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David A. Halsey, MD

AAOS Now

Published 6/1/2018
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David A. Halsey, MD

Advocacy Never Stops, and Neither Will We

The NOLC facilitates in-person meetings with AAOS members and their congressional representatives

Once every year, hundreds of orthopaedic surgeons from around the country visit Washington, D.C., to meet with their congressional representatives as part of the American Association of Orthopaedic Surgeons (AAOS) National Orthopaedic Leadership Conference (NOLC).

This year’s NOLC is upon us, taking place the first week of June. The enthusiasm and passion that these doctors bring to the Hill—as well as those doctors who contribute through sending emails to their legislators or attending in-district meetings—are a testament to our members’ understanding of the significance of advocacy for our profession and our patients. As you’ve undoubtedly heard before: In advocacy, if you are not at the table, you are on the menu. And this is especially true as we approach the midterm elections and while healthcare reform remains a focus of President Donald J. Trump’s Administration and members of Congress alike.

This year, we chose to focus our NOLC efforts on three advocacy areas that impact our members on a day-to-day basis. We know how important your practice and your patients are to you, and we want to ensure that you can continue to take care of these priorities without any additional and unnecessary stress or barriers. With the prevalence of bone and joint disorders in the United States today, it is vital that we ensure healthcare policy provides unencumbered access to specialty care.

Regulatory relief

First, the NOLC will provide us with the opportunity to discuss regulatory relief with our legislators. Specifically, with increased government requirements and ever-changing payment models, oftentimes physicians and other clinical staff are pulled away from patient care, diverting limited resources and energy to regulatory compliance.

Both the Trump Administration and Congress have evaluated the current state of affairs and committed to better protect the patient-physician relationship. For example, U.S. Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma recently launched a “Patients over Paperwork” initiative, which the agency notes “is in accord with President Trump’s executive order that directs federal agencies to ‘cut the red tape’ to reduce burdensome regulations.”

Additionally, Congress recently included several regulatory relief efforts and positive updates to the Medicare Access and CHIP Reauthorization Act in the Bipartisan Budget Act (BBA), which was signed into law earlier this year. In addition to repealing the harmful Independent Payment Advisory Board, the BBA made much-needed improvements to the Merit-based Incentive Payment System’s low-volume threshold and the cost performance category, while providing CMS with added flexibility to fine-tune specific provisions in the new payment program.

But, the work isn’t done.

Additional opportunities for regulatory relief that we are discussing with Congress include improving the interoperability of electronic health records, advancing Stark law reform, and finding ways to fix prior authorization and narrow network issues.

For example, the nearly 30-year-old self-referral prohibitions—or Stark laws—make it difficult for physicians to fully and successfully participate in alternative payment models (APMs) and other care coordination efforts. Legislation, like the Medicare Care Coordination Improvement Act of 2017 (H.R. 4206/S. 2051) would provide CMS with the regulatory authority to create exceptions under the Stark laws for APMs, in addition to providing other needed flexibility to support high-quality, coordinated care.

Opioid epidemic

The second topic we are addressing at the NOLC is opioids. While the conversation surrounding the opioid epidemic is complicated, it is clear that orthopaedic surgeons must take a leadership role in shaping the legislative and regulatory solutions offered by members of Congress and others.

Both the House and the Senate are making progress on comprehensive opioid-focused packages they hope to approve this summer, and AAOS has been working closely with legislators on a number of related AAOS priorities and positions.

Most importantly, AAOS is urging caution in the area of prescription limits, as we believe that national standards without the requisite evidence or exceptions could interfere with the patient-physician relationship and inappropriately limit patients’ access to necessary pain management. We are also encouraging electronic prescribing of medications as a means of promoting patient safety. For more on what AAOS is doing to address the opioid epidemic, including our pain relief toolkit, visit www.aaos.org/opioids.

Good Samaritan Health Professionals Act

The final priority at the NOLC focuses on increasing the ease with which orthopaedic surgeons and other medical professionals can safely and confidently deploy across state lines when there is a federally declared disaster.

A number of recent events, such as the hurricanes that hit Texas, the Gulf Coast, and Puerto Rico, have underscored why this effort is imperative. Specifically, whether you have volunteered your services in the past or might be called to volunteer during a future disaster, AAOS believes healthcare professionals should be able to serve during a disaster without confusion or limitations from medical liability issues.

The Good Samaritan Health Professionals Act (H.R. 1875/S. 781) would help address some of the gaps in federal and state laws to ensure medical volunteers can—without hesitation—take care of patients and communities in an emergency.

Beyond the NOLC

Certainly, there are a number of additional advocacy issues that AAOS is working on at any given moment.

Our Council on Advocacy and Office of Government Relations is continually evaluating orthopaedic healthcare policy priorities, analyzing specific pieces of legislation and regulation, and coordinating with Congress and agencies to provide valuable input and solutions that advance access to specialty health care.

I encourage you to join us in this effort through participation in our Orthopaedic Political Action Committee (PAC). As you know, the Orthopaedic PAC is the only national political action committee in Washington, D.C., that solely represents the interests of the orthopaedic community before Congress. Visit www.aaos.org/PAC or text aaos to 41444 to make a donation. For other ways to get involved or to learn more about all our advocacy issues, visit www.aaos.org/advocacy.

The NOLC is an important opportunity to advance our agenda, but anyone can make a difference at any time—advocacy never stops, and neither will we.