance year 2014, CMS conducted the survey on behalf of all group practices with 100 or more EPs that reported via the GPRO web interface or that reported via a qualified registry or EHR and elected to participate in CAHPS for PQRS.  CMS also conducted the survey for group practices with 25-99 EPs that reported via EHR, registry or web interface and elected to participate in CAHPS for PQRS.  Practices registered for PQRS during April 1 – October 5, 2014 for data collection that occurs January – April 2015. Click here to read more.
Bundled Payments Discussed at Annual Meeting We have a healthcare spending problem and it is not going away,” said Brian S. Parsley, MD, during Thursday’s symposium, “Implementing Bundled Payment Initiatives for Total Joint Replacement: Decreasing Cost and Increasing Quality.” According to Dr. Parsley, who moderated the symposium, payment alternatives are needed to address recent healthcare changes. Care coordination, best practices, care paths, and reducing disutility are all driving value in health care, he said. He added that cost containment is another important part of value-based healthcare delivery that must be examined, along with increasing access and improving quality. Click here to read more.
Gov. Ehrlich Speaks at PAC Luncheon At the 2015 Orthopaedic Political Action Committee (PAC) luncheon, former Maryland governor Robert “Bob” Ehrlich discussed some of what he sees as the most difficult issues confronting our culture and country, including redistricting, internal party dynamics, the importance of political speech, and even social media. The luncheon, held at the 2015 AAOS Annual meeting to show appreciation for 2014 PAC donors, included remarks from Frederick M. Azar, MD, past president of the AAOS and incoming Orthopaedic PAC Chair John Gill, MD. Click here to read more.
Save the Date: Sixth Annual Physician & Dentist Candidate Workshop, July 10-11, 2015 With many health policy challenges on the horizon, it is more important than ever that individuals who understand and care about the future of medicine are elected to public office. Fortunately, physician involvement in politics has grown considerably in recent years. In the 114th Congress there are 17 physician members serving in Congress, including two orthopaedic surgeons: Dr. Tom Price (R-GA-06) and Dr. John Barrasso (R-WY). Many more physicians are serving their communities through elected office at the state and local level. The Orthopaedic PAC strives to educate and help elect AAOS members and other specialty physicians to political office at all levels. AAOS is co-hosting the 6th Annual Specialty Physician and Dentist Candidate Workshop on Saturday, July 11 in Washington, DC along with the American Congress of Obstetricians and Gynecologists, American Society of Anesthesiologists, American College of Radiology and the American Dental Association. Click here to read more.
AAOS Orthopaedic PAC Online Contribution Center The Orthopaedic PAC website features an online contribution center, which can now accept contributions via credit card by visiting the site and using your AAOS login credentials. Credit card contributions can also be conveniently scheduled for a monthly, quarterly or yearly recurring donation. Consider joining the Orthopaedic PAC with a monthly contribution of $25 or make a $1,000 contribution manageable through $250 quarterly contributions to qualify for the new “Capitol Club”. Visit www.aaos.org/pac and select Donate to the Orthopaedic PAC for more information or to contribute today. Don’t remember when you last contributed? Log in to the contribution center today to view your complete donation history!