Medicare

IPAB and Physical Therapy Included in Congress’ Medicare Extender Package

February 9, 2018

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,…

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Medicare Announces New Bundled Payments

February 5, 2018

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…

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Medicare’s Removal from TKA from Inpatient-Only: Clarification

January 30, 2018

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…

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Medicare’s Quality Payment Program Rule for Year 2 (MIPS/MACRA)

November 3, 2017

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…

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CMS Announces New Direction for CMMI

September 20, 2017

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…

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AAOS Comments on Medicare’s 2018 Quality Payment Rule

August 23, 2017

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…

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Texas Cities Remain in Medicare’s CJR; Effect of Tuesday’s Announcement

August 16, 2017

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…

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Ten Percent Cuts to CR X-rays Looming

August 4, 2017

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…

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