New York Overturns Payment Policy on Knee Arthroscopy

AAOS intervention prompts state to reconsider Medicaid coverage decision

In November 2011, the New York State Department of Health issued a new coverage guideline for knee arthroscopy. Under the guideline, the department planned to discontinue payments under Medicaid for all arthroscopic knee surgeries. The decision cited the AAOS clinical practice guidelines (CPGs) on treatment of osteoarthritis (OA) of the knee as one of the reasons for discontinuing coverage.

The AAOS quickly responded with a letter from AAOS President John R. Tongue, MD, citing the Academy’s belief that “the work group has misinterpreted some of the source documents they cite as evidence in support of their recommendations.”

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