November 09, 2019

AAOS on Concerning Changes in CMS 2020 Final Payment Rules

Washington, D.C. —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 and 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.”

For more information:
 
Contact(s):
Kristen Coultas
phone: (202) 546-4430
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