The AAOS OGR (office of government relations) works with a variety of specialty societies to affect legislation.
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Published 1/1/2016
Julie Williams

Teaming Up Gets Results

Legislative "wins" with specialty societies
The American Association of Orthopaedic Surgeons (AAOS) office of government relations (OGR), based in Washington, D.C., is dedicated to ensuring the voice of orthopaedic surgeons is heard on Capitol Hill. One of its top priorities is working with orthopaedic specialty societies to help them achieve their federal legislative objectives.

Collaboration with orthopaedic specialty societies is not only in the best interests of the AAOS, its members, and their patients, but also critical to the future of orthopaedics. In 2015, in addition to broader legislative successes, like repeal of the sustainable growth rate formula, several legislative successes in Congress relate directly to the specialty societies and were the result of teamwork with the OGR.

Team physician proposals
Currently, it is illegal for team doctors travelling with their teams to carry critical medications that might be needed for pain control or emergency management of significant medical injuries. But the AAOS and the American Orthopaedic Society for Sports Medicine (AOSSM) are working to change that restriction.

On Oct. 8, 2015, Alan F. Anderson, MD, AOSSM president, testified before Congress about HR 3014, the Medical Controlled Substances Transportation Act. The bill enables a physician who is traveling with a team to transport small quantities of a controlled substance to another practice setting or to a disaster area, provided certain conditions are met. Subsequent to the hearing, the Energy and Commerce Committee unanimously agreed to send the measure to the full House.

A related bill, HR 921, the Sports Medicine Licensure Clarity Act of 2015, enables physicians to be covered by their medical liability insurance when they travel across a state line. This measure was considered at a hearing of the Energy and Commerce Committee on Dec. 9, 2015, and is on the fast-track for passage.

Podiatry scope of practice
Rep. Brad Wenstrup (R-Ohio), a podiatrist, introduced a bill that would define podiatrists as physicians under the Veterans Administration (VA) system. AAOS partnered with the American Orthopaedic Foot & Ankle Society (AOFAS) in opposing the bill and initiated a strong grassroots effort, targeting members of the House VA Committee. A meeting to consider the bill has been cancelled indefinitely.

Women's health research
Report language regarding women's health research was included in the omnibus appropriations bill for fiscal year 2015, as well as in the 2016 fiscal year funding bill for the Departments of Labor and Health and Human Services. Report language is nonbinding language that accompanies statutory language, and sends a message to Congress that could have a significant impact.

The language, among other things, asked that the National Institutes of Health (NIH) ensure the analysis of data by sex and other subgroup demographics as part of the grant reporting process. It also asked the NIH to fund studies on sex differences and conditions that predominantly affect women. This issue has been a priority for the Ruth Jackson Orthopaedic Society as well as for the AAOS.

Defense research funding
AAOS helped secure $30 million in funding for the Department of Defense Peer Reviewed Orthopaedic Research Program (PRORP) in the House 2015 Defense Appropriations bill. AAOS has worked with the Society of Military Orthopaedic Surgeons, the Orthopaedic Trauma Association (OTA), and Orthopaedic Research Society on this issue. This program seeks to optimize the opportunity for recovery and restoration of function in those affected by military orthopaedic injuries.

Phentolamine shortage
AAOS worked with the American Society for Surgery of the Hand and the American Association of Hand Surgeons to urge the Food and Drug Administration (FDA) to address the shortage of phentolamine and its impact on clinicians and patients. Phentolamine is an alpha blocking agent that is used to reverse the alpha receptor vasoconstriction caused by epinephrine injections.

A letter was sent to the FDA signed by eight specialty groups. Ultimately, the FDA responded by posting the appropriate material on its website so that physicians can import the necessary drugs from Canada. The FDA also worked with pharmaceutical manufacturers to increase supplies.

Ensuring access to necessary trauma medical services was the focus of two bills supported by the AAOS and OTA. Both measures passed the House unanimously. HR 648, the Trauma Systems and Regionalization of Emergency Care Reauthorization, and HR 647, the Access to Life-Saving Trauma Care for All Americans Act, are critical to the efficient delivery of services through trauma centers and the highly specialized teams that staff them. The measures also support the development of regionalized systems of trauma and emergency care to ensure timely access for injured patients to appropriate facilities.

A resolution to the American Medical Association (AMA) House of Delegates submitted by the AAOS focuses on graduate medical education (GME). The resolution urges that there be no decreases in current funding levels for GME in medical (MD) and osteopathic (DO) programs while funding of GME in other professions is increasing. In addition, it requests that the AMA advocate for proportional increases in current funding levels for MD and DO GME, similar to increases in GME funding in other professions. AAOS worked with the AOFAS on this resolution.

Prosthetic devices
In this arena, success could be defined as "heading them off at the pass." Medicare administrators decided not to finalize plans to revise payments for artificial limbs. Instead, a working group will be convened to further examine the issue. The proposed policy would have limited and potentially denied access to appropriate prosthetic care, eliminating coverage for certain prosthetic devices. AAOS expressed its concern and is pleased with the response.

As can be seen from these examples, shared synergies result in an effective use of resources and increased likelihood of success. According to Board of Specialty Society (BOS) Chairman David A. Halsey, MD, "The BOS officers are very pleased with the increased communication and collaboration between the AAOS OGR and the specialty societies in terms of advocacy. Clearly, teaming up gets results." 

Julie Williams is the senior manager of government relations in the AAOS OGR. She can be reached at