Summer 2022

MA Ortho News: No Surprise Act, State Patient Disclosure Requirements, New DPH Emergency Orders, Renew 2022

Orthopaedic News & Updates January 2022 NEW REQUIREMENTS FOR PHYSICIANS Federal No Surprise Act State - Puts Patients First Act State of Massachusetts - "Patients First" Act The Massachusetts Department of Public Health (MDPH) issued a notice (effective January 1, 2022) to physicians and other healthcare providers outlining their responsibilities related to scheduling procedures and admissions, referral to another physician or health care provider, network status and price transparency. These requirements are part of, An Act Promoting a Resilient Health Care System that Puts Patients First, signed into law by Governor Baker on January 1, 2021.   While there is some overlap with similar notice and transparency provisions under the Federal No Surprises Act (see article below for more information on the No Surprises Act), there are specific provisions as outlined by the DPH in the notice sent to physicians including state penalties for failure to comply. Thanks to the work of the MA Medical Society, there is a delay in enforcement of penalties until July 2022, however the MOA urges its members to be aware of the documentation requirements for purposes of determining compliance. The MOA continues to monitor the requirements and will keep our members updated.  The MOA has also extended our assistance and collective voice to the MA Medical Society (MMS) to augment any additional advocacy by the MMS and the MA Health and Hospital Association as they pursue a clear understanding of responsibilities and necessary changes.    For your reference: DPH Notice to Providers (includes frequently asked questions.) & DPH Notice to Patients The MMS website has additional information and resources. Federal - "No Surprises" Act This document is intended to provide information on the federal “No Surprise Act” requirements physicians must comply with beginning January 1, 2022. The new rule requires physicians to notify patients of their rights under the new law and to provide good faith estimate of expected charges to uninsured or self-pay patients.    CMS published guidance and resources about provider obligations under the federal No Surprises Act can be found on their website: https://www.cms.gov/nosurprises and several of resources and forms are listed below with model template forms attached. The AMA NSA tool kit may also be helpful to you and your staff.   RESOURCES   · Overview of Rules and Fact Sheets     · Provider Requirements and Resources; Forms & Guidance (Please note: It is possible CMS will update/modify documents so please check the CMS website. ) Model CMS Disclosure Document Model Notice and Consent Document For uninsured/self-pay patients ·      Model CMS Good Faith Estimate Template* ·      Right to Receive a Good Faith Estimate Notice ·      Appendix for Good Faith Estimates Data Elements** · High Level Overview of Provider Requirements · Information and documentation about Good Faith Estimate calculations for uninsured/self-pay patients     *The Model CMS “Good Faith Estimate Template” meets the No Surprises Act requirement with respect to providing a Good Faith Estimate of Expected Charges to uninsured/self-pay patients.   It is important to note that information regarding the availability of a Good Faith Estimate must be prominently displayed on your website and in the office and on-site where scheduling or cost of healthcare questions may be asked. The Model CMS “Right to Receive a Good Faith Estimate Notice” is not required but may be helpful to provide to patients to inform them of the availability of a Good Faith Estimate of Expected Charges.   **The Appendix notes that the good faith estimate information must be submitted by both the convening provider or convening facility (i.e. the provider or facility that initially received the request and scheduled services) as well as any other additional provider(s) or facility(ies) that may provide healthcare services or items to the uninsured/self-pay patient. However, until December 31, 2022, HHS will exercise its enforcement discretion in situations where a good faith estimate only includes estimates from the convening provider and does not include expected charges for items or services from any additional provider(s) or facility(ies).   