Advocacy

Guided by the Health Policy Committee, AAHKS provides physicians and their patients comprehensive and timely analysis of health policy issues pertaining to hip and knee surgery. Each year, there are changes in regulations affecting patient care reimbursement for hip and knee surgery. AAHKS develops strategies to keep up with changes and to influence the law-making process. Advocacy is necessary to maintain adequate compensation and reimbursement for services performed by hip and knee surgeons, as well as to ensure the quality of patient care.

Advocacy is Time Well Spent

A 2020 Orthopedics Today issue features the cover story, “Advocacy gives physicians a voice, benefits patients” including interviews with leaders in orthopaedics who are making a difference in Washington, D.C. AAHKS Advocacy Committee Chair, James I. “Hutch” Huddleston, MD and 2020 AAHKS Presidential Award recipient, advises orthopaedic surgeons to get involved in their subspecialty advocacy groups. A strong presence on Capitol Hill that AAHKS has established amplifies the impact that volunteers can have on health policy. Full story.

CMS Releases CJR Model Three Year Extension and Changes Proposed Rule

On February 20, 2020 the Centers for Medicare & Medicaid Services (CMS) released Proposed Rule Comprehensive Care for Joint Replacement (CJR) Model Three Year Extension and Changes to Episode Definition and Pricing (CMS 5529 P). The Proposed Rule would extend the CJR to December 31, 2023 for Performance Years 6-8. It would also expand the model to include outpatient THA and TKA beginning in 2021, as well as adjusting target pricing and include some risk adjustment at reconciliation. The Rule proposes to eliminate the 50% cap on gainsharing payments, distribution payments, and downstream distribution payments when the recipient of these payments is a physician, non-physician practitioner, physician group practice, or non-physician practitioner group practice. Read our summary for more information. AAHKS will be submitting comments to CMS and will share those as well.

 

CMS Releases CY2020 OPPS and ASC Payment Systems Final Rule

The Centers for Medicare & Medicaid Services (CMS) published the 2020 Medicare Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center Payment Systems Final Rule on November 12, 2019.  In the Rule CMS removed total hip arthroplasty (THA) from the CMS inpatient only list (IPO) and added total knee arthroplasty (TKA) to the Ambulatory Surgical Centers (ASC) Covered Surgical Procedures List (CPL) in CY 2020. Full story.

You can read the AAHKS comment letter here, and a summary of the Final Rule, highlighting relevant issues, here.