October 1999 Bulletin


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.

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