AAOS Comments on Proposed Changes to Medicare Payment Policy for 2023

WASHINGTON, September 12, 2022 /PRNewswire/ — The American Association of Orthopedic Surgeons (AAOS) has issued formal comments to the Centers for Medicare & Medicaid Services (CMS) on the agency’s proposed payment policy changes for Calendar Year (CY) 2023. In the two letters, the AAOS urged the agency to address rising health care costs, expand access to care, and ease the burden on physicians as they continue to navigate patient care. patients, amid financial and practice management challenges exacerbated by the pandemic.

Medicare Physician Fee Schedule
The AAOS’s concerns center on continued reductions in physician reimbursement, including a reduction in the conversion factor of nearly 4.5%, while practice expenses continue to rise. In the letter, AAOS President Felix H. “Buddy” Savoie III, MD, FAAOS explained, “With inflation reaching 40-year highs this year, ongoing and planned statutory payment reductions and many medical practices still facing pandemic-related financial challenges and staffing issues, the current CMS proposal compromises the long-term sustainability of medical practices while threatening patient access to physicians participating in Medicare.

AAOS urges CMS to reform the current physician reimbursement system and create value-based payment models that include incentives tailored to the distinct needs of specialist physicians. It also urges CMS to implement the changes recommended by the RUC to the assessment and management component of the global surgical codes in order to maintain the relativity of the physician fee schedule.

Dr Savoie wrote: “The legal prohibition against paying physicians differently for the same work applies regardless of the code’s method of assessment and incremental increases should apply to all physicians.

Outpatient Prospective Payment Systems for Medicare Hospital and Ambulatory Surgical Centers
The AAOS comments address the “dangerous precedent” for increased prior authorization in outpatient hospital settings and its negative impact on patient care. Dr Savoie said requiring third-party approval who is removed from clinical decision-making “erodes the doctor-patient relationship and the ability to make decisions that are in the best interest of the patient” . He added that it compromises the years of training and schooling of doctors, and he calls for the proposal to be officially removed from the CY 2023 OPPS final rule.

Another element of the rule addressed by the AAOS is the proposal to remove CPT code 22632 (Arthrodesis) from the Inpatient Only (IPO) list. Although the AAOS believes there is sufficient evidence to prove that the primary procedure can be performed safely on an outpatient basis, it reiterated that “surgeons should decide the actual setting of the surgery and it should not there may be no warrants or prior authorizations necessary to determine inpatient versus day surgery even if a procedure is off the IPO list.”

Read AAOS comments on CY 2022 PFS here.

Read AAOS’ full comments on CY 2023 OPPS/ASC here.

About AAOS
The Government Relations Office of the American Association of Orthopedic Surgeons (AAOS) promotes and advocates the views of the orthopedic community to federal and state legislative, regulatory, and executive agencies. Situated at washington d.c.with additional staff at the Academy’s headquarters in Rosemont, ILthe Office of Government Relations identifies, analyzes and directs all health policy activities and initiatives to position the AAOS as a trusted leader in promoting musculoskeletal health.

For more information on all of AAOS’ advocacy efforts, visit http://www.aaos.org/dc.

SOURCE American Association of Orthopedic Surgeons

About Matthew R. Dailey

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