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November 2019

Regulatory: I wanted to flag a press release that we distributed this week on CMS’ final rules on the Outpatient Prospective Payment System (OPPS) and the Medicare Physician Fee Schedule (MPFS). We have concerns with the recent final rules, including CMS’ decision to not extend the updated value for e/m codes to global codes and the removal of THA from the Medicare in-patient only list (ipo).

On surprise billing: The White House is tweeting that this will be done this year. However, 2/3 key committees in the House haven’t reached any sort of agreement and the last we heard, 14 Senators still have a hold on the Alexander bill that included surprise billing.  We are also still hearing, as of last week, that Pelosi didn’t want to touch the issue and that McConnell was hesitant as well.  That being said, we are also hearing that this will get dropped in an end of the year deal, especially with the alleged savings it would generate, and we need to brace ourselves for this possibility. Now that Congress is back in, we can monitor the situation a bit more closely, and we’ll keep you posted on what we are hearing.

On POH: Senator James Lankford (R-OK) will be introducing the Senate version of the bill to lift restrictions on POH today. The original cosponsors include: Barrasso, Boozman, Braun, Cassidy, Cornyn, Cotton, Crapo, Cruz, Inhofe, Paul, Tillis and Young – two more than last year!!  The bill text will be the same as last Congress, completely lifting Section 6001 restrictions from the ACA.  The House version of the bill,  introduced by Representative Burgess (R-TX)  now has 36 bipartisan cosponsors.  We are gaining momentum!!


Stacie Monroe
Senior Director, Political Affairs
Office of Government Relations
American Association of Orthopaedic Surgeons (AAOS)
317 Massachusetts Avenue, NE, Suite 100
Washington, DC 20002
202.548.4150 office
419.250.5873 cell