AAOS on Concerning Changes in CMS 2020 Final Payment Rules

WASHINGTON, D.C. (November 9, 2019) — American Association of Orthopaedic Surgeons (AAOS) President Kristy L. Weber, MD, FAAOS, issued the following statement in response to concerning changes that the Centers for Medicare & Medicaid Services (CMS) finalized in its newly released 2020 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center (OPPS/ASC) Payment System Final Rule and the Medicare Physician Fee Schedule (MPFS) Final Rule:

“AAOS is extremely disappointed with CMS’ decision to remove hip replacements from the inpatient-only list beginning 2020, especially as the removal of knee replacements in 2018 and the unintended consequences of that policy change continue to plague Medicare providers and threaten patient safety. It is both troublesome and disheartening to know that the repeated concerns of the surgical community were not heeded in making this critical change to the delivery of care.

“Furthermore, CMS is setting a dangerous precedent for the future of musculoskeletal procedures and their perceived value—despite our aging population. In failing to apply updated evaluation and management values to global codes for 2021, the agency has chosen to blatantly disregard recommendations from the medical community and disrupt the relativity mandated by Congress for the Medicare fee schedule. For orthopaedics, this will mean an unfair differential in future reimbursements for specialty care.

“Our ask now is that CMS adequately prepare for the effect of these concerning changes. Physicians must be trusted and empowered to designate the best practice setting for their patients, and not be crippled by the burden of proof. Additionally, the statutory requirements of MACRA section 523(a) must be upheld to ensure integrity of the relative value scale and appropriate access to surgical care. We hope that the agency recognizes these impending challenges and is thoughtful about the enforcement of these new policies.”

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About the AAOS 
The American Association of Orthopaedic Surgeons’ (AAOS) Office of Government Relations promotes and advocates the viewpoint of the orthopaedic community before federal and state legislative, regulatory, and executive agencies. Based in Washington, D.C., with additional staff in the Academy’s headquarters in Rosemont, Illinois, the Office of Government Relations identifies, analyzes, and directs all health policy activities and initiatives to position the AAOS as the trusted leaders in advancing musculoskeletal health.

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Chris J. Stewart

Chris currently serves as President and CEO of Surgio Health. Chris has close to 20 years of healthcare management experience, with an infinity to improve healthcare delivery through the development and implementation of innovative solutions that result in improved efficiencies, reduction of unnecessary financial & clinical variation, and help achieve better patient outcomes. Previously, Chris was assistant vice president and business unit leader for HPG/HCA. He has presented at numerous healthcare forums on topics that include disruptive innovation, physician engagement, shifting reimbursement models, cost per clinical episode and the future of supply chain delivery.

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