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COVID-19 Presidential Update from Joseph A. Bosco III, MD, FAAOS

June 15, 2020

The phased reopening of the U.S. healthcare system is proceeding smoothly. Despite the need for social distancing, our clinical activities are steadily increasing, and we are now able to provide all of our patients with safe, high-quality care. We have all seen the images of people acting irresponsibly and not taking the necessary precautions to prevent the spread of COVID-19. Unfortunately, there are consequences to these actions. For example, some states that initially had very low COVID-19 burdens are now experiencing generalized increases of the disease. Thankfully, this has not affected our clinical activities. As long as we practice in a responsible manner, including taking the necessary precautions mentioned in the re-entry guidance document we signed last week, and as long as patients follow the new guidance from the Centers for Medicare & Medicaid Services (CMS), we will be able to maintain our clinical growth.

Advocacy efforts led by the Office of Government Relations (OGR) have resulted in a substantial amount of governmental support for our practices and, ultimately, care for our patients. Whether through the Paycheck Protection Program, the Provider Relief Fund, the Small Business Administration loan program or the Medicare & Medicaid Accelerated and Advance Payments program, our practices have received, for the most part, the financial support they deserve and need to preserve musculoskeletal care. Most recently, we learned that $15 billion will be targeted to providers participating in Medicaid and the Children’s Health Insurance Program and that $10 billion will go to safety-net hospitals. We will learn more about these programs and the congressional response to COVID-19 (listen to related podcast) from members of Congress themselves in the upcoming webinar series the Academy is hosting with the American Association of Neurological Surgeons, the Congress of Neurological Surgeons, and the North American Spine Society. The first webinar will be held at 8:00 p.m. ET on June 17th and will feature U.S. Rep. Larry Bucshon, MD (IN-8) (register here).

The OGR is continuing to work with our colleagues in government to steer more financial support our way, but it appears that there will be no large tranches of funds heading in our direction anytime soon. Therefore, we are focusing our efforts on maintaining the regulatory gains afforded by the Presidential Public Health Emergency Declaration, including the expansion of telehealth services. We are also fighting to maintain the ability to treat Medicare patients in our physician-owned hospitals by leveraging the success of this new flexibility, and we are advocating for more ASCs in Certificate-of-Need states. Lastly, the OGR is strongly advocating for H.R. 7059, better known as the Coronavirus Provider Protection Act, which offers liability protection to physicians who treated COVID-19 patients. It is sponsored by our congressional colleagues, U.S. Reps. Phil Roe, MD (R-Tenn.) and Lou Correa (D-Calif.). Our Orthopaedic PAC supported both of these members and this support continues to pay dividends.

The COVID-19 pandemic caused extreme disruption across the nation but, despite this severe health crisis, we have not stopped working for our members. Along with AAHKS, the Academy remains engaged with the CMS to ensure that the current values for total hip and knee arthroplasty are maintained. We also recently joined our colleagues in AOSSM, AANA, and ASES in strongly objecting to a commercial insurer’s effort to claim that arthroscopic subacromial decompressions (CPT 29826) are neither indicated nor reimbursable in rotator cuff repairs. Finally, with the help of Daniel Murrey, MD, FAAOS, Chair of the AAOS Health Care Systems Committee, we are working with Robert Barrack, MD, FAAOS, and the Hip Society to ensure that United Healthcare’s new policy that imaging be included with total joint pre-authorization requests be as provider-friendly as possible.

Although we all hope that the COVID-19 pandemic is close to being over, few of us truly believe this to be the case. However, in most of the U.S., the acute emergency is over, and we are now contending with the “new normal.” The Academy understands this and is emerging from crisis mode in order to address our pre-COVID-19 challenges. Fortunately, even during the worst of the pandemic, we never lost focus on the goals of the Strategic Plan, and we will continue to work tirelessly to ensure that Academy members are able to provide high-quality musculoskeletal care to their patients.

It has been two weeks since I shared my thoughts about the murder of George Floyd. Since then, many of you have expressed similar thoughts, and some of you have had the courage to share your personal experiences with racism. Recently, Eric Ward Carson, MD, FAAOS, current president of the J. Robert Gladden Orthopaedic Society, wrote about his experiences with racism. Anyone who reads his letter cannot help but be moved by the gravity of his story and the eloquence with which he tells it. We should all have access to Dr. Carson’s letter and the Academy will help amplify this message in the following ways:

  1. Adding the letter to AAOS Now.org under trending content.
  2. Disseminating the letter through the AAOS Social Media Ambassadors’ own channels to generate larger reach.
  3. Posting a message on all AAOS social media channels to acknowledge Dr. Carson’s letter.

Just as the Academy is taking action through its strategic plan to diversify leadership across our organization and advocating for changes that will narrow the disparity gap for our patients, we are dedicated to doing our part to make a real difference in this important movement.

Thank you, and stay well,

Joseph A. Bosco, III, MD, FAAOS
AAOS President