Association tells concerns about proposed rules
The American Association of Orthopaedic Surgeons
is greatly concerned that orthopaedic surgeons' exposure to malpractice
litigation is not adequately compensated through the new resource-based
malpractice values being proposed by the Health Care Financing
Administration. In commenting on the proposed rule on the "Medicare
Program; Revisions to Payment Policies Under the Physician Fee
Schedule for Calendar Year 2000," the Association recommends
the malpractice RVUs be kept as interim throughout all of 2000.
The Association said it does not appear HCFA "seriously explored
alternative methodologies," and has concerns about the reliability
and accuracy of the data used in developing the relative values.
The Association also recommends that HCFA add 15 minutes intraoperative
facility staff time to all codes to ensure that this activity
is accounted for fully. At the very least, the agency should provide
a detailed explanation of how this time is included on the indirect
payment side. The Association disagrees with HCFA's proposal to
limit the facility RVU rate no higher than the nonfacility rate
for any code. Instead, the Association said HCFA should study
each code and make a determination as to whether the facility
RVU should be reduced or the nonfacility rate should be increased.
Concerning a proposal to expand the use of modifier -25 to include
procedures where the global surgery rule does not apply, the Association
requests a 60- to 90-day period where physicians may continue
to be paid for both the E/M service and the minor procedure, even
if the modifier is not added.
Ask AHCPR to study viscosupplementation for osteoarthritis
The Academy has asked the Agency for Health Care
Policy and Research (AHCPR) to consider intraarticular injections
of hyaluronic acid, or viscosupplementation treatments, as a topic
for one of the AHCPR-supported Evidence-Based Practice Centers.
Documentation of true chondroprotective effects or alteration
of the natural history of cartilage degeneration by new drugs
approved by the Food and Drug Administration is lacking in the
literature and awaits further study, said Robert D. D'Ambrosia,
MD, AAOS president. Other issues that need to be studied range
from optimal dosing regimens to how hyaluronic acid-based therapy
can be effectively integrated both therapeutically and economically
into current osteoarthritis treatments.
1st U.S. multicenter study of glucosamine, chondroitin sulfate
The first multicenter study in the United States
to investigate glucosamine and chondroitin sulfate for knee osteoarthritis
has been awarded by the National Center for Complementary and
Alternative Medicine in collaboration with the National Institute
of Arthritis and Musculoskeletal and Skin Diseases. The University
of Utah School of Medicine was awarded a four-year research contract
totaling about $6.6 million to coordinate a nine-center effort
to study the effectiveness of glucosamine and chondroitin sulfate
in more than 1,000 patients with osteoarthritis of the knee. Researchers
will conduct a randomized, double-blind, placebo-controlled study.
Patients will be evaluated at monthly intervals for 16 weeks and
closely monitored for improvement of their osteoarthritis and
possible adverse reactions.
Orthopaedic surgeon aids injured in Turkey earthquake
In the midst of serving two weeks of active duty
as a reservist at the U.S. Navy Hospital in Naples, Italy, Michael
B. Strauss, MD, was dispatched to Izmit, Turkey on Aug. 18, the
day after an earthquake to provide medical attention to thousands
of injured people. Reports state that the devastating earthquake
has left an estimated 20,000 people dead or missing and 200,000
homeless. As a Captain and member of the U.S. Navy's Surgical
Response Team, Dr. Strauss was among one the first U.S. medical
teams to arrive in Turkey. In civilian life, Dr. Strauss is the
director of orthopaedic surgery at Long Beach Memorial Medical
Center, Long Beach, Calif.
Tenn. orthopaedists support walk to raise osteoporosis awareness
More than 1,000 women participated last month in
"American Walks for Strong Women" in Nashville, Tenn.,
sponsored by the Tennessee Orthopaedic Society to raise funds
to support the efforts of the National Osteoporosis Foundation.
Some 25 participants from the Nashville area orthopaedic community
raised $3,500, the most funds by a group in the event. The Tennessee
Orthopaedic Society has identified osteoporosis as a major community
awareness and legislative initiative for 2000. The "American
Walks for Strong Women" also will be held in Atlanta, Chicago,
Houston, Indianapolis, Denver, San Diego and Washington, D.C.
Hyatt Hotel opens adjacent to AAOS
The 206-room Hyatt Rosemont Hotel, adjacent to the AAOS headquarters in Rosemont, opens this month. The hotel offers convenient lodging for members attending meetings at the Academy and continuing medical education courses at the Orthopaedic Learning Center.