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…
Greetings, Thank you for your interest in the newest CMS model – Bundled Payments for Care Improvement Advanced (BPCI Advanced). We are excited about the enthusiastic response to our model announcement on January 9, 2018. We continue to receive a high volume of inquiries in the BPCI Advanced inbox and will address most of the…
Per the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC): On November 20, 2017, The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) solicited and received constructive input from workers’ compensation system participants on the proposed Lumbar Spine Magnetic Resonance Imaging (MRI) Plan-Based Audit (Plan-Based Audit). TDI-DWC appreciates the input provided by system…
The Texas Department of Insurance – Division of Workers’ Compensation (TDI-DWC) announced that it is accepting comments regarding potential changes to the rules related to Commission on Accreditation of Rehabilitation Facilities (CARF)-accredited programs. The Workers’ Compensation Research and Evaluation Group recently published a report entitled “Outcome Comparisons of Return to Work Rehabilitation Programs by Accreditation…
The Texas Medical Board (TMB) released a proposed rule in November 2017 to identify physicians who have failed to properly register as a pain clinic. Unfortunately, as written, the proposed rule could unintentionally include orthopaedic surgeons in the pain clinic registration, despite the fact that orthopaedic surgeons are not operating as pain clinics. TOA will…
Texas HHSC has proposed new Medicaid rates for musculoskeletal services (effective January 1, 2018). Click here to view the proposed rates. The Texas Orthopaedic Association and Texas Medical Association submitted a response to Texas HHSC. Click here to view the response.
Congressman Kenny Marchant (R-Coppell) joined three other colleagues to introduce “The Medicare Care Coordination Improvement Act of 2017.” H.R. 4206 was introduced to address certain aspects of the Stark Law and physician self-referral laws that are preventing MACRA’s alternative payment models (APMs) from performing. The updates to the Stark Law are needed for Congress 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…
The Centers for Medicare and Medicaid Services (CMS) released the CY 2018 final payment rule for the Medicare Physician Fee Schedule on November 2, 2017. The following is a summary of the final rule. TOA’s summary of the CY 2018 proposed rule, which was released this summer, can be found following this summary. Appropriate Use…
The Texas Medical Disclosure Panel (TMDP) announced earlier this fall that it will be updating its patient notification form of required risks and hazards related to the nervous system. The TMDP is asking for recommendations by December 1, 2017. Please provide your suggestions to TOA (Bobby@toa.org). Click here to view the current disclosure of risks and hazards…
