AAOS Lobbying Congress to Pass Two Bills Before 2023

One proposal seeks to maintain physicians’ financial stability and one would provide timely patient care.

The American Association of Orthopaedic Surgeons (AAOS) has asked Congress to intervene to stop impending Medicare reimbursement rates for physicians scheduled to go into effect Jan. 1. The group also wants immediate legislation to improve the process for securing prior authorizations for Medicare cases.

In a Nov. 15 letter to congressional leaders, AAOS asked for the passage of House Bill 8800, which would prevent the 4.47% physicians pay reduction for Medicare Cases next year. AAOS says the impending reduction is exacerbated by a related 4% cut what would result in an 8.5% pay reduction for doctors.

"These impending cuts and lack of inflationary update are simply not sustainable and continue to generate significant instability for physicians moving forward, threatening beneficiaries' timely access to essential health care services," wrote AAOS President Felix H. Savoie III, MD, FAAOS. Dr. Savoie explains that without congressional action, the cuts will drive hospital consolidation, limit patient access, and harm physicians' ability to run their businesses.

The second bill, H.R. 3173/S. 3018, would improve the prior authorization process for Medicare cases. "While the prior authorization process is ostensibly intended to control costs, it can delay necessary medical care and negatively influence patient outcomes, consequentially creating a larger cost burden," says Dr. Savoie in the letter.

A study by the U.S. Department of Health and Human Services’ Office of Inspector General found Medicare Advantage plans inappropriately denied up to 85,000 requests in 2019. An American Medical Association review showed 34% of physicians reported a serious adverse event for a patient due to prior authorization delays and clinicians spend an average of two days a week completing requests.

The AAOS letter asks for immediate action by the current lame-duck session of Congress, which ends before the Christmas holidays. "Our patients and physicians cannot wait until the next Congress for additional action," says Dr. Savoie.