Washington, DC--Yesterday, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that addresses significant concerns raised by the American Association of Orthopaedic Surgeons (AAOS) related to mandatory bundled payment programs. First, the proposed rule would reduce the number of mandatory geographic areas participating in the Center for Medicare and Medicaid Innovation’s Comprehensive Care for Joint Replacement (CJR) model from 67 to 34. In addition, the proposed rule would allow CJR participants in the 33 remaining areas to participate on a voluntary basis. CMS also proposes to make participation in the CJR model voluntary for ALL low volume and rural hospitals in all of the CJR geographic areas. Finally, CMS is proposing to cancel the Surgical Hip and Femur Fracture Treatment (SHFFT) payment model and others that were scheduled to begin on January 1, 2018.

AAOS commends CMS for this important proposal and, after further analyzing all details in the rule, AAOS will be submitting comments by the October 16 due date.

"AAOS applauds Secretary Price, Administrator Seema Verma, and others at CMS for clearly hearing concerns of orthopaedic surgeons related to these mandatory payment models," stated AAOS President William J. Maloney, MD. "As we have said before, AAOS strongly supports the efforts of all stakeholders to develop payment models that incentivize care coordination and address rising health care costs. Additionally, appropriate alternative payment models are a necessary component of the current Quality Payment Program. However, imposing mandatory models on surgeons and facilities that lack the familiarity, experience, or infrastructure required has serious unintended consequences. Reducing the geographic area for CJR while still leaving a voluntary option significantly remedies this issue. We thank CMS for their work on this proposed rule and will be commenting officially with a more detailed response."

“Changing the scope of these models allows CMS to test and evaluate improvements in care processes that will improve quality, reduce costs, and ease burdens on hospitals,” said CMS Administrator Seema Verma. “Stakeholders have asked for more input on the design of these models. These changes make this possible and give CMS maximum flexibility to test other episode-based models that will bring about innovation and provide better care for Medicare beneficiaries.”

For more information on the Comprehensive Care for Joint Replacement Model, please visit: https://innovation.cms.gov/initiatives/cjr.

For more information on the models proposed for rescission, please visit: https://innovation.cms.gov/initiatives/epm

The proposed rule (CMS-5524-P) can be downloaded from the Federal Register at: https://www.federalregister.gov/public-inspection. Public comments are due by October 16 at 11:59 pm EST.

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Follow the AAOS Office of Government Relations on Twitter: www.twitter.com/AAOSAdvocacy

Stacie Monroe

Senior Manager, Political Affairs

Office of Government Relations

American Association of Orthopaedic Surgeons (AAOS)

317 Massachusetts Avenue, NE, Suite 100

Washington, DC 20002

202.548.4150 office

419.250.5873 cell

The House on Wednesday easily approved a bill that would allow patients to stay longer at ambulatory-surgical centers and open the door for a new type of health-care facility known as "recovery care centers." The bill (HB 85), sponsored by Rep. Heather Fitzenhagen, R-Fort Myers, is part of a series of health-care regulatory changes backed by House Republican leaders. Currently, patients cannot stay overnight at ambulatory-surgical centers, but the bill would allow them to stay up to 24 hours. Also, the bill would allow the creation of recovery care centers, where patients could stay up to 72 hours after surgery. House members voted 82-34 to approve the bill, which now goes to the Senate. Fitzenhagen said the bill can help lower costs and increase treatment options for patients. It remains unclear, however, whether the House and Senate will reach agreement on the issues before the March 11 end of the legislative session. The Senate has included the ambulatory surgical-center proposal in a much-broader bill (SB 212) dealing with health-care issues.

Source: The News Service of Florida 

Florida Orthopaedic Society in action.  Click the following videos to view testimony on debates taking place during Legislative Session in Tallahassee that impact the practice of orthopaedics.  Please fast forward the videos to the time stamps provided to see the debates on the specific bills listed.

