Despite AAHKS’s calls for clarity from the Centers for Medicare and Medicaid Services (CMS), there has been continued disorder regarding the removal of TKA from the Inpatient Only (IPO) List. Although CMS committed to suspending audits by Medicare Recovery Audit Contractors (RACs) for two years, members have reported other CMS audits, such as those by quality improvement organization (QIO) contractors. QIOs assume the task of reviewing claims over appropriate admission status for short stays.
Your feedback is vital to the success of AAHKS and our advocacy efforts. We ask that you complete a two-minute survey that will help us work with Congress and CMS to prevent our TKA patients from experiencing adverse consequences due to the regulatory change. You can access the survey here.
In addition, if you have any details regarding QIO audits, these examples will allow us to review and find any disparities in the review standards applied by QIOs. Please do not include any protected health information (PHI). Any references to names, locations or institutions will be blinded. You can send the QIO documentation to and submit a TKA patient anecdote to AAHKS here. Your input is important as AAHKS continues to work on this issue!