The MOA will continue to provide membership with any relevant updates and news. As a MOA member, you are invited to register for the webinar below. We hope you will join the informational presentation. FEDERAL NO SURPRISES ACT – ONE MONTH IN. WHAT HAVE WE LEARNED? WHAT QUESTIONS REMAIN? Garfunkel Wild - COMPLIMENTARY WEBINAR TUESDAY - FEBRUARY 1, 2022 Noon - 1:00 PM Garfunkel Wild’s Debra Silverman, John Martin and Carmen Jule will present the webinar “Federal No Surprises Act – One month in. What have we learned? What questions remain?″ As we near the effective date of January 1, 2022, there are many unanswered questions surrounding the Federal No Surprises Act. Fortunately the Garfunkel Wild Working Group will be both advising clients in the trenches and studying all guidance and developments released regarding the Act’s implementation during the Act’s first 30 days. In this Webinar, we will report back and update everyone on what the first month of living with the Federal No Surprises Act has taught us.  The Webinar will provide answers where questions have been resolved and will address continuing areas of uncertainty, all with the same expert insight and analysis that Garfunkel Wild has always furnished to our Health Care clients. Click Here To Register.  DPH Issues New Orders to Preserve Health System Capacity The Department of Public Health (DPH) has released several new orders, pursuant to the current COVID-19 public health emergency declaration, effective immediately, which impacts the practice of medicine. The new orders seek to preserve the health system’s capacity and ability to effectively respond to COVID-19. Click here for all current DPH orders outlined below. Order No. 2022-02 authorizes qualified physician assistants to practice without physician supervision under specified conditions. The order does not authorize physician assistants to practice independently outside of a physician practice or health care facility. Order No. 2022-05 directs all hospitals and facilities licensed or operated by DPH (DPH-regulated hospitals or facilities) to immediately expedite credentialing procedures to process applications from licensed independent practitioners. The order also authorizes all licensed and certified clinical staff, including licensed independent practitioners, who are employed by or work at any DPH-regulated hospital or facility to work at any other DPH-regulated hospital or facility.    Order No. 2022-04 directs the Board of Registration in Medicine to adopt policy outlined in the order that expedites licensure of eligible physicians who are graduates of International Medical Schools, are currently practicing in the United States, and have completed at least two years of approved postgraduate medical training. Have You Renewed? MOA 2022 Membership Have a Colleague Who Wants to Join? Membership Value & Benefits The MOA is your strongest ally and is 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 is the only statewide orthopaedic organization representing the entire orthopaedic community: private practice, hospital and academic employed.   Over the last year, your membership assisted the advocacy work of the MOA on State and Federal matters including:   o  Prior Authorization Reform o  Medicare Reimbursement o  Telehealth o  Out of Network/Surprise Billing o  Modifier 25 o  Scope of Practice Issues o  Mandatory Seatbelt Use and more.   MOA Membership Benefits also include: o  Representation to the Medicare Carrier Advisory Committee. o  Communication with commercial insurers regarding Coverage and Reimbursement Policies. o  Oversight of and representation to the Worker’s Compensation. o  CME Accredited Annual Meeting including Risk Management. o  Webinars on CPT Coding and practice matters for you and your staff at low or no fee. o  Fostering orthopaedic resident involvement through paper presentation competition. o  Monthly Enewsletter to keep you and your practice informed and up to date. o  Online directory of orthopaedic surgeon members for the public.   Now more than ever, your membership renewal and support are important.   Please Renew for 2022 Today.   Pay by credit card online www.massortho.org Complete the form and mail a check payable to the MA Orthopaedic Association.                             Discounted group billing, please call the MOA at 860-690-1146 to arrange, or email your request to maorthoexec@gmail.com. Your participation and renewal are vital to the work of the MOA; supporting you, the profession, the practice and patients.    Thank you!

