CMS issues final IPPS rule

Jacque Roche; Lindsay Law

Three conditions added to HAC payment policy Under the final inpatient prospective payment system (IPPS) rule updating Medicare payments to hospitals for fiscal year 2009, the Centers for Medicare and Medicaid Services (CMS) added three new conditions to the list of hospital-acquired conditions (HAC) for which Medicare will not pay at the enhanced complication/comorbidity payment level.

Health care and the 2008 election

Stuart L. Weinstein, MD

Orthopaedic PAC presents opportunity for access Not since President William Jefferson Clinton’s first term has health care been as high a priority as it is in this election. Health care will also be one of the defining issues in many congressional races. Both presidential candidates have been talking about their plans for healthcare reform. The American public expects each candidate to address the issues related to our “unsustainable” healthcare system.

AAOS expresses concerns on HAC policy

On June 13, 2008, the American Association of Orthopaedic Surgeons (AAOS) submitted a comment to the Centers for Medicare and Medicaid Services (CMS) on the hospital-acquired condition (HAC) payment policy for fiscal year 2009 inpatient prospective payment system. The following excerpts are from that comment. General concerns regarding HAC policy The AAOS … support[s] a payment system that reflects quality care, including withholding payment for certain “never events.”

What does HR 6331 mean for orthopaedics?

the AAOS Office of Government Relations

Key provisions of the Medicare Improvements for Patients and Providers Act of 2008 HR 6331, the “Medicare Improvements for Patients and Providers Act of 2008,” was passed by Congress over President Bush’s veto on July 15, 2008. The legislation averted a 10.6 percent physician payment cut scheduled for July 1, 2008, but also results in a cut of more than 20 percent to Medicare physician payments on January 1, 2010.

Step up the advocacy ladder

Frank B. Kelly, MD

AAOS advocacy depends on you During the past decade, AAOS advocacy efforts—addressing the concerns of orthopaedic patients, improving the quality of health care, and strengthening our profession—have become increasingly important to AAOS members. Recognizing this, the American Association of Orthopaedic Surgeons (the other AAOS we belong to) was formed in 1999 to enhance advocacy activities at both the federal and state levels.

Hands-on healthcare advocacy counts

Peter Pollack

Texas orthopaedist makes sure politicians hear his voice Like many orthopaedic surgeons, John T. Gill, MD, has strong opinions about the state of the healthcare system in the United States. Unlike many, he has chosen to carry his message directly to his elected representatives by working on their campaigns. During the last decade, Dr.

Expect incremental progress in pediatric device development

Jeanie Kennedy

FDA legislation changes pediatric research and development In late September 2007, President Bush signed into law the Food and Drug Administration Amendments Act of 2007 (FDAAA) into law. The expansive legislation covered most aspects of the FDA’s charges and was a “must-pass” bill, meaning that approximately 2,000 employees would be laid off if the legislation was not enacted.

COA defeats PT direct access legislation

By Charlene K. MacDonald, MPP, and Diane Przepiorski Fight is expected to resume in 2009 The California Orthopaedic Association (COA) this year successfully thwarted an attempt by the California Physical Therapy Association (CPTA) to expand physical therapists’ scope of practice and allow them direct access to patients without a physician’s diagnosis. COA, however, fully expects the legislation to be reintroduced next year.

Second Look – Reimbursement & Regulation

FDA can’t keep up with drug company marketing abuses A draft report from the U.S. Government Accountability Office states that it takes the Food and Drug Administration (FDA) an average of 7 months to issue a warning if the agency finds a drug manufacturer marketing prescription medications for off-label use and that the FDA has no staff exclusively assigned to monitor whether the rule against marketing drugs for unapproved uses is being violated.

How well does tort reform work?

Tim Maglione, Esq

In Ohio, it works very well indeed The spring of 2002 was not a happy one for many of Ohio’s physicians. Professional liability insurance rates had skyrocketed, making coverage unaffordable and sometimes unobtainable, especially for those in high-risk specialties like obstetrics, neurosurgery, and orthopaedics. Many physicians were considering retiring early, moving, or eliminating high-risk procedures.