Dear NVOS Members,
The articles contained in this e-newsletter are excerpted from AAOS newsletters and other media sources to help our members stay current on national issues.
The NVOS Staff |
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Temporary 'Doc Fix' Agreement Reached, Boehner Says
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Another temporary 12-month patch will be enacted for the "doc fix" prior to the scheduled March 31 expiration of the current patch, House Speaker John Boehner (R-Ohio) indicated today.
Updated information on the SGR is breaking news and new developments are evolving rapidly as we head to the March 31 deadline.
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| CMS Proposal Marks Shift From ACA Implementation To Refinement | |
HealthLeaders Media reports that, under a proposal from the U.S.  Centers for Medicare & Medicaid Services (CMS), health insurance exchanges created under the Affordable Care Act (ACA) would be adjusted to improve user experience and minimize the influence of state officials over consumer advisors. The proposed changes include adjustments for insurance companies, including:
- Reallocating required reinsurance contributions so that the U.S. Department of Treasury is paid last
- Increasing insurers' permitted administrative expenses by 2 percent
- Raising insurers' "profit floor" from 3 percent to 5 percent for purposes of risk corridor adjustments
Observers say the move marks a shift on the part of CMS from launch and enrollment efforts under ACA to refining the operation of the exchanges.
Read more...
Read the proposal (large PDF)...
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| AMA Offers Resources For Dealing With ACA Insurance "Grace Period" |
The American Medical Association (AMA) has announced the availability of a set of resources designed to guide physicians on navigating a little-known rule in the Affordable Care Act (ACA) that provides individuals who purchase subsidized coverage through the state insurance exchanges a 90-day grace period before their coverage is cancelled for nonpayment. Under the rule, insurers in health exchanges are required to pay any claims incurred during the first 30 days of the grace period, but they are not required to pay claims incurred during the last 60 days for any patient whose coverage is terminated, placing healthcare providers at risk for uncompensated care. The AMA resources include:
- Guide to the ACA grace period
- Grace period collections policy checklist
- Model financial agreement language for patients who receive Advance Premium Tax Credits
- Sample grace period notice to patients
Read more...
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| Study: Growth In Prescribing Of Opioid Analgesics In U.S. EDs Appears To Outpace Increase In Pain-Related Complaints | |
Findings from a study published in the March issue of the journal Academic Emergency Medicine suggest that growth in the prescribing of opioid analgesics in U.S. emergency departments (EDs) has outpaced a rise in pain-related complaints over the last 10 years. The research team drew data from the National Hospital Ambulatory Medical Care Survey and found that between 2001 and 2010, the percentage of overall ED visits where any opioid analgesic was prescribed increased from 20.8 percent to 31.0 percent. Overall, use of schedule III through V agents increased from 12.6 percent in 2001 to 15.6 percent in 2010, an absolute increase of 3.0 percent and a relative increase of 23.8 percent. The prescribing of hydrocodone, hydromorphone, morphine, and oxycodone all increased significantly during that period, while codeine and meperidine use declined. Over the same span, prescribing of nonopioid analgesics did not change significantly, increasing from 26.2 percent in 2001 to 27.3 percent in 2010. The percentage of visits for painful conditions during the period increased from 47.1 percent in 2001 to 51.1 percent in 2010, an absolute increase of 4.0 percent.
Read more...
Read the abstract...
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Study: Implementation Of Surgical Checklists Not Associated With Significant Reductions In Surgical Mortality Or Complication Rates
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A Canadian study published in the March 13 issue of The New England Journal of Medicine suggests that implementation of surgical safety checklists may not be associated with significant reductions in surgical mortality or complications. The research team surveyed all acute care hospitals in Ontario for 3-month periods before and after adoption of a surgical safety checklist, and found that the adjusted risk of death during a hospital stay or within 30 days after surgery was 0.71 percent before implementation of a surgical checklist and 0.65 percent afterward. The adjusted risk of surgical complications was 3.86 percent before implementation and 3.82 afterward.
Read the abstract...
An accompanying editorial suggests that time periods examined by the researchers (3 months before and after introduction) may be too short to fully gauge the impact of checklist use. "It is not the act of ticking off a checklist that reduces complications," the author writes, "but performance of the actions it calls for." The author notes that implementation of a checklist system is difficult, and many hospitals may "lack the resources or expertise to organize and lead a checklist-implementation effort or to manage the changes needed, collect data, and build teams."
Read more...
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| CMS Rule Change Would Set Minimum Advance Notice For Medicare Advantage Network Changes | |
According to Kaiser Health News, a set of rules proposed by CMS would, if adopted, help protect seniors when insurers remove physicians and other healthcare providers from their Medicare Advantage networks. The proposals would require insurers to notify providers at least 60 days in advance of a contract termination, and to provide beneficiaries at least 30 days notice of network changes. In addition, insurers would be required to notify CMS of any such changes at least 90 days in advance, so the agency can ensure that the remaining providers "will continue to meet required network standards." The publication reports that final rules may be released as early as April 7.
Read more...
Read the proposal (large PDF)...
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2013-2014 Board of Directors
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