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MA Ortho News-Take Action - Medicare 2022 Reductions Proposed, Telehealth Update, Out of Network Info, Register 2021 Annual Meeting & Golf

Orthopaedic News & Updates September 2021 Proposed 2022 Medicare Fee Cuts Please Take Action - Your Voice Counts Orthopaedic surgeons face significant cuts in Medicare reimbursement beginning in January 2022. It is estimated that the cuts amount to almost 10% reduction.  The MOA is adding its collective voice to an AAOS comment letter (to be released) to CMS urging reconsideration of the proposed reductions. In addition, members of the MOA Board will be meeting with members of Congress later this month to urge the Massachusetts Delegation to protect patients access to care and stop the payment cuts to orthopaedic surgeons treating Medicare patients. You can help too! Please take a few minutes to answer the AAOS Call to Action and contact members of Congress. The AAOS Action Advocacy Center makes it easy for you to take action. Simply click on this link and follow the prompts. Add your voice to Stop the 2022 Proposed Medicare Cuts. Don’t Delay, Act Today! Continued Access to Telehealth Coverage Division of Insurance Issues Update On September 7th the DOI released Bulletin 2021-10, outlining continued access to telehealth coverage and the requirements that health insurance carriers of fully funded commercial plans must follow to implement the requirements of Chapter 260 of the Acts of 2020. The provisions allow carriers to maintain current rates of reimbursement for telehealth services beyond the 90-day glide path following the end of the state of emergency on June 15, 2021. Carriers that choose to alter the telehealth reimbursement rates must submit an implementation plan, subject to the approval of the DOI and may NOT implement any changes prior to such approval.  Recognizing the need for existing telehealth flexibilities, the Bulletin allows health insurers to choose to maintain their current rates of reimbursement for all telehealth services including those required under Chapter 260 of the Acts of 2020, as follows: Rates of payment for in-network providers of chronic disease management and primary care services must be no less that in-person rates through January 1, 2023; and Rates of payment for all other in-network providers must be no less that in-person rates through September 13, 2021. Rates of payment for in-network providers of behavioral health services must be no less than in-person rates. DOI emphasized that a carrier CAN NOT make changes to telehealth rate policies or notify providers of any changes without going through the review process established by DOI as outlined in Bulletin 2021-10. These changes, if requested by a carrier, would constitute a material change and the DOI expects that they will be subject to Chapter 175, Section 24B, which requires 60 days’ notice.   If you are notified of any proposed changes by health carriers, please share the information with the MOA via email or phone 860-690-1146. Out of Network Billing & Reimbursement Recommendations to Legislature The Executive Office of Health and Human Services (EOHHS) and the Health Policy Commission (HPC) were charged with developing recommendations around Out of Network billing for emergency and non-emergency care. Those recommendations were released on September 7, 2021, and can be found here. The report recommends that the legislature set OON billing at the median in-network rate without a separate independent dispute resolution process at the state level. (Please note - this recommendation is predicated on the assumption that the federal law is severable and not a blanket opt in or opt out, which is unclear at this time.) The legislature would have to act on the recommendations for them to take effect. That would mean that legislation would have to be drafted (no such bill exists at this time), passed by the House and Senate, and signed by the Governor. If the legislature does not act by the end of the year, the federal law would take effect in Massachusetts on January 1, 2022. The message from the MOA, and much of the physician and hospital community, has been to do nothing and let the federal law take effect. The timeframe for legislative action, if they so choose, is short. The legislature came back into formal session this week and will recess again the Wednesday before Thanksgiving. Although the state legislative session continues into 2022, and thus, a bill could be passed next year, the thought is that once the federal bill takes effect, the impetus for the state to pass an OON law is significantly less.  At this time, MOA Lobbyist, Ronna Wallace does not anticipate the legislature will take up health care, but that could change, especially if the insurers push hard for state action. That’s why the MOA is going to be proactive and communicate our position to the House and Senate leadership and Baker administration. The MOA will continue to advocate for orthopaedic surgeons and patients. Your Invited to Attend MOA 2021 Annual Meeting NEW LOCATION - NEW LOCATION SPACE IS LIMITED- ADVANCE REGISTRATION REQUIRED October 5, 2021 Noon - 6 pm    Granite Links Golf Club 100 Quarry Road Quincy, MA   The Association is looking forward to offering its members an opportunity to gather in person and learn together again, better, and stronger and hope you will join us in the Fall.  REGISTER TO ATTEND Space is limited. Advanced registration is required by September 20th. Orthopaedic surgeons, physician assistants and residents are invited to attend and learn the important issues affecting the practice of medicine and patient care, receive clinical updates with CME credits, review the latest legislative and regulatory matters impacting the profession, honor the 2021 Orthopaedist of the Year, John Richmond, MD, network with your colleagues and much more.   You won't want to miss this educational event with topics including: ·      How to Bring Your Orthopaedic Idea to Commercial Product. ·      The Pros and Cons of A.I. & Robotics in Orthopaedic Surgery ·      Orthopaedic Hospitalists – The Answer to Trauma Care, Post Op Care & Call Coverage Problems? ·      AAOS News & Updates ·      Physician Guilds & Unions ·      Current State Legislative Matters Impacting Your Practice and Your Patients. 2021 Program Agenda Register & Pay Online   All current 2021 MOA Members and Affiliate PA Members attend at the reduced rate of $100.00. Emeritus Members rate is $75.00. Haven't renewed for 2021? Simply renew online when registering for the meeting. IMPORTANT NOTICE YOUR SAFETY IS OUR PRIORITY The MOA will be following State Covid-19 Safety Protocols. In addition, the MOA requests all meeting participants to be fully vaccinated or to have had a negative Covid PCR test 72 hours prior to the meeting. Masks will be required. Thank you.   Start the Day with a Round of Golf Early Morning Tee Times Available. MOA has arranged for a preferred early morning golf tee times. prior to the start of the Annual Meeting for those attending the meeting. Enjoy a round a golf and then join the MOA for lunch and the Annual Meeting. The cost per golfer for 18 holes and cart is $190.00, and is payable to the MOA. To register your foursome or just yourself, please contact the MOA directly by email or call Susan at 860-690-1146, to secure your tee time. Deadline for registration is September 24, 2021.