Ambulatory Surgery Centers – HB 85

1/12/16 – House Health Care Appropriations Committee - http://www.myfloridahouse.gov/VideoPlayer.aspx?eventID=2443575804_2016011140&committeeID=2834

Start of Bill Debate: Forward to 0.46 time stamp on the video

Start of FOS Testimony: Forward to 8:30 time stamp on the video

Consumer Debt Collection – SB 562

1/19/16 – Senate Banking and Insurance Committee - http://www.flsenate.gov/media/videoplayer?EventID=2443575804_2016011205

Start of Bill Debate: forward to 51:30 time stamp on the video

Start of FOS Testimony: forward to 72:18 time stamp on the video

Out of Network Health Insurance Coverage (Balance Billing) – HB 221 –

1/19/16 – House Insurance and Banking Committee - http://www.myfloridahouse.gov/VideoPlayer.aspx?eventID=2443575804_2016011189&committeeID=2845

Start of Bill Debate: Forward to 1:21 time stamp on the video

Start of FOS Testimony: Forward to 1:48 time stamp on the video

The Florida Orthopaedic Society is extremely pleased to participate in the Legislative Day in Tallahassee being organized by the Florida Chapter of the American College of Surgeons.  The event is taking place Thursday, February 4^th in Tallahassee.  

We are working to secure a delegation of our members to join us in Tallahassee for a day of lobbying on those issues that are important to your practice and out patients.    We invite any of our members to consider participating in this event.   Members that do participate will be responsible to pay for their travel expenses.  Participants should plan to arrive in Tallahassee on Wednesday, February 3^rd.  We have a small block of rooms set aside for our participants. 

The 2016 Florida Legislative Session starts next week and is shaping up to be extremely busy for our organization.  Legislators are set to debate critical issues including Ambulatory Surgery Center expansion, Workers Compensation reimbursement, and a strict limitation on reimbursement for non-contracted emergency care.   Your engagement in the political process this year is extremely important to the profession.

If you are interested in joining us in Tallahassee, please email Fraser Cobbe at fcobbe@cobbemanagement.com. 

By Carol Gentry Health News Florida Special Correspondent

Source: Health News Florida

The FOS is passing along an opportunity for one of our members to participate in the WCRI Florida CompScope Advisory Committee.   The FOS does not have any affiliation with WCRI.   We do feel this opportunity outlined below may be of interest to some of our members and may be an opportunity to influence some of the trends and benchmarks that the WCRI publishes.  If you are interested in volunteering, please email me at  fcobbe@cobbemanagement.com.

About the Opportunity

The Workers Compensation Research Institute (WCRI), organized in 1983, is an independent, not-for-profit research organization that studies workers' compensation benefit delivery systems nationwide and has broad membership support. WCRI does not take positions on the issues it researches; rather it provides objective, reliable information to public policy makers and system stakeholders and serves as a catalyst for change in the system. All WCRI studies are subject to a rigorous peer review process and are published only if the reviewers approve the study as accurate and balanced.  WCRI publishes benchmark studies on various aspects of the Florida workers' compensation system. These studies (called CompScope Benchmarks) analyze trends and compare Florida with 15 other study states.

We have a WCRI Florida CompScope™ Advisory Committee that meets to discuss key points in the WCRI draft reports, offer reactions to the preliminary findings, and discuss emerging issues or concerns in Florida. The advisory committee consists of a cross section of stakeholders from labor, business, state agencies, insurance, and health care providers who are knowledgeable about workers' compensation in Florida.

We have an opening on this committee for a practicing surgeon, who works with workers' compensation patients. We have medical providers who represent other fields of medicine treating workers' compensation patients appointed to the committee and I would appreciate your help in identifying a candidate to fill the vacancy we have in this discipline.  

The time commitment is modest. The committee meets twice each year usually in Tallahassee for approximately 3 hours.  The next meeting will be in January or February 2014 and focus on the key points from the CompScope Medical Benchmarks, which drill down into the medical costs and utilization for Florida.

WCRI is a nonprofit, nonpartisan research organization. We do not take positions on the issues we research.  We do no advocacy work or lobbying. And to further ensure objectivity, our research is subject to rigorous, unbiased quality control procedures.  Our web site is www.wcrinet.org.