From left: Rep. Pete Sessions; Daniel K. Guy, MD; Wilford K. Gibson, MD; Amy L. Ladd, MD; and John T. Gill, MD.

AAOS Now

Published 8/1/2017
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Elizabeth Fassbender

NOLC Makes a Stand on Capitol Hill

Orthopaedic surgeons support advocacy efforts, meet with Congress
More than 300 orthopaedic surgeons from around the country took to Capitol Hill on Thursday, April 27, to meet with their congressional representatives as part of the American Association of Orthopaedic Surgeons (AAOS) National Orthopaedic Leadership Conference (NOLC).

Held annually, the NOLC is an important meeting that enables the advancement of the AAOS' advocacy agenda by providing legislative and regulatory education, building support for orthopaedic-related legislation and regulation, and strengthening relationships with key decision makers in Congress. This year, attendees addressed three issues: repeal of the Independent Payment Advisory Board (IPAB), reversal of restrictions on physician-owned hospitals, and medical liability reform. Orthopaedic surgeons also shared information on AAOS efforts to raise awareness of the importance of prescription safety and the dangers of opioid misuse, as featured in the Academy's new public service campaign's print and radio ads.

"While Congress continues to debate the future of health care, we urge legislators to consider important measures that promote and ensure access to effective, high-quality health care," said AAOS President William J. Maloney, MD. "AAOS believes healthcare policy should ensure unencumbered access to specialty care, make healthcare coverage more affordable, and improve quality of care."

On the importance of IPAB repeal, NOLC attendees urged Congress to support the Protecting Seniors' Access to Medicare Act (S. 260/H.R. 849). The creation of the IPAB not only severely limited congressional authority, it essentially eliminated the transparency of hearings and debate as well as precluded meaningful opportunity for stakeholder input. Furthermore, because IPAB is required to achieve savings in 1-year increments, it is not conducive to generating savings through long-term delivery reforms.

The Protecting Seniors' Access to Medicare Act, introduced by Sen. John Cornyn (R-Texas) in the Senate and Rep. Phil Roe, MD (R-Tenn.) in the House, is especially important this year. With the Medicare per capita growth rate projected to exceed the per capita target growth rate in 2017, IPAB-directed cuts could be forthcoming. Orthopaedic surgeons' efforts have resulted in a dramatic increase in the number of cosponsors for this legislation—as of July 1, 2017, 222 legislators in the House have signed on to support the bill, which represents an increase of approximately 100 cosponsors since the NOLC.

NOLC attendees also urged Congress to reverse the restrictions on physician-owned hospitals by passing the Patient Access to Higher Quality Health Care Act. The legislation would lift the ban on the creation and expansion of physician-owned hospitals and allow such hospitals to participate in Medicare and Medicaid. NOLC efforts continued to raise the visibility of this key issue and, as a result, added 13 House cosponsors and initiated the introduction of a Senate version of the bill by Sen. James Lankford (R-Okla.).

"Obamacare is not working for most Americans, costs have skyrocketed, and choices have diminished," said Sen. Lankford. "There are many smaller healthcare reform steps that can target specific problems within health care. The Patient Access to Higher Quality Health Care Act of 2017 will increase competition, which will lower healthcare costs and expand quality of care by empowering smaller, physician-owned hospitals to innovate and tailor their services to the communities they serve. We need strong general care hospitals in Oklahoma, but that should not preclude smaller, innovative hospitals from also providing care."

The third issue
raised by orthopaedic surgeons was the importance of meaningful medical liability reform. The Accessible Care by Curbing Excessive Lawsuits (ACCESS) Act (H.R. 1704) would mirror successful reforms in California and Texas to protect patients, end medical lawsuit abuse, and ensure that all patients can afford the medical care they need. Similar legislation, the Protecting Access to Care Act (H.R. 1215), picked up significant momentum as a result of NOLC efforts. Consequently, on June 28, 2017, the U.S. House of Representatives passed this legislation by a vote of 218 to 210.

"AAOS applauds the House of Representatives for passing vital medical liability reforms," said Dr. Maloney. "H.R. 1215 will protect patients in need while addressing some of the challenges of the current medical liability system and maintaining the traditional role of the states. These reforms will not only ensure negligently injured patients are compensated promptly and equitably, they will—importantly—improve our overall healthcare system even before the filing of a lawsuit, by lowering healthcare costs, improving patient safety, and preserving the patient-physician relationship. We thank members of Congress for their support of this legislation and we urge the Senate to consider H.R. 1215 as soon as possible."

As AAOS explained in a letter to Speaker of the House Paul Ryan (R-Wisc.), this legislation adopts many of the reforms that have been thoroughly tested in the states and have proven successful in improving the medical liability climate in those states. At the same time, it protects state authority by applying its provisions only in cases involving health care provided via the expenditure of federal funds. The bill also provides substantial flexibility for states to adopt variations of these reforms in order to meet their unique circumstances. In addition, as noted by the Congressional Budget Office, these reforms will bring significant budgetary savings to aid in the effort to reduce our national deficit.

The legislation now moves to the Senate where AAOS will continue efforts to gain its passage. However, Senate rules in effect require 60 votes to pass this or a similar bill, and because not all Republicans support federal medical liability reform legislation, gaining Senate approval will likely be an uphill battle. Check the AAOS Office of Government Relations website at www.aaos.org/dc and follow the AAOS Office of Government Relations on Twitter (https://twitter.com/AAOSAdvocacy) for updates and actions you can take to help move this legislation forward.

Finally, for the third year in a row, the NOLC kicked off with the Orthopaedic Political Action Committee (PAC) congressional reception. To thank members of the Orthopaedic PAC's top donor level, the Capitol Club, for their generous support, donors joined members of Congress and congressional staff on the roof of the W Hotel in Washington, D.C. More than 20 members of Congress attended, including Reps. Michael Burgess, MD (R-Texas), Pete Sessions (R-Texas), Andy Barr (R-Ky.), Steve Stivers (R-Ohio), Dutch Ruppersberger (D-Md.), and Anthony Brown (D-Md.).

For more on AAOS advocacy efforts, visit www.aaos.org/dc

Elizabeth Fassbender is the communications manager in the AAOS office of government relations. She can be reached at fassbender@aaos.org