MA Ortho News-Impt. Telehealth and Out of Network, 2021 Annual Meeting & Golf

Orthopaedic News & Updates July 2021 MOA Urges MA Legislators Support for Telehealth Parity and Federal Out of Network Provisions Telehealth Since the beginning of the pandemic the orthopaedic community has adopted to the use of telehealth in their practice for the benefit of their patients. The MOA continues to advocate for the orthopaedic community and patients in support of extending telehealth policies implemented during the Public Health Emergency including reimbursement parity.  Recently, MOA testimony was submitted before the Joint Committee on Financial Services, in support of H.1101/S.678, An Act Relative to Telehealth and Digital Equity for Patients. In addition to parity, this bill would protect patients from insurer’s imposing prior authorization for medically necessary telehealth visits if not applicable to in-person visits among several other provisions in the bill.  The MOA testimony is consistent with previous testimony submitted by the Association on other related telehealth bills as well as formal comments to the Division of Insurance regarding telehealth policies and regulations post pandemic.   Out of Network Billing With the federal No Surprise Act taking effect on January 1, 2022, the MOA, in recent testimony, urged members of the Joint Committee on Financial Services to utilize the Act as the foundation for the State. The No Surprise Act provides for a fair and uniform system to determine reimbursement rates paid by insurers while protecting patients from surprise medical bills.  The provisions of the proposed MA bill, H.1197/S.680, An Act Relative to Out-Of-Network Billing, could be applied, if necessary, as a mechanism for implementation of the federal law. The MOA will continue to support a fair and uniform system that includes an independent arbitration process and fair reimbursement.  Our advocacy also entailed orthopaedic representation on the recent out of network listening sessions held by the MA Executive Office of Health and Human Services (EOHHS). EOHHS was tasked by the legislature with submitting recommendations on out-of-network, non-contracted, commercial rates for emergency and non-emergency care. Following the sessions, MOA President, Walter Stanwood, MD, submitted formal comments on behalf of the orthopaedic community urging EOHHS to include in their recommendation provisions for an independent dispute resolution process and a fair and equitable reimbursement model that would not allow insurers to set rates or tie to a percentage of Medicare.   Your Invited to Attend MOA 2021 Annual Meeting NEW LOCATION - NEW LOCATION October 5, 2021 Noon - 6 pm    Granite Links Golf Club 100 Quarry Road Quincy, MA   The Association is looking forward to offering its members an opportunity to gather in person and learn together again, better, and stronger and hope you will join us in the Fall.  REGISTER TO ATTEND Advanced registration is required by September 20th. Orthopaedic surgeons, physician assistants and residents are invited to attend and learn the important issues affecting the practice of medicine and patient care, receive clinical updates with CME credits, review the latest legislative and regulatory matters impacting the profession, honor the 2021 Orthopaedist of the Year, John Richmond, MD, network with your colleagues and much more.   You won't want to miss this educational event with topics including: ·      How to Bring Your Orthopaedic Idea to Commercial Product. ·      The Pros and Cons of A.I. & Robotics in Orthopaedic Surgery ·      Orthopaedic Hospitalists – The Answer to Trauma Care, Post Op Care & Call Coverage Problems? ·      AAOS News & Updates ·      Physician Guilds & Unions ·      Current State Legislative Matters Impacting Your Practice and Your Patients.   Register & Pay Online   All current 2021 MOA Members and Affiliate PA Members attend at the reduced rate of $100.00. Emeritus Members rate is $75.00. All others attend at the non-member rate of $375.00. Haven't renewed for 2021? Simply renew online when registering for the meeting. Start the Day with a Round of Golf Early Morning Tee Times Available. MOA has arranged for a preferred early morning golf tee times. prior to the start of the Annual Meeting for those attending the meeting. Enjoy a round a golf and then join the MOA for lunch and the Annual Meeting. The cost per golfer for 18 holes and cart is $190.00, and is payable to the MOA. To register your foursome or just yourself, please contact the MOA directly by email or call Susan at 860-690-1146, to secure your tee time. Deadline for registration is September 24, 2021. MA Directory of Orthopaedic Surgeon Members 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. MOA 2021 Membership Renewal  Now more than ever, your membership support is needed.  