Nonparticipation Has a Price

Brian McCardel, MD

This year, for the first time, many physicians began receiving negative payment adjustments to their Medicare reimbursements—penalties for not participating in the Physician Quality Reporting System (PQRS). For many surgeons, PQRS started out as just another Federal acronym, with little impact on their practice or their reimbursements.

Open Payments Reporting Under Way

Melissa Young, JD

The second year of reporting under the Open Payments Program—established by the Centers for Medicare & Medicaid Services (CMS) as a result of the passage of the Physician Payments Sunshine Act—is now under way. Applicable manufacturers and group purchasing organizations (GPOs) have until March 31 to submit corrected data for 2013 and new data for 2014. Data submitted for the 2014 program year covers payments made to physicians during 2014.

A Brief Overview of Antitrust Issues Facing Surgeons

Minal Tapadia, JD, MD, MA; John Froelich, MD; Roshan Shah, MD, JD

Collective bargaining efforts that lead to monopolies are prohibited under several state and federal laws, including the Sherman Antitrust Act and the Clayton Act. The public policy behind this is to maintain competition that promotes innovation and drives down prices to protect consumers. In a 1975 case, Goldfarb v Virginia State Bar, the court stated that “learned professions are not exempt from antitrust laws,” thus bringing physicians under the purview of antitrust law.

Quality Strategy Enters New Phase

Elizabeth Fassbender

Established as part of the Affordable Care Act (ACA), the National Quality Strategy was first published in 2011. It is administered by the Agency for Healthcare Research and Quality on behalf of the U.S. Department of Health and Human Services (HHS) and serves as a framework for aligning stakeholders on quality improvement efforts and a single approach to measuring quality.

CMS to Address Meaningful Use Concerns

Elizabeth Fassbender

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced its intent to engage in rulemaking to update the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. These changes, CMS wrote, are intended to help reduce the reporting burden on providers and specifically address concerns about software implementation, information exchange readiness, and developments in the industry. The new rule is expected this spring.

Patients Join Advocacy Effort on NIH Funding

Since 2004, the AAOS Research Capitol Hill Days have brought together physicians, researchers, and patients to advocate for the future of musculoskeletal care, specifically increased research funding for the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (NIH). This year, nearly 30 surgeons and researchers and 18 orthopaedic patients will be meeting with members of Congress on Thursday, March 5.

AAOS and Medical Specialties Urge Congress to #FixSGR Now

Elizabeth Fassbender

It was a real—as well as a virtual—convergence in Washington, D.C., on Feb. 4, 2015. Members of the American Association of Orthopaedic Surgeons (AAOS) and representatives from other medical specialty associations flew to the capital to urge members of Congress to repeal and replace the sustainable growth rate (SGR) formula before the current SGR patch expires on March 31.