Sports Legislation Advances, Some MIPS Reporting Requirements May be Waived

Legislation to protect team physicians as they travel with their teams across state lines has for the first time passed a critical committee test in the Senate. S. 808, the Sports Medicine Licensure Clarity Act, was referred out of the Senate Health, Education, Labor, and Pensions (HELP) Committee on June 26, 2018, by a unanimous voice vote.

The vote follows a coordinated support effort from AAOS and the American Orthopaedic Society for Sports Medicine (AOSSM) involving meetings, letters, grassroots efforts, and more. Read the joint letter in support of the bill here. The legislation provides licensure and liability protection for healthcare professionals treating their team while outside their primary state. A similar version of the bill passed the House of Representatives on January 9, 2017.

Join AAOS Advocacy Resources Committee (ARC) Chair Claudette Lajam, MD and other advocacy leaders on July 11 for a webinar on in-district congressional advocacy. The webinar will cover proven strategies that will help you be an effective advocate at home, without having to travel to DC. Register here. All those who register will also receive a recording after the event.

The Centers for Medicare and Medicaid Services (CMS) is seeking comments on a proposal to launch a Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration to test waiving Merit-Based Incentive Payment System (MIPS) requirements for clinicians who participate in certain Medicare Advantage plans that already undertake adequate risk and report on quality metrics.

Under the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act (MACRA, 2015), eligible clinicians currently participate through one of two pathways: MIPS, which adjusts Medicare payments based on combined performance on measures of quality, cost, improvement activities; and promoting interoperability; or Advanced Alternate Payment Models (APMs), which require clinicians to take on risk for their patients’ health outcomes and expenditures. This announcement is significant for at least three reasons.

Providers wishing to participate in Bundled Payments for Care Improvement Advanced (BPCI Advanced) have been given an additional week to send in Participation Agreements. The original August 1st deadline has been extended to August 8th.

In January 2018, the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) announced a new voluntary episode payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced) that would qualify as an Advanced Alternative Payment Model (APM) under the Quality Payment Program. There are 11 orthopaedic episodes within BPCI Advanced.

On Wednesday, June 27th, the Senate Committee on Health, Education, Labor, and Pensions (HELP) chaired by Sen. Lamar Alexander (R-TN) held the first of three or four intended hearings entitled “How to Reduce Health Care Costs: Understanding the Cost of Health Care in America”. Sen. Alexander framed the goals of the hearing to explore the causes and solutions to rising healthcare costs separate from the political rancor of health insurance.

In a study quoted by the senators and performed by one of the witnesses, Dr. Ashish Jha, in a comparison to 10 other high-income countries including the UK, Germany, Australia, and Switzerland it was found the United States spends nearly twice the percentage of its GDP on health care but is relatively average in terms of utilization. This points to issues in the health care system besides overuse and waste as the drivers of costs.

Dr. Julio Gonzalez, a board certified orthopaedic surgeon, is running for the open seat in Florida’s open 17th district. Orthopedists are lining up around the country, supporting Julio, recognizing the importance of having one of our own in the US House of Representatives. Most recently, the Rothman Institute partnered with the Orthopaedic PAC and hosted an event to support one of our colleagues. The event, which was hosted at the home of Dr. David Nazarian, was held before a critical end of quarter fundraising deadline. At the event Dr. Gonzalez discussed why he wanted to run for office, stating when his seat opened he “recognized the importance of physician participation in Congress, particularly in light of the dwindling numbers of members who are physicians.” He then went on and thanked and recognized the deep support from his orthopedist colleagues and gave high praise to the AAOS’ political operation.

The AAOS Medical Liability Committee is seeking applicants for two upcoming vacancies! MLC members work with AAOS Office of Government Relations and the Council on Advocacy to monitor trends regarding professional liability and tort reform and serve as support and policy-making resource; develop appropriate organizational statements to serve the AAOS Fellowship in the arena of professional liability; and, develop programs, publications and products and conduct studies that educate the Fellowship on liability risks and methods to decrease the orthopaedic surgeons exposure to liability. The two-year appointment extends from March 18, 2019 to March 12, 2021, and is eligible for a second two-year appointment. Active Fellows can apply through the CAP system until August 3, 2018. For more information please contact Stephanie Hazlett, Manager of Government Relations, at hazlett@aaos.org.

Click here, to view the interactive version of the map below, which features each state’s PAC support for 2017.