Pay online at www.massortho.org  & update your new directory profile.   The MOA continues to work to ensure the enactment of sensible health care reforms, telehealth parity and fair, objective out of network reimbursement. In addition, the MOA represented orthopaedic surgeons during the listening discussions with the Division of Insurance regarding regulations to implement telehealth bill passed in 2020. 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.    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.   Renew for 2021 Today - Three easy ways pay. Thank you.                                                                     Online www.massortho.org Complete the form and enclose it with a check payable to the MA Orthopaedic Association.                                                           Arrange for convenient group billing, please call the MOA at 860-690-1146, or email your request to maorthoexec@gmail.com. The MOA, supporting the profession, the practice of medicine and patients.

MA Ortho News-Impt. Telehealth, Telehealth DOI Sessions, 2021 Annual Meeting, MA Ortho Surgeon Directory, Renew Membership & More

Orthopaedic News & Updates May/June 2021 MOA Supports Telehealth Senate Amendments Concerns Regarding Executive Order Lifting Telehealth Provisions With the recent announcement by Governor Baker lifting restrictions by May 29, 2021, and ending the State of Emergency on June 15, 2021, the Executive Order issued during the pandemic providing telehealth provisions will end 90 days after the end of the State of Emergency.   With patient access to care in mind, the MOA continues to have concerns about the adequacy of a 90-day timeframe to address a massive shift in health care insurers’ reimbursement policies.   As noted in a previous MOA Enewsletter, the passage of Chapter 260 of the Acts of 2020, by the MA Legislature granted permanent telehealth reimbursement parity for behavioral health and allows for parity for two years from the passage of the bill (until January 2023) for chronic disease management* and primary care however the current definition for chronic disease management in the Acts is narrowly defined.   Currently the MA Senate budget proposal (S.3) contains amendments (561 and 565) to address the timeline and definition concerns of the physician community. MOA President, Walter Stanwood, MD, has communicated the orthopaedic community’s support for the Amendments that seek to expand the current definition of chronic disease and extend the current 90-day expiration to 180 days via “Glidepath” model. (READ MOA LETTER)   Amendment #561 Chronic Disease Management (Gomez) This amendment would change the currently narrow definition of “chronic disease management” in Chapter 260 of the Acts of 2020, for the purposes of reimbursement for telehealth services, to one which defines chronic disease management as “care and services for the management of chronic conditions that last one year or more and require ongoing medical attention or limit activities of daily living or both. Chronic disease management shall also include care for COVID-19 and its long-term symptoms. “This definition is consistent with that which is utilized by the Centers for Disease Control and Prevention (CDC). The value of this approach is to eliminate the need for specific diagnosis and instead focus on conditions that can be controlled, but not cured. Utilization of the CDC definition will ensure that the state’s implementation of telehealth remains aligned with evolving medical evidence and precludes the need to pre-establish a list of conditions.   Amendment #565 Glidepath for Telehealth Reimbursement Parity (Gomez) This amendment would require reimbursement parity for telehealth services to remain in effect for 180 days after the end of the COVID-19 state of emergency, up from 90 days as directed by Chapter 260 of the Acts of 2020.   The MOA continues to play an active role in supporting parity in telehealth beyond the pandemic for patients and its members.   *Current Chronic Disease Management Definition - Chapter 260 of the Acts of 2020 SECTION 56.  