AAOS responds to CMS-proposed Medicare payment policy changes for 2021
The American Association of Orthopaedic Surgeons issued two formal letters to CMS regarding the proposed Medicare outpatient prospective payment system, ASC payment system and physician fee schedule for 2021, according to a press release.
In its responses, AAOS thanked CMS for its efforts in helping physicians and patients during the COVID-19 pandemic and offered comments on several proposals that impact musculoskeletal care.
AAOS urged CMS to consider the risks of eliminating the inpatient only list for Medicare beneficiaries, citing safety concerns, out-of-pocket costs and access-to-care issues, according to the release. AAOS petitioned CMS to set criteria for determining which procedures can be performed in the outpatient setting. Additionally, AAOS asked CMS to abandon the two-midnight rule, “which continues to be a source of confusion for hospitals and private payers and administrative burden for physicians,” according to the release.
“The AAOS believes that determining the appropriate setting of care should be done through the lens of patient safety and peer-reviewed evidence, and that physicians are best qualified for leading this individualized decision-making process with their patients," Joseph A. Bosco III, MD, FAAOS, president of AAOS, said in the release.
AAOS also expressed its concern with the proposed Medicare physician fee schedule for 2021, which would cut physician payments for many procedures for Medicare patients.
“Now is not the time to reduce payment and imperil access to high quality musculoskeletal care,” Bosco said. “AAOS strongly urges CMS to maintain the current funding levels. This is critical to preserving access to patient care in the wake of the COVID-19 public health emergency,” he added.
“If these Medicare cuts are finalized, it sends a strong signal: when providers in the vanguard of value-based care begin to achieve some efficiencies in the delivery of care, CMS will use those positive developments as a justification to cut Medicare fee-for-service reimbursement regardless of the extra work that goes into achieving these outcomes,” said C. Lowry Barnes, MD, president of the American Association of Hip and Knee Surgeons, which provided recommendations to AAOS.
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