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American Association of Hip and Knee Surgeons

Advocacy, Education, Research

‘Medicare’

Projected Costs of Medicare, Medicaid, and SGR Repeal Reduced

According to Kaiser Health News, late August estimates from the Congressional Budget Office show that Medicare and Medicaid will cost a combined $89 billion less over 10 years than the CBO previously projected. Medicare is expected to spend $49 billion less from 2015 to 2024, while Medicaid spending is expected to be $40 billion less over the same… Read More

AAHKS Provides Comments on 2015 Proposed Physician Fee Schedule

On behalf of AAHKS, President Brian S. Parsley, MD, submitted comments to CMS on the Proposed Physician Fee Schedule for 2015. Dr. Parsley urged no further reductions in fees for arthroplasty and that CMS proceed carefully in adopting any future expansion of the Value-Based Payment Modifier program for 2017. He expressed AAHKS support for continuing the 90-day global… Read More

Open Payments Website Back Online

CMS has re-opened the Sunshine Act Portal in the physician open payments system on their website. The site had been down for two weeks while errors were corrected. About one-third of the data has been removed for viewing after CMS discovered erroneous information. The deadline for data review is now September 8, 2014. Go to the Open Payments… Read More

AAHKS Shares Views at CMS Visit

CMS Visit

President Brian S. Parsley, MD and Health Policy Chair Mark I. Froimson, MD, MBA, lead an AAHKS team that also included Executive Director Mike Zarski, JD and regulatory counsel Gail Daubert, JD on a visit to CMS headquarters in Baltimore. The team met with Marc Hartstein, Group Director, Hospital and Ambulatory Policy Group; Kathy Bryant, JD, Director, Division… Read More

Physician Payments Sunshine Act Database Taken Offline

In order to address glitches in the system, the CMS has taken the Open Payments system offline until next month. In the same week, the American Medical Association and 100 other medical societies including the American Academy of Orthopaedic Surgeons (AAOS) sent a letter to CMS to express their concerns with implementation of the Sunshine Act. Citing expansion… Read More

CMS Restarts RAC Audits

CMS announced that Recovery Audit Contractors (RAC) will resume work in August to review some claims for improper Medicare payments. CMS’ statement reads as follows: “Recovery Auditors are an important part of CMS’ efforts to ensure proper payments are made on behalf of patients and taxpayers by correcting improper payments in Medicare claims for health care services provided… Read More

Medicare 2015 Fee Schedule Released

On July 3rd, CMS released their proposed 2015 physician fee schedule. The final rates and policies will be effective January 1, 2015. Among other things, the Proposed Rule would refine the physician work and practice expense (PE) resource-based relative value units (RVUs) and make changes to the payment rates for services paid under the MPFS. CMS expects reimbursement… Read More

AJRR to Provide Hip and Knee Replacement Outcomes to CMS

The American Joint Replacement Registry (AJRR) recently received designation as a Qualified Clinical Data Registry (QCDR) by the Centers for Medicare and Medicaid Services (CMS) to report physician and patient observations and data. As a QCDR, the Registry could report hip and knee replacement outcomes to CMS. Beginning in 2015, physicians who send outcome data to an accredited… Read More

OIG Report Estimates Improper Payments for E/M Services Cost Medicare Billions

The HHS Office of Inspector General (OIG) estimates that Medicare inappropriately paid $6.7 billion for E/M services that were upcoded, downcoded, and/or lacked documentation in 2010. In response, CMS states that it will continue to issue education documents on E/M services and will collaborate with contractors to respond to questions and clarify policies when inconsistencies in billing practices… Read More