Orthopaedic News & Updates
February/March 2021
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BCBS MA - New Policy Effective March 1, 2021
MOA Update
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BCBS MA - Same-day E/M Service with Global Day Procedure Update
The MOA advocated for members and patients urging BCBS MA to further delay and reconsider the change in policy regarding global day procedures. The policy was to be implemented in 2020 however due to the public health emergency, BCBS MA postponed the effective date.
In the letter to BCBS MA, MOA President Walter Stanwood, MD, highlighted the need to safeguard a patient’s timely and safe access to care, especially during the ongoing pandemic. “As physicians, we continue our commitment to providing our patients access to high quality care and feel strongly that we should be reimbursed fairly for those services and procedures we perform. This payment policy is unacceptable to the orthopaedic community as it negatively impacts the most effective and efficient care of our patient. To institute a policy that may delay treatment, places patients at risk during the pandemic and creates hardship for many of our immobile orthopaedic patients and does not serve those insured by BCBS MA nor the employers who purchase your insurance products.” READ MORE.
In addition to the MOA, MMS, AMA and State Specialty Societies also reached out to BCBS MA to discuss the policy change. Despite these efforts, BCBS MA has implemented the policy, effective March 1st citing market forces and the belief that there is an overlap in expenses. The MOA received a reply from BCBS MA echoing similar reasons as to the implementation. READ LETTER.
The MOA has highlighted the policy below and welcomes any comments, feedback, concerns and patient impact of the policy in an effort to readdress this matter with BCBS MA.
BCBS MA - Same-day E/M Service with Global Day Procedure Update
Effective March 1, 2021, when a distinct evaluation and management (E/M) service is provided to a patient at the same session on the same day as a procedure with a CMS global period indicator of 0, 10, or 90 days:
•BCBS MA will reimburse the lesser allowable service at 50% of the fee schedule allowance.
•BCBS MA will continue to reimburse the higher allowable service at 100% of the fee schedule allowance.
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Your Surgeon Profile
Have you updated your Directory Profile on the MOA website? Visit the MOA website for timely updates, membership renewal and directory of surgeons* and be sure to update your profile.
The Directory and Profile are available for 2021 MOA members (dues paid). Log on using your email address and request a password. Haven't renewed for 2021? Not a problem, simply log on to pay online and update your profile at the same time. Any questions, comments, concerns, please contact Susan Schaffman.
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MOA State Legislative Update |
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The Massachusetts state legislature is formally back in session, with a new House Speaker, 20 freshman members of the House and Senate, new committee appointments and over 6500 bills awaiting consideration in the 2021/22 session.
With the retirement of Speaker Robert DeLeo, former House Majority Leader Ron Mariano was elected by his House colleagues to fill that role, marking the first change in that office in 12 years. The MOA is pleased to have a longstanding relationship with Speaker Mariano and has worked closely with him and his staff for many years on such issues as podiatry scope of practice and Out of Network billing, among others. MOA President Walter Stanwood, MD, wrote Speaker Mariano congratulating him and expressing the MOA’s enthusiasm for continued collaboration during his tenure. Senator Karen Spilka was unanimously re-elected as Senate President by her democratic peers.
Other noteworthy changes in key House leadership appointments include Rep. John Lawn as House Chair of Health Care Financing, Rep. Marjorie Decker as House Chair of Public Health, and Rep Jon Santiago as Vice Chair of the newly created Joint Committee on COVID-19 and Emergency Preparedness and Management.
On the Senate side, Sen. Cindy Friedman remains Chair of Health Care Financing and Sen. Joanne Comerford as Chair of Public Health. There were no changes made to the leadership of House and Senate Ways and Means, with Rep. Aaron Michlewitz and Sen Michael Rodrigues, respectively, remaining at the helm of those powerful appropriations committees.
In the 2021/22 session, the MOA will look to build upon successes in the last session, namely continuing to prevent podiatrists from expanding their scope of practice without a corresponding increase in education or training, or improved oversight under the Board of Registration in Medicine. Chapter 260 of the Acts of 2020, the comprehensive health care bill passed at the end of 2020, included provisions to increase the scope of practice for nurse practitioners, certified registered nurse anesthesiologists, and optometrists, but did not include podiatry, a big win for orthopedists and their patients. The MOA refiled its bill to put podiatrists under the Board of Registration in Medicine, and the podiatrists refiled their bill to expand their scope of practice without such increased oversight, so once again, the battle lines have been drawn. Expect more on this when the bills get referred to committees and hearing dates are announced.
The MOA will also closely monitor regulations to implement other relevant provisions in Chapter 260, including reimbursement for telehealth visits and a commission to recommend a reimbursement formula and patient notification of non-emergency OON care.
We look forward to your support and advocacy participation as we continue to lobby for key bills that support Massachusetts’ orthopaedic community and the patients served. Look for legislative alerts and details on legislation as the session continues.
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MOA 2021 Membership Renewal |
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Your participation and renewal is vital to the work of the MOA; supporting the profession, the practice and patients.
While this has been a challenging time for our profession and critical time for the health of our State, the Massachusetts Orthopaedic Association continues to advocate, inform, and support the orthopaedic community.
Even with the disruption of the 2020 legislative session, the MOA has been lobbying for sensible health care reforms, Covid 19 liability relief, telehealth parity and fair, objective out of network reimbursement. In addition, the MOA represented you during Covid 19 related discussions with the Division of Insurance, Department of Public Health and CMS.
During the most critical stages of the pandemic, the MOA worked to provide timely Covid 19 updates as well as share business and practice suggestions. Furthermore, we distributed telehealth codes and policies for all insurers to ensure safe patient care and fair practice reimbursement. And, while we were unable to hold the Annual Meeting this year, we offered a clinical webinar on Orthobiologics presented by Christian Lattermann, MD, to all orthopaedic surgeons at no cost.
We have much more work ahead to be done. Your continued involvement and dues renewal for 2021 is critical to the Association and vital to the ongoing advocacy efforts, educational programs, and representation by MOA for the entire orthopaedic community: private practice, hospital and academic employed. Now more than ever, your membership support is needed.
The MOA is your strongest ally and the only statewide association committed to effecting positive change for the orthopaedic community and patients while delivering value to members with the low annual membership fee of $300.00.
The MOA and its Board looks forward to serving the orthopaedic community as well as its patients in 2021.
Renew for 2021 Today - Three easy ways pay. Thank you.
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Online www.massortho.org
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Complete the form and enclose it with a check payable to the MA Orthopaedic Association.
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Arrange for convenient group billing, please call the MOA at 860-690-1146, or email your request to maorthoexec@gmail.com.
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