Advocacy News
April 4, 2017

IN THIS ISSUE

What’s Next for Health Care?

CMS Delays Implementation of Bundled Payment Model

Congress Talks Medical Device User Fee Act

Research Capitol Hill Days Urges NIH Funding

Antitrust Legislation
Passes House

Stark Briefing Addresses Value-Based Payment

State Corner:
Out of Network Update

What We're Reading

Political Graphic of the Week

Quality Payment Program Resources

Twitter Stream

PAC Participation Leader Board by State

Learn More About the Advisor’s Circle

AAOS Orthopaedic PAC Online and Mobile Donations

 
MORE RESOURCES

AAOS Website

AAOS Calendar

House of Representatives Legislative Activities

Facebook Twitter

Republican AHCA Vote Pulled, Congress Turns to FDA and Appropriations Work
 
For questions or concerns on these or other advocacy issues, contact the Office of Government Relations at dc@aaos.org.
 
WhatÕs Next for Health Care?

On March 24, 2017, House Speaker Paul Ryan (R-WI) pulled the American Health Care Act (AHCA) from consideration after it was clear Republicans could not secure a basic majority to advance the bill (read more about the legislation in Advocacy Now online here). The AHCA was proposed by Republicans as the first phase in repealing and replacing the Affordable Care Act (ACA). Conservatives in the House Freedom Caucus said it did not do enough and demanded several major policy changes, including a repeal of the law’s essential health benefits. On the other hand, rank-and-file lawmakers were facing pressure to walk away from the politically tricky vote by interest groups, seniors’ advocates, and constituents.

“We came really close today, but we came up short,” said Ryan in a press conference. “I will not sugar coat this: This is a disappointing day for us. Doing big things is hard. All of us. All of us—myself included—we will need time to reflect on how we got to this moment, what we could have done to do it better.”

Click here to read more.

 
CMS Delays Implementation of Bundled Payment Model

On March 21, 2017, the Centers for Medicare & Medicaid Services (CMS) published an interim final rule with comments that delays the Surgical Hip and Femur Fracture Treatment (SHFFT) model from the original implementation date of July 1, 2017 to October 1, 2017. Additionally, CMS is asking for comments to further delay the start date to January 1, 2018. In addition, the rule means that compliance requirements for the Comprehensive Care for Joint Replacement (CJR) model related to becoming an Advanced Alternative Payment Model (APM) will not begin until October 1, 2017.

Click here to read more.

 
Congress Talks Medical Device User Fee Act

On Tuesday, March 29, 2017, the Health Subcommittee of the House’s Energy and Commerce Committee held the third of its hearings on the reauthorizations of the User Fee Acts, due to expire on September 30. Tuesday’s hearing was devoted exclusively to the Medical Device User Fee Act (MDUFA), as committee members discussed the provisions of MDUFA IV and negotiated among industry stakeholders and officials at the Food and Drug Administration (FDA).

On hand to answer the subcommittee’s questions was Dr. Jeffrey Shuren, the Director of the FDA’s Center for Devices and Radiological Health. In his opening statement, Dr. Shuren described many of the improvements MDUFA IV will make to the Act’s previous incarnation: “MDUFA IV agreement includes a new quality management program that will enhance consistency and predictability in premarket review processes. MDUFA IV agreement would also allow FDA to move forward in some critical and strategic areas such as strengthening our partnerships with patients. Strengthening patient input will allow us to promote more patient-centric clinical trials, advance benefit-risk assessments that are informed by patient perspectives, and foster earlier access to new devices. Another critical area supported by the MDUFA IV agreement is the development of the National Evaluation System for health Technology, or NEST.”

Click here to read more.
 

Research Capitol Hill Days Urges NIH Funding

The American Academy of Orthopaedic Surgeons’ Research Capitol Hill Days, an annual event promoting federal funding for musculoskeletal research, gives physicians, researchers, and patients the opportunity to meet with targeted Senators and Representatives to personally advocate for the future of musculoskeletal care, and specifically, increased research funding for the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) of the National Institutes of Health (NIH).


Research Capitol Hill Days provides both doctor and patient participants with training, including an overview of advocacy skills and legislative outreach. Each year, over 60 orthopaedic patients, surgeons, and researchers met with U.S. Senators and Representatives to personally advocate for the future of musculoskeletal care and stress the importance of continued support of research funding. Meetings include members of the Senate and House Appropriations Committees. For more information, click here.

 

Antitrust Legislation Passes House


On March 22, 2017, the House easily approved a bill that Republicans have said is part of their broader plan to remake the health care system. According to House Majority Leader Kevin McCarthy (R-CA), the Competitive Health Insurance Reform Act (H.R. 372) “makes needed reforms to the McCarran-Ferguson Act to reduce health care costs for consumers by ensuring competition.” McCarthy further stated that the legislation will protect consumers from consolidation in the health care marketplace and restore competition to the health care industry, “bringing down costs and expanding choices for American consumers.”

Click here to read more.
 

