July 1996 AAOS Report

AMA to join Academy to delay start of HCFA's practice expense levels

At its June meeting, the American Medical Association's House of Delegates agreed to join the Academy and other specialty societies in calling for an one-year delay in implementation of the new "resource-based" Medicare practice expense payments. Currently, the law requires the Health Care Financing Administration (HCFA) to establish these new payment levels by January 1998. The delay is necessary because HCFA, by its own admission, needs more time than originally anticipated to study physician practice costs. Without the delay, the new practice expense payment levels would be based on faulty data, which could result in larger than expected payment decreases for orthopaedic and other surgical services. The Academy also succeeded in getting the AMA House of Delegates to oppose HCFA's use of the term "participating centers of excellence" in its payment bundling demonstration project for total hip and total knee replacement procedures. In addition, the House agreed to back the Academy and other specialty societies in trying to persuade HCFA to establish new payment levels for surgical global services. This effort has been undertaken because payments for physician visits and consultations are going up starting in 1997. Since most surgical global services also include some pre - and postoperative visits and consultations, payments for these services also should, presumably, increase as well.

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