Advocacy News
February 21, 2017

IN THIS ISSUE

AAOS Applauds House for Introducing Legislation to Lift Hospital BanEnerg

CMS Proposes Significant Changes to Medicare Standards for Providers and Suppliers of Prosthetics and Custom-Fabricated Orthotics

CMS Nominee Questioned by Senate Finance Committee

AMA Discusses Regulatory Burden

California Orthopaedic Association Produces Two White Papers on Value-Based Reimbursement

Residents! Attend the Orthopaedic PAC Resident Networking Reception at the 2017 AAOS Annual Meeting

What We're Reading

CMS Issues Proposed Rule to Increase PatientsÕ Health Insurance Choices for 2018

Political Graphic of the Week

Quality Payment Program Resources

PAC Participation Leader Board by State

Learn More About the AdvisorÕs Circle

AAOS Orthopaedic PAC Online Contribution Center and Mobile

 
MORE RESOURCES

AAOS Website

AAOS Calendar

House of Representatives Legislative Activities

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Physician-Owned Hospital Bill Introduced, New CMS Proposed Rules, and More
 
For questions or concerns on these or other advocacy issues, contact the Office of Government Relations at dc@aaos.org.
 
AAOS Applauds House for Introducing Legislation to Lift Hospital Ban

On February 16, 2017, Reps. Sam Johnson (R-TX) and Sheila Jackson-Lee (D-TX) introduced H.R. 1156, the Patient Access to Higher Quality Health Care Act of 2017. This legislation would repeal controversial restrictions contained within the Affordable Care Act (ACA) that prevent the expansion and new construction of physician-owned hospitals (POH)s. Section 6001 of the ACA included provisions that strictly prohibit any new POH from participating in Medicare or Medicaid. Furthermore, the ACA also prohibits existing POHs from expanding unless they meet a very complicated set of criteria as part of a long application process. H.R. 1156 will repeal these provisions.

Click here to read more.


CMS Proposes Significant Changes to Medicare Standards for Providers and Suppliers of Prosthetics and Custom-Fabricated OrthoticsÊ
 

CMS has issued a proposed rule that would revise 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.  If finalized it would take effect in future months but the agency is still considering whether to move forward with the changes and stakeholders have the opportunity to provide input via public comments.

Under the proposed rule, as a condition of Medicare payment, prosthetics and custom-fabricated orthotics (as defined by CMS) must be:

  • Furnished by a qualified practitioner.  CMS proposes to define a qualified practitioner as an occupational therapist, ocularist, orthotist, pedorthist, physical therapist, physician, or prosthetist who meets specified standards.  In particular, if the practitioner is not an enrolled Medicare DMEPOS supplier, the practitioner must be:  (1) licensed in orthotics, pedorthics or prosthetics, or (2) in states without licensure, specifically trained and educated to provide and manage the provision of pedorthics, prosthetics, and orthotics, and certified by the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC), the Board for Orthotist/Prosthetist Certification International, Incorporated (BOC), or an organization with equivalent standards.

Click here to read more.

 
CMS Nominee Questioned by Senate Finance Committee

On February 16, 2016, the Senate Finance Committee held a hearing to consider the nomination of Seema Verma to serve as Administrator of the Centers for Medicare & Medicaid Services (CMS). As explained by the committee, CMS is the world’s largest health insurer, covering over one-third of the U.S. population through Medicare and Medicaid alone. It has a budget of over one trillion dollars and it processes over 1.2 billion claims a year for services provided to some of our nation’s most vulnerable citizens.

Click here to read more.

 

AMA Discusses Regulatory Burden


On Wednesday, February 15th, the AMA held a meeting to discuss reducing the burden of non-MACRA/QPP related regulations. Representatives of more than two dozen specialty societies participated in the discussion, including AAOS, and were able to emphasize some of the shared regulatory challenges facing physicians. As part of continuing that discussion and addressing the concerns that arose, the AMA will be forming three new working groups on Medicaid, insurance markets, and on regulatory relief more generally.

Click here to read more.
 

California Orthopaedic Association Produces Two White Papers on Value-Based Reimbursement
Whitepaper
In the quickly changing healthcare landscape, both public and private payers are shifting from fee for service to a value-based reimbursement structure that takes a population health approach. According to these payers, the evolution toward value-based reimbursement benefits the patient, the physicians and the payer. The California Orthopaedic Association (COA) has produced two white papers that support their members in the shift towards value-based reimbursement.



Click here to read more.

Residents! Attend the Orthopaedic PAC Resident Networking Reception at the 2017 AAOS Annual Meeting

Orthopaedic residents represent the future of the AAOS. Attend this reception on Thursday, March 16, 6:30 p.m. to 9:00 p.m. to network with influential advocacy leaders and celebrate the next generation of advocates. Join the PAC Executive Committee, the Board of Councilors, the Board of Specialty Societies, and the Resident Assembly at the Bay City Brewery for drinks, food, and great company. This brewery, the best in San Diego, is owned by an orthopaedic surgeon. Transportation will be provided and all resident and PAC donors are invited to attend. A $25 resident/$100 donation is required for drink tickets.

Space is limited – please RSVP to pac@aaos.org.
 

What WeÕre Reading

Trump: Obamacare Replacement Coming in a Couple of Weeks, The Hill, 2/18/17

McConnell: Health Care Overhaul Will Be Done Without Democratic Support, Morning Consult, 2/17/17

Conservatives Object to Obamacare Replacement’s Tax Credits
, Bloomberg, 2/17/17

GOP Leaders Offer Outlines of Plan to Replace Obamacare
, Morning Consult, 2/16/17

Emerging GOP Plan Would Replace Parts of Obamacare as It’s Repealed
, Roll Call, 2/16/17

House GOP Leaders Will Elaborate on Their Obamacare Plans
, The Washington Post, 2/15/17

White House Proposes New Rules to Steady Insurance Markets Under Health Law
, The
New York Times, 2/15/17

Freedom Caucus Backs ACA Repeal and Replace That Counts on Private Health Care
, The
Washington Post, 2/15/17

Senate Easily Confirms Trump Pick of Shulkin as VA Secretary
, Modern Healthcare, 2/14/17

Antitrust Rulings Put Chill on Health-Insurance Mergers
, The Wall Street Journal, 2/14/17

Republicans, Aiming to Kill Health Law, Also Work to Shore It Up
, The New York Times, 2/12/17

The Stealth Republican Force Behind Obamacare Repeal
, Politico, 2/11/17

Physician-Owned Hospitals Should Be Included in ACA Repeal Bill
, D Health Daily, 2/10/17

 

CMS Issues Proposed Rule to Increase Patients’ Health Insurance Choices for 2018

The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule for 2018, which proposes new reforms that are critical to stabilizing the individual and small group health insurance markets to help protect patients. This proposed rule would make changes to special enrollment periods, the annual open enrollment period, guaranteed availability, network adequacy rules, essential community providers, and actuarial value requirements; and announces upcoming changes to the qualified health plan certification timeline.

“Americans participating in the individual health insurance markets deserve as many health insurance options as possible,” said Dr. Patrick Conway, Acting Administrator of the Centers for Medicare & Medicaid Services.  “This proposal will take steps to stabilize the Marketplace, provide more flexibility to states and insurers, and give patients access to more coverage options. They will help protect Americans enrolled in the individual and small group health insurance markets while future reforms are being debated.”

 Click here to read more.

 
   
 
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Account @AAOSAdvocacy


 
   
 

Political Graphic of the Week



Click here to view or download graphic.

 

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.

 

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

image 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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