Researchers using genetic information from hundreds of thousands of British nationals, identified several genes which, they say, could be targeted with therapies to ward off osteoporosis. The study was funded by the National Institutes of Health (NIH). “They then confirmed these associations using personal genetics data from hundreds of thousands of people collected by 23andMe, […]
Two California based companies are at the center of a growing scandal over contaminated HCT/P products that, says the CDC, sickened 12 patients, so far. The allograft tissues in question were processed umbilical cords which were distributed primarily to orthopedic and spine physicians. Here are the details.
Buried deep in a new federal inter-agency task force report, which recommends a new national pain management policy, is a stinging rebuke of the 2016 Centers for Disease Control (CDC) opioid prescription guidelines. The report also calls for major improvements in the 50 widely varied state prescription drug management programs (PDMPs). Titled “Draft Report on […]
Based on flawed assumptions and guesswork, CMS is about to cut benefits to Accountable Care Organizations. Of course, that’s now how it is being packaged for clinic or physician consumption. Here are the details.
New medical device and drug applications will be delayed at least a bit. Medical device manufacturers which paid their user fees before December 22, 2018 will see progress on their pre-market notification and pre-market approval requests, the Food and Drug Administration (FDA) says in a statement at its website about the effects of the federal […]
In mid-December, the Food and Drug Administration (FDA) issued a murky and confusing notice saying that companies intending to submit a new premarket approval application (PMA) or supplement to a PMA for a new or changed use of injectable hyaluronic acid (HA) “are encouraged to obtain an informal or formal classification and jurisdiction determination through […]
The Centers of Medicaid and Medicare Services (CMS) operates the mandatory Open Payments Reporting system. OTW has found that the system is so racked with flaws that it may well have lost as much as $800 million in reported payments and never engaged in an enforcement action. Here is the exclusive OTW story.
The American Hospital Association (AHA), the American Association of Medical Colleges (AAMC) and some individual hospitals sued to block the department of Health and Human Services from implementing the so-called “site neutrality” rule which the Centers for Medicare and Medicaid Services (CMS) has finalized for 2019 (“CMS Finalizes Outpatient ‘Site Neutrality’ Rules,” Orthopedics This Week, […]
Orthopedists as a group are suffering more stress from being metaphorically chained to electronic health records systems (EHRs) than any other specialty, a new study says. Of 1,792 physicians who responded to a survey sent to all physicians practicing in Rhode Island, 70% said they were stressed by using their electronic health records systems, and […]
A new U.S. Department of Health and Human Services (HHS) and National Institutes of Health (NIH) program called the Back Pain Consortium (BACPAC) Research Program, announced details December 10 of an offer of nearly $25 million in research grants under four programs in 2019, with more money over the next four years to grant winners. […]
An FDA plan to stiffen device regulations seems to be building momentum. Recent pronouncements from FDA Commissioner Gottlieb and CDRH Chief Shuren are clearly pointing in that direction. Media reports of adverse device events may also be contributing. Read the latest.
As we reported, a Johns Hopkins Medicine researcher criticized the industry-leading Epic electronic health record (EHR) system for having a default of a five-day prescription set up in the system, saying five days are too long (“The EPIC Problem With the CDC Opioid Guideline,” Orthopedics This Week, November 21, 2018.) It seemed unfair to single […]
The American Academy of Orthopaedic Surgeons (AAOS) issued a statement praising two initiatives in “Reforming America’s Healthcare System Through Choice and Competition,” a December 3, 2018 joint statement by three Trump Cabinet agencies of plans to upend parts of the Affordable Care Act (ACA) and push the President’s health care agenda. Sent to the White […]
Four U.S. legislators—two Senators and two Congressman—asked the FDA and EPA to act to curtail use of ethylene oxide for medical product sterilization. Apparently, an outsourcing sterilization facility in Chicago is releasing it in the air. Neighbors are not happy.
Orthopedic surgeons and their hospitals are in a fight to preserve their pay—whether they realize it or not. Anthem is lobbying CMS hard to change the RVU calculation for physician pay. Here are the surprising details.
The Centers for Medicare and Medicaid Services (CMS) has ordered a review of Medicare reimbursements for total hip arthroplasty (THA, CPT Code 27130) and total knee arthroplasty (TKA, CPT code 27447) based on allegations that surgeons are overpaid (see Anthem Lobbying Hard to Slash TKA, THA Pay) and has asked the Relative Value Scale Update […]
In a breakthrough which literally shows government how to govern, Johns Hopkins Medicine (JHM, which includes Johns Hopkins University, Johns Hopkins Hospital, and Johns Hopkins Health System) created what are apparently the first-in-the-nation, procedure-specific guidelines which set precise dose ranges for prescribing opioids for 20 procedures. Four of the guidelines are for orthopedic procedures: arthroscopic […]
When the Centers for Disease Control (CDC) published its opioid-prescribing guideline in 2016, it became a de facto national standard, almost as if it were a government regulation. Why? There was no other standard or guideline. And federal drug enforcers spy on prescribing patterns in state prescription drug management programs (PDMPs). However, the CDC guideline has […]
Pain management is both a hotbed of innovation and controversy. Here are some timely dispatches from the front lines of this critical orthopedic specialty. Surgery patients use only a fraction of their prescribed opioids However, they used more if prescribed more, says a new University of Michigan study, Association of Opioid Prescribing With Opioid Consumption […]
“Those aaa–aaa–are…the good old days” – Carly Simon, Anticipation Could we look back on the current fee structure and say, “those were the good old days”? New cuts in physician fee schedule (PFS) reimbursements may be under active consideration at the Centers for Medicare and Medicaid Services (CMS). Judging by the frantic way the American […]
The Centers for Medicare & Medicaid Services (CMS) issued a 2,378-page final rule on calendar year (CY) 2019 physician payment rates on November 1, with numerous new payment policies and quality rules. There are also changes, some up, some down, in payment amounts for various procedures. It’s far too much to provide details in this report, […]
The Centers for Medicare and Medicaid Services (CMS) issued a new, massive set of final regulations November 2 which, it says, “removes unnecessary and inefficient payment differences between certain provider and supplier types so patients can have more affordable choices and options” starting January 1, 2019. Behind the lofty language: hospital off-campus surgery centers will […]
As previously reported, in that massive July 31 proposed rule (“CMS to Pay Extra for Exparel in ASCs, Not Hospitals,” Orthopedics This Week, October 9, 2018), the Centers for Medicare and Medicaid Services (CMS) singled out one pain medication, the drug Exparel, for extra reimbursement under the bundled-payment system for outpatient surgeries such as total […]
This hodgepodge of legislative initiatives, all 660 pages of it, is probably the biggest federal opioids law ever written. Unfortunately, it will likely inflict pain on physicians. In terms of the reducing opioid abuse, it will help a bit, but not much. Here’s what to expect in your practice.
