BOC update Fall 2017 - SLRI Committee

BOC update - SLRI Committee

1. Protecting physician ownership of patient services In a major win for the AAOS, the South Carolina Supreme Court agreed with two orthopaedic surgeons in their decade long fight protecting the integration of physical therapy (PT) and physician services. The AAOS' Health Policy Action Fund and the South Carolina Orthopaedic Association have invested significant time and resources into this battle and protecting physician ownership of ancillary services like PT.

Similarly, the Massachusetts Orthopaedic Association (MOA) successfully advocated for significant reforms in Massachusetts's determination of need (DoN) law, a highly restrictive certificate of need law. Existing ASC's now have the freedom to expand and the door for new ASC's in Massachusetts is open for the first time in over 20 years. All existing facilities will be allowed to apply for a DoN without affiliation or in a joint venture with an acute care hospital. Multispecialty facilities will be allowed to add a new service line, expand the facility and transfer ownership. Similar pathways will be created for single specialty facilities.

The Maryland Orthopaedic Association successfully advocated for HB 403, a measure that exempts a health care practitioner who has a specified compensation arrangement with a health care entity from the prohibition against self-referral so long as that compensation if from an advanced payment model. Maryland, before this law, had the most restrictive regulatory burdens on physician ownership of imaging services. The project was funded, in part, by the AAOS' Health Policy Action Fund.

SLRI continues to advocate the repeal of Missouri's law banning physician employment of physical therapists and awarded the state orthopaedic societies a grant to expand their efforts.

2. Out of Network/ Balance Billing In 2017, AAOS continued to work through legislative proposals addressing out-of-network bills or "surprise" bills. In fact, more than half of all states had at least one proposal this year. Four state laws (AZ, IN, NH and LA) were largely disclosure and/or study committee bills. Texas expanded their current mediation process, with the support of the Texas Orthopaedic Association, while Maine was the only state that passed broader regulations on out-of-network billing. A problematic bill passed both Houses in Nevada, but was ultimately vetoed by Governor Brian Sandoval citing, in part, opposition from the Nevada Orthopaedic Society.

3. AAOS Offers State Orthopaedic Societies Free Grassroots Advocacy Tools Starting from January 2018, all state orthopaedic societies will have access to grassroots advocacy tools through AAOS for no cost. These tools will help drive legislative action from single-click tools, allowing one-click options for contacting your legislators via email, phone or Twitter. Email Manthan at Bhatt@aaos.org to get started.

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