Don't Forget - VOTE!

• TOA President's Update
• Texas District by District: Mark Strama
• On The TOA Radar Screen: Restricting Or Limiting Of Patient's Choice Of Facilities Letter
• Worth Repeating: AAOS and AAHKS Avert Significant Cuts To Certain Orthopaedic Work Values
• Texas Orthopaedic Association - 2007 Dues

TOA President's Update
  

By David Teuscher, MD President, Texas Orthopaedic Association You may have missed the news last week, but the Centers for Medicare and Medicaid Services (CMS) pulled back from their proposal to cut the work values (RVU) for total hip arthroplasty, total knee arthroplasty, and open treatment of femoral neck fractures. This was part of the recent five-year review conducted by the AMA's Relative Value

Scale (RVS) Update Committee (RUC). The original proposal would have cut the relative value and therefore reimbursement for THA by over 10%, TKA by over 4%, and open treatment of femoral neck fractures by over 6%. The decision to leave the RVU for these procedures at their current level is a huge victory for all orthopaedists. 

If the cuts had gone into effect it would have resulted in annual Medicare payment cuts of $50 million per year for these codes alone. If you take into account that nearly all commercial payers and workers comp tie their rates of payment to Medicare, you can see that the total savings for orthopaedic surgeons exceeds $100 million. Now if you are not a hip and knee surgeon you might think that this wouldn’t have affected you. Guess again, as these are relative values that every other procedure we perform is compared to. You can bet that if CMS was successful in cutting these codes, they would soon want to pay you less for lumbar discectomy, carpal tunnel release, and knee arthroscopy codes. Add in the planned 5% decrease in Medicare reimbursement that is scheduled to go into effect in January, and you can see what a slippery slope we are on.

Are you wondering how CMS came to their senses? Only after a small group of dedicated volunteer physician leaders from AAOS and AAHKS lead a coordinated effort over the past six months to “educate” CMS of their flawed methodology. I am proud to tell you that Dr. Brian Parsley of Houston was one of those who worked tirelessly on this project. While this work was focused on hip and knee codes, other specialties will find themselves in similar situations in the future, the same amount of dedication and energy to ensure just compensation for the outstanding services that you provide to your patients. It is so very important that we work together on these issues. Together we are stronger.

Medicare physician payment rates are projected by 2015 to be cut by about 40% due to the flawed payment update formula, with payments in Texas to be cut by $12.84 billion on Medicare alone. For physicians in Texas, the average annual cut over this period of time will be $29,000 per year for each physician. The 2007 cut alone to Texas physicians will be $219 million due to the negative 5% update, not counting the devastating impact it will have on our commercial and workers comp payments that are tied to Medicare rates. 

If this concerns you as much as it does me, then my challenge to you is to contact your Congressman and tell them to fix the Medicare mess that they made before the end of this year. A lame duck session of Congress is planned after the election and before the new 110^th Congress takes office in January. We need to turn up the pressure on our Representatives to do the right thing and prevent further access to care problems for our seniors and disabled Texans. As Samuel Adams said, “It does not take a majority to prevail ... but rather an irate, tireless minority, keen on setting brushfires of freedom in the minds of men.”  Join me.
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Texas District by District: Mark Strama
    

Mark Strama, elected to the Texas House of Representatives in 2004, is a native Texan who has divided his career between public service and private business, always fighting to empower voters and make government more responsive to every American. After graduating from Brown University, he worked on Ann Richards' successful 1990 campaign for governor. He went on to become Chief of Staff for State Senator Rodney Ellis. During Mark's tenure, Senator Ellis.

During Strama's tenure, Senator Ellis was named one of the ten best legislators in the state by Texas Monthly. In 1995, Strama left government to become the Director of Programs at Rock the Vote, where he helped register more than a million new voters. Strama returned to Austin to found the first company to register voters online. Working to bring the economy, efficiency, and convenience of new technology to the democratic process, Strama's company was acquired by New York-based Election.com in 2000, and helped over 700,000 Americans register to vote online in the 2000 election cycle. Strama is a member of the Greater Pflugerville Chamber of Commerce and the Pflugerville Council of Neighborhood Associations. He is also a founding member of the Pflugerville ISD MEN in Education program, which places male volunteers in schools and school activities to serve as mentors and role models. Strama has served on the Board of Directors of KidsVoting USA , a national non-profit organization that develops civics education programs for K-12 students. He was a founding board member of Hope Street Group, a non-partisan organization of young business leaders that seeks to achieve equality of opportunity in a high-growth economy. With a broad range of experience in the business sector, non-profit sector, and in government, Strama is a voice for independence and integrity in the Texas Legislature. He advocates comprehensive reforms to the political system, so that politicians will place the public interest above special interests to improve our schools, health care, transportation systems, and economy. Strama and his wife, Crystal, are thrilled to be expecting their first child early next year. Email Representative Strama to thank him for his work! [top] [back to e-card archive page]

On The TOA Radar Screen: Restricting Or Limiting Of Patient's Choice Of Facilities Letter

Worth Repeating: AAOS & AAHKS Avert Significant Cuts To Certain Orthopaedic Work Values
  

and

Richard F. Kyle, MD, President of AAOS, and William J. Hozack, MD, President of the American Association of Hip and Knee Surgeons (AAHKS), announced in a joint communication to the orthopaedic community that on Nov. 1, the Centers for Medicare and Medicaid Services (CMS) reversed its initial decision and has accepted the AMA Relative Value Scale Update Committee’s (RUC) recommendations for the work values of total hip arthroplasty, total knee arthroplasty and open treatment of femoral neck fractures. Well done! [top] [back to e-card archive page]

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