The U.S. House and U.S. Senate approved a funding resolution on February 9 that includes several Medicare provisions that affect musculoskeletal care: Physician-owned Hospitals: No Relief. An effort by Texas lawmakers to allow physician-owned hospitals located in areas affected by the recent hurricane to expand by 50 percent was not included in the bill. However,…
The Centers for Medicare and Medicaid Services (CMS) announced on January 9, 2018 that it is creating the voluntary Bundled Payments for Care Improvement Advanced (BPCI Advanced) demonstration that requires participants to take on financial risk. In addition, the program, which includes outpatient and inpatient episodes of care, would count as an Advanced APM for…
The Centers for Medicare and Medicaid Services (CMS) removed total knee arthroplasty from Medicare’s inpatient-only (IPO) list for the 2018 final rule. However, this does not mean that Medicare will pay for TKA in ambulatory surgery centers (ASCs). The American Association of Orthopaedic Surgeons (AAOS) produced the following FAQs to answer questions. Click here to…
The Centers for Medicare and Medicaid Services (CMS) released the final rule for the Quality Payment Program’s second year on November 2, 2017. Click here for an extensive overview of the rule. Click here for an executive summary of the rule: Among the highlights: From 90 Days to a Full Year Physicians will be…
CMS announced a request for information regarding the future direction of the CMS Innovation Center. The Texas Orthopaedic Association will be providing comments regarding solutions for enhancing muculoskeletal in the Medicare program. Per CMS: In partnership with clinicians, patients, entrepreneurs, state officials, and others, the Centers for Medicare & Medicaid Services (CMS) plays a leading…
The American Association of Orthopaedic Surgeons (AAOS) submitted stakeholder comments to the Centers for Medicare and Medicaid Services (CMS) on its CY 2018 Updates to the Quality Payment Program for physician payments. Click here to view the letter. The comments focus on the Merit-based Incentive Payment System (MIPS) and Alternative Payment Model (APM) payment mechanisms…
Tuesday’s proposal by the Centers for Medicare and Medicaid Services (CMS) would scale back the Comprehensive Center for Joint Replacement (CJR) mandatory bundles for lower extremity joint replacement and would eliminate the mandatory episode payment models (EPMs) for surgical hip/femur fracture episodes of care (SHFFT). CMS stated: Many providers are currently engaged in voluntary initiatives…
Congress passed an omnibus appropriations bill in 2015 that led to cuts for computed radiography (CR) x-rays by 7 percent in 2018 and 10 percent in 2023. This was supposed to serve as an incentive for practices to upgrade to digital radiography (DR). However, CR is still digital, which makes it capable of interfacing with…
CMS issued the final rule for its calendar year 2017 payment policy for hospital outpatient departments (HOPD) and ASCs, and CMS backed off some of its proposals to limit higher payments for off-campus, provider-based departments. To review, President Obama signed a budget bill on November 2, 2015 that ended higher payments for off-campus, provider-based departments…
CMS released the final rule for the calendar year 2017 Medicare Physician Fee Schedule on November 2, 2016, and CMS dedicated a large amount of the commentary to how it will collect data on global surgical packages. Thanks to the Texas orthopaedic surgeons who responded to the AAOS/TOA survey on August 12. As a result…