Following surgeons and nurses around with stopwatches, counting every tray, checking supply delivery dates and OR scheduling patterns – then using a new software tool called SIGHT—Ochsner slashed its TKA costs 29%. Without the efficiency expert lingo, here’s how they did it.
On October 3, the U.S. Senate passed by an overwhelming vote of 98-1 the bipartisan-supported House omnibus opioids bill, H.R.6, the “ SUPPORT for Patients and Communities Act,” which made its way through Congress for most of the year as dozens of separate bills. The House passed this final version September 28. Much of the […]
Most of the benefits for orthopedics survived a House-Senate conference when President Donald Trump signed that Defense-Labor-HHS “minibus” appropriations bill on September 28 (“Major Increase in Ortho Research Funding on the Way,” Orthopedics This Week, September 13, 2018). “We are pleased to see a $2 billion increase in funding for NIH [National Institutes of Health]—a […]
The Centers for Medicare and Medicaid Services wants to give new money to ambulatory surgery centers (ASCs) to prescribe anything but opioids for immediate post-surgical pain—but not hospitals paid under the Outpatient Prospective Payment System (OPPS). The proposal, in the lengthy rule proposal which aims to otherwise make payments site-neutral between hospital outpatient surgery centers […]
The first public sign of skirmishing between the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) over opioids was in 2016, when CDC issued a sweeping guideline on prescribing opioids, recommending that many initial prescriptions should be as brief as three days and no longer than seven days. As we’ve reported […]
The Food and Drug Administration (FDA) isn’t saying so, but its plan to create federal guidelines for prescribing opioid is an implicit rebuke to the Centers for Disease Control and Prevention (CDC). FDA Commissioner Scott Gottlieb, M.D., announced August 22 that FDA has contracted with the National Academies of Sciences, Engineering, and Medicine (NASEM) to […]
If the Centers for Medicare and Medicaid Services (CMS) goes through with proposed new rules for Accountable Care Organizations (ACO), 70% of ACOs which would be forced onto riskier programs in January 2019 say they’ll quit the program. The proposed new CMS rule would fundamentally change the terms under which Accountable Care Organizations are reimbursed. […]
Changes proposed by the Centers for Medicare and Medicaid Services (CMS) would slash reimbursements and patients’ copayments to hospitals’ off-campus treatment facilities, making them approximately equal to payments to ambulatory surgical centers (ASCs). At present, PBDs enjoy significantly higher reimbursements than ASCs. CMS says this “site neutrality” change both benefit patients and “control unnecessary increases […]
A small and simple bill appears about to pass and, if signed into law, would deliver huge legal protections for orthopedists and other licensed caregivers who travel with sports teams. H.R. 302, the “Sports Medicine Licensure Clarity Act of 2017″ (“Sports Medicine Bill Before Congress” Orthopedics This Week, March 24, 2017), passed the U.S. Senate […]
The U.S. House and Senate took a big step toward passing a funding bill with benefits for orthopedics when they named conferees September 4 and 6, 2018 to iron out differences between their versions of a so-called “Minibus” Defense Department-Labor-HHS Appropriations bill. “AAOS is pleased to see an increase in National Institutes of Health [NIH] […]
Quality of life far beyond mobility is impaired by degenerative hip and knee disease, and arthroplasty can restore well-being, says Depuy Synthes survey.
Take any procedure you perform: is there a better approach based on medical evidence or patients’ experience (or both)? In Sweden, they have answers on outcome dating back to 1975. Here, starting with hip arthroplasties, those answers are coming.
Compared to doing nothing, yes. That’s not saying much. New, credible data is NOT finding a link between opioid prescriptions and opioid abuse. Let that sink in. PDMPs are not meeting expectations because that link may not actually exist. Is patient care suffering? This article explains the issue well.
Is this rational? No, it isn’t. Neither, as it turns out, is the general understanding of the relationship between orthopedic care and the use of opioid pain relievers. Here, in Part II of a series, OTW tries to set the record straight.
Is this rational? No, it isn’t. Neither, as it turns out, is the general understanding of the relationship between orthopedic care and the use of opioid pain relievers. Here, in a two-part series, OTW tries to set the record straight.
