AAOS Bulletin - June, 2005

In the news

AAOS sponsors Evidence-Based Analysis Workshop

The AAOS Evidence-Based Practice Committee is sponsoring an Evidence-Based Analysis Workshop on Monday, Nov. 21, 2005 at the AAOS offices in Rosemont, Ill. This workshop will teach the fundamentals of evidence-based analysis. The goal is to assist orthopaedists in integrating evidence-based medicine into their practices and to help develop a larger cadre of physicians who are qualified to assist AAOS in developing evidence-based practice guidelines. The AAOS will pay travel and accommodation expenses for the first 50 registrants. Physicians attending the workshop at Academy expense will be expected to assist the Academy in ongoing evidence-based guideline development. 

Orthopaedic fellows and senior residents are encouraged to participate. CME credit will be given, and there is no charge for the workshop itself. Direct questions to Jill Hughes at hughes@aaos.org or (847) 384-4313. A registration form can be downloaded from http://www.aaos.org/Research/Committee/Evidence/ebpc.asp

CMS accepting applications for National Provider Identifier

AAOS members can apply for the new National Provider Identifier (NPI). The NPI, a requirement under the Health Insurance Portability and Accountability Act, is intended to replace the multiple health care provider identifiers currently being used by Medicare, Medicaid, private health insurance companies and health care clearinghouses. The Centers for Medicare and Medicaid Services (CMS) began accepting Web-based applications on May 23, 2005. To apply over the Web, go to: https://nppes.cms.hhs.gov

Paper applications will be accepted beginning July 1, 2005. A copy of the application, including the appropriate mailing address, will be available on https://nppes.cms.hhs.gov or can be requested by phone: (800) 465-3203 or (800) 692-2326 (TTY). Additional information is available at http://www.cms.hhs.gov/hipaa/hipaa2

States in crisis: Add Rhode Island; drop Texas

Add Rhode Island to the list of 19 states in medical liability crisis, where patient access to care is threatened due to spiraling medical liability insurance costs. A recent survey by the Rhode Island Medical Society found that 49 percent of the state’s physicians have discontinued or considered discontinuing certain services due to increasing medical liability costs. Additionally, 48 percent of Rhode Island physicians said that high medical liability costs have forced them to consider leaving the state or giving up clinical practice.

Texas, which passed sweeping reforms in 2003, was dropped from the list. There, access to care is increasing, claims are down, new insurers are entering the market and all five of the largest insurers in the Texas medical liability market have announced rate cuts.

AAOS testifies before appropriations subcommittee on orthopaedic trauma research needs

AAOS fellow David W. Polly Jr., MD, testified on May 17, 2005, before the Senate Defense Appropriations Subcommittee. Dr. Polly, who previously served as chair of the department of orthopaedic surgery and rehabilitation at Walter Reed Army Medical Center, spoke in support of AAOS’ proposal to establish a program at the U.S. Army Institute of Surgical Research (ISR) at Ft. Sam Houston, Texas, to fund peer reviewed intramural and extramural orthopaedic trauma research. Both Subcommittee Chairman Ted Stevens (R-Alaska) and Ranking Member Daniel Inouye (D-Hawaii) commented on the importance of expanded orthopaedic trauma research. The House and the Senate have not drafted their respective FY 2006 defense appropriations bills, but final passage is expected before the August congressional recess.

Medicare physician payment legislation introduced

In May, bills to reform the Medicare physician payment system were introduced in the U.S. House and Senate. The House bill (HR 2356) would give physicians a Medicare payment increase of approximately 2.7 percent in 2006 and would base future annual payment updates on the Medicare Economic Index (MEI), which would more appropriately reflect practice costs. The Senate bill simply provides an additional positive update in 2007 of approximately 2.6 percent, reflecting physician practice cost inflation. AAOS and the Alliance of Specialty Medicine have been involved in discussions with Congress and the Centers for Medicare and Medicaid Services (CMS) to address the current flawed formula and approaches to pay-for-performance. The two groups met with CMS on April 29 to discuss issues related to the Medicare physician payment formula. For a report on the meeting, visit: The May 6, 2005 Legislative Update.

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