Stark Briefing Addresses Value-Based Payment

The Healthcare Leadership Council (HLC) hosted a panel briefing on Stark and anti-kickback law on March 24, in the Rayburn House Office Building. Panelists represented Ascension Health, a non-profit healthcare organization with 2,500 sites of care; Medtronic, a “global leader in medical technology”; and the healthcare practice of Crowell & Moring. The HLC arranged the event as part of its mission to modernize the fraud and abuse laws that can act as barriers to the kind of care coordination HLC envisions.

Panelists shared the sentiment that Stark and anti-kickback law were designed for a payment landscape that isn’t necessarily reflected in today’s transactions and can act as impediments to a value-based payment environment. They argued that the laws should be updated to provide clear, comprehensive protection for those value-based payment arrangements that do not pose undue risk of fraud/abuse by, for example, extending existing waivers to all payers; or, short of this, creating new exceptions and safe harbors; as well as clarifying key standards found in Stark exceptions and anti-kickback safe harbors.

Click here to read more.

State Corner: Out of Network Update

In March 2017, AAOS formally signed onto a coalition to fight the impact of potential regulation of provider payments in the case of “surprise billing” with several other specialty societies. The coalition principles are based on one overarching principle: When patients are treated, they should be confident in the knowledge that their health insurance will cover them. The coalition has opposed and supported bills on this issue in California, Washington, Oregon, Idaho, Nevada, Utah, Colorado, Texas, Florida, Indiana, Pennsylvania, New Jersey and others. Click here to read the coalition principles.

In late 2015, the American Association of Orthopaedic Surgeons (AAOS) informed orthopaedic surgeons of the National Association of Insurance Commissioners’ (NAIC) model legislation to regulate provider payments. At the time, AAOS recommended that Executive Directors monitor their state legislatures and actively oppose legislation that creates a ceiling on out-of-network payments to a percentage of Medicare.

Click here to read more.

What WeÕre Reading

Is Obamacare Repeal Dead or a Legislative Zombie? Associated Press, 3/31/17

Intraparty Tensions Boil Over Amid GOP Health Care Struggles, Morning Consult, 3/30/17

After Repeal Failure, GOP Senators Propose Obamacare Subsidy Patch, The Hill, 3/30/17

Freedom Caucus Isn’t Backing Down After Trump Threat
, Roll Call, 3/30/17

GOP Senators Propose Bill for People Without Insurance Options Next Year
, Morning Consult, 3/29/17

Liberals See Opportunity in Health Care After GOP Meltdown
, The Washington Post, 3/29/17

Could Trump’s Top DOJ Antitrust Pick Help Seal the Anthem-Cigna Deal?
Modern Healthcare, 3/28/17

After GOP Health Bill’s Demise, More States Weigh Expanding Medicaid
, The Wall Street Journal, 3/28/17

Repeal of Affordable Care Act Is Back on Agenda, Republicans Say
, The New York Times,
3/28/17

Strung Out In Suburbia: Opioid Drug Crisis Hits the Suburbs, Modern Healthcare, 3/25/17

Political Graphic of the Week

Infographic


Click here to download infographic.

 

Quality Payment Program Resources

The Centers for Medicare & Medicaid Services (CMS) recently posted new resources to the Quality Payment Program website to help eligible clinicians and data submission vendors successfully prepare to participate in the program. According to the agency email announcement, CMS encourages these eligible clinicians, registries, qualified clinical data registries (QCDRs), and electronic health record (EHR) vendors to visit the website to review the new materials and information, including:

For Clinicians:

Click here to read more.

 
   
 
Follow Our New Twitter
Account @AAOSAdvocacy


 
   
 

PAC Participation Leader Board by State


Click here, to view the interactive version of the map below, which features each state’s PAC support through September 1, 2016.

Map


Learn More About the AdvisorÕs Circle


In 2016, the Orthopaedic PAC announced a new program specifically designed for group practices, called the Advisor’s Circle. If your group practice is looking to become more involved in the political advocacy arena, or for more sophisticated opportunities, the Advisor’s Circle offers just this. We have created a tiered benefits structure that offers unique activities that will exponentially increase your partners’, your practice’s, your patients’ and your own political reach. Benefits vary, from congressional fundraising retreats; to legislative fly-in assistance and in-district training and PAC checks; even a leadership role in bringing forth priority issues to the PAC Executive Committee. The Advisor’s Circle has a broad array of benefits that are completely separate from our individual donor benefits.

To schedule a one on one meeting to learn more about the Advisor’s Circle and a free assessment of your group’s needs email Stacie Monroe at monroe@aaos.org.

 
 
     
  AAOS Orthopaedic PAC Online and Mobile Donations

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Orthopaedic PAC is now mobile! Supporting by phone is easy: simply text AAOS to the number 41444, and follow the link, no log-in required. We encourage our supporters to share this technology with your colleagues who have yet to renew or join and to encourage signing up on a recurring basis, for just $84 a month, or $250 a quarter you can become part of our Capitol Club Program. And don’t forget! The Orthopaedic PAC website features an online contribution center, which can 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. 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!

 
     
   
 

©American Association of Orthopaedic Surgeons, 2017


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