Said section 1 of said chapter 176O, as so appearing, is hereby further amended by inserting after the definition of “Case management” the following definition:-“Chronic disease management”, care and services for the management of chronic conditions, as defined by the federal Centers for Medicare and Medicaid Services, that include, but are not limited to, diabetes, chronic obstructive pulmonary disease, asthma, congestive heart failure, hypertension, history of stroke, cancer and coronary artery disease. DOI Telehealth Regulations & MOA Comments The Division of Insurance and MassHealth concluded the scheduled listening information sessions conducted with all stakeholders to review and provide feedback for the purpose of promulgating draft regulations implement Chapter 260 of the Acts of 2020.  The MOA actively participated and submitted formal comments on the topics discussed including: ·       What constitutes a telehealth visit? ·       Definitions of Services ·       Reimbursement ·       Billing  ·       Utilization Review for Telehealth  ·       Telehealth Standards to be Added to Managed Care Accreditation Reviews The timeline for promulgating draft regulations has not been determined (as of this publication date) however once they are released, a public hearing will be conducted, and the MOA will provide testimony on behalf of its members to support access to telehealth including audio only for patients and reimbursement parity for physicians. If you have any comments and/or concerns regarding telehealth post pandemic you would like to share with the MOA, please email the Association. MOA Comment Letter #1 MOA Comment Letter #2 Join Your Colleagues - MOA Annual Meeting Tuesday, October 5, 2021 Noon - 6 pm     NEW LOCATION-NEW LOCATION  Granite Links Golf Club (Outdoor Pavilion Tent) 100 Quarry Road, Quincy, MA   REGISTER TO ATTEND   The MOA Board is pleased to invite you to attend the MOA’s 2021 in person Annual Meeting on Tuesday, October 5, 2021, from Noon – 6:00 p.m., at our new venue, Granite Links Golf Club in Quincy, Massachusetts. The new location will allow for the annual meeting to be conducted outside under the pavilion tent, allowing for members to attend in a protected outdoor venue.    Orthopaedic surgeons, physician assistants and residents are invited to attend and learn the important issues affecting the practice of medicine and patient care, receive clinical updates with CME credits, review the latest legislative and regulatory matters impacting the profession, honor the 2021 Orthopaedist of the Year, John Richmond, MD, network with your colleagues and much more.   You won't want to miss this educational event with topics including: ·      How to Bring Your Orthopaedic Idea to Commercial Product. ·      The Pros and Cons of A.I. & Robotics in Orthopaedic Surgery ·      Orthopaedic Hospitalists – The Answer to Trauma Care, Post Op Care & Call Coverage Problems? ·      AAOS News & Updates ·      Physician Guilds & Unions ·      Current State Legislative Matters Impacting Your Practice and Your Patients.   Register & Pay Online   All current 2021 MOA Members and Affiliate PA Members attend at the reduced rate of $100.00. Emeritus Members rate is $75.00. All others attend at the non-member rate of $375.00.  Haven't renewed for 2021? Simply renew online when registering for the meeting.     The Association is looking forward to offering its members an opportunity to gather and learn together again, better, and stronger and hope you can join us in the Fall. MA Directory of Orthopaedic Surgeon Members 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. MOA 2021 Membership Renewal  Now more than ever, your membership support is needed.  Pay online at www.massortho.org  & update your new directory profile.   The MOA continues to work to ensure the enactment of sensible health care reforms, telehealth parity and fair, objective out of network reimbursement. In addition, the MOA represented orthopaedic surgeons during the listening discussions with the Division of Insurance regarding regulations to implement telehealth bill passed in 2020. 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.    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.   Renew for 2021 Today - Three easy ways pay. Thank you.                                                                     Online www.massortho.org Complete the form and enclose it with a check payable to the MA Orthopaedic Association.                                                           Arrange for convenient group billing, please call the MOA at 860-690-1146, or email your request to maorthoexec@gmail.com. The MOA, supporting the profession, the practice of medicine and patients.

