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American Association of Hip and Knee Surgeons

Advocacy, Education, Research

‘CMS’

CMS Announces New “BPCI Advanced” Episode Payment Model

The Centers for Medicare & Medicaid Services (CMS) announced Bundled Payments for Care Improvement Advanced (BPCI Advanced), a new voluntary episode payment model that will test a new iteration of bundled payments for 32 Clinical Episodes (29 inpatient and 3 outpatient), including major joint replacement of the lower extremity. CMS has indicated that BPCI Advanced will qualify as… Read More

AAHKS and AAOS Leaders Spend the Day with CMS, on Capitol Hill

Richard Iorio, MD, Chair, AAHKS Health Policy Council, was in Washington, DC on Monday for meetings with CMS and CMMI staff. Dr. Iorio was joined by AAHKS and AAOS staff in discussions about the TJA bundled payment projects and the need to improve them through risk stratification, target pricing methodology, and physician initiation. This comes with the revision… Read More

CMS Final Rule Alters CJR Participation and Cancels Mandatory Episode Payment Models

On November 30, 2017, the Centers for Medicare & Medicaid Services (CMS) released its final rule, “Cancellation of Advancing Care Coordination through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model: Extreme and Uncontrollable Circumstances Policy for the Comprehensive Care for Joint Replacement Payment Model (CJR).” This action finalizes policies… Read More

AAHKS Interprets “Two-Midnight Rule” for TKA

Following the announcement that total knee arthroplasty (TKA) is being removed from the inpatient only list in the most recent CMS CY18 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems (HOPPS) rule, AAHKS and our regulatory firm Epstein Becker & Green discussed with CMS Hospital and Ambulatory Policy Group staff the interpretation of the “Two-Midnight Rule”… Read More

AAHKS Comments on MACRA Episode-Based Cost Measures Field Testing for TKA Draft Measure

AAHKS and The Knee Society submitted comments to the Centers for Medicare & Medicaid Services (CMS) and Acumen, LLC regarding its MACRA Episode-Based Cost Measures Field Testing. Comments involved both the TKA draft cost measure itself and what information it collects, but also the reports that are generated for physicians’ use and the difficulty in accessing and reviewing… Read More

AAHKS Comments on CMMI New Direction Request for Information

AAHKS submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its Center for Medicare & Medicaid Innovation (“Innovation Center” or CMMI) New Direction Request for Information (RFI). AAHKS is guided by its three principles: payment reform is most effective when physician-led; the burden of excessive physician reporting on metrics detracts from care; and patient access,… Read More

MACRA Field Testing Deadline Extended

The Centers for Medicare & Medicaid Services (CMS) and Acumen, LLC have extended the deadline to provide feedback on MACRA Episode-Based Cost Measures field testing. The new deadline (12:00 p.m. EST on Monday, November 20, 2017) will allow more time to review and provide feedback on confidential field test reports and supplemental documentation, including the mock report and… Read More

AAHKS Statement on CMS Outpatient Rule

AAHKS released a statement regarding the 2018 Medicare Hospital Outpatient Prospective Payment System (OPPS) Final Rule released by the Centers for Medicare & Medicaid Services (CMS) on November 1. CMS finalized their earlier proposal to remove total knee arthroplasty (TKA) from the inpatient only list (IPO). This means that Medicare will now reimburse TKA procedures performed on an… Read More

“Meaningful Measures,” New CMS Initiative

Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced a new approach to quality measurement this week. “Meaningful Measures” will involve only assessing those core issues that are most vital to providing high-quality care and improving patient outcomes. CMS released a statement that said it “aims to focus on outcome-based measures going forward as opposed to… Read More

AAHKS Comments on CMS Proposed Rule

CMS has collected comments on the Proposed Rule CMS-5524-P: Medicare Program; Cancellation of Advancing Care Coordination Through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model. This rule recommends, among other issues, to reduce the number of mandatory MSAs that are participating in the Comprehensive Care for Joint Replacement Model… Read More