MA Ortho News-State Legislative News, Telehealth DOI Sessions, AAOS Suprise Billing, 2021 Annual Meeting, Renew Membership & More

Orthopaedic News & Updates April 2021 Announcing the MOA 2021 Annual Meeting   Tuesday - October 5, 2021   In an effort to conduct the Society’s 2021 Annual Meeting in person and within a safe environment while allowing time for the COVID-19 vaccination distribution to reach a wider population, the MOA Board has decided to hold the MOA’s Annual Meeting on Tuesday, October 5, 2021, from Noon – 6:00 p.m.  We are also excited to introduce the new meeting venue, Granite Links Golf Club in Quincy, Massachusetts. The new location will allow for the annual meeting to be conducted outside under the pavilion tent, allowing for members to attend in a protected outdoor venue. Hope you will join the MOA and your colleagues in October. READ MORE . MOA State Legislative Update   The Massachusetts State Legislature continues to conduct formal sessions and hearings virtually. while the State House remains closed to all except for essential personnel. Chapter 260 of the Acts of 2020, the comprehensive health care bill passed at the end of 2020, and 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.  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. 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 announced.  The MOA is closely monitoring regulations to implement other relevant provisions in Chapter 260 of the Acts of 2020 including policies and reimbursement for telehealth visits and a commission to recommend a reimbursement formula and patient notification of non-emergency OON care. For more information on the Division of Insurance and MassHealth telehealth listening sessions and the MOA’s input, see article below. Next on the Legislature’s agenda will be the state budget deliberations. The MOA carefully reviews all health care line-items, outside sections and requested amendments to assess any impact on orthopedists or your patients. Also expected shortly are the assignment of bills to committees and early committee hearings.  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. Stay tuned and stay active in the MOA!  Division of Insurance-Telehealth Regulations MOA Participation The Division of Insurance and MassHealth are holding information sessions to discuss the implementation of telehealth provisions that are included within Chapter 260 of the Acts of 2020.   The MOA has been participating and provided comments (click here for MOA comments) for the first two sessions on the topics discussed including: ·       What constitutes a telehealth visit? ·       Definitions of Services ·       Reimbursement ·       Billing  The remaining sessions include discussion regarding: ·       Utilization Review for Telehealth  ·       Telehealth Standards to be Added to Managed Care Accreditation Reviews ​​​​​​​ If you and/or your staff would like to participate, the DOI will be holding a special session on Thursday, April 29, 2021, from 6:30 – 8 p.m. to accommodate those who can not typically attend the workday discussions. Please visit their website for details and Zoom connection. https://www.mass.gov/service-details/telehealth-information-sessions MOA Supports AAOS Comments on No Suprises Act in Washington The MOA was pleased to support the AAOS letter to HHS and CMS outlining concerns and providing comments to both agencies regarding the upcoming rulemaking on the No Surprises Act of 2020 passed by Congress. The AAOS letter emphasized the importance of retaining a balance billing option for physicians; supporting the use of a an in-network median rate for all local health plans; the mechanics of the arbitration process and implications for state surprise billing laws. The MOA will continue to monitor the rulemaking process in Washington as we work on the Massachusetts out of network bill this session. Update Your Surgeon Profile Online 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. MOA 2021 Membership Renewal Your participation and renewal is vital to the work of the MOA; supporting the profession, the practice and patients. Pay online at www.massortho.org  & update your new directory profile.   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 continues to lobby for sensible health care reforms, telehealth parity and fair, objective out of network reimbursement. In addition, the MOA is representing you during the listening discussions with the Division of Insurance regarding regulations to implement telehealth bill passed in 2020.   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.                                                                     Online www.massortho.org Complete the form and enclose it with a check payable to the MA Orthopaedic Association.                                                           Arrange for convenient group billing, please call the MOA at 860-690-1146, or email your request to maorthoexec@gmail.com.

MA Ortho News-BCBS MA Policy, State Legislative News, 2021 Renew Membership & More

Orthopaedic News & Updates February/March 2021 BCBS MA - New Policy Effective March 1, 2021 MOA Update   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. 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. MOA State Legislative Update 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.  MOA 2021 Membership Renewal Your participation and renewal is vital to the work of the MOA; supporting the profession, the practice and patients. Pay online at www.massortho.org  & update your new directory profile.   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.                                                                     Online www.massortho.org Complete the form and enclose it with a check payable to the MA Orthopaedic Association.                                                           Arrange for convenient group billing, please call the MOA at 860-690-1146, or email your request to maorthoexec@gmail.com.