Advocacy Now

Advocacy Now is an email newsletter produced bi-weekly by the Office of Government Relations to keep AAOS members on top of important health care policy issues as well as supporting advocacy efforts. Questions or concerns about related content can be emailed to staff at

Below are updates from the most recent newsletter, as well as an archive of old issues.

Advocacy Now, June 30, 2020

AAOS Advocacy in Action

  • Expressed our support for the Creating Capacity for Communities in Need Act (S. 3547), which would allow physician-owned hospitals to expand capacity and access to address the COVID-19 emergency.
  • Urged Congress to waive the budget neutrality requirements stipulated by the Social Security Act for the finalized evaluation and management code proposal slated for implementation on January 1, 2021.

The Bone Beat New Episode

Conversations on health policy issues affecting musculoskeletal care...

Reducing Disparities in Health Care
The Bone Beat Episode 6.jpgStructural inequities and barriers to health care existed prior to COVID-19. But the pandemic has put a spotlight on the problem, which has also recently become the focus of advocacy efforts nationwide. In this episode, Movement is Life Chair Mary O’Connor, MD, FAAOS, explains how public policy and individual surgeons together can strengthen community-based programs to ultimately help narrow the health equity gap. 


AAOS Urges CMS to Waive Interest Rate on Advance Payments
On June 23, the AAOS wrote to the Centers for Medicare & Medicaid Services (CMS) regarding the agency's described "statutory obligations" with the COVID-19 Accelerated and Advance Payment (CAAP) program. Specifically, we urged CMS to rely on existing authorities to waive or substantially reduce the exorbitant interest rate that will be applied to the balance of advance payments which remain following the recoupment period. We pointed out that amounts owed are a debt, not an overpayment, and that the agency has the authority to ease the financial hardships on medical providers during this once-in-a-century pandemic. The AAOS also noted that other financial assistance that has been offered to healthcare providers during COVID-19, such as the Provider Relief Fund and the Paycheck Protection Program, are either grants or loans with zero to minimal interest at a rate that is much lower than the one applied under the Advance Payment Program. Read the full letter to CMS…

Members of Congress Request Maintenance of Hip and Knee Reimbursement Levels
In a recent letter to the Centers for Medicare & Medicaid Services (CMS), a group of 37 members of Congress requested that current reimbursement levels for hip and knee replacement surgery be maintained in 2021. They expressed concern for the economic strain placed on physician practices which have been shuttered during the pandemic, as well as the tens of thousands of patients left waiting for surgeries to relieve them of pain and restore their quality of life. "If cuts were proposed, it would send a message to physicians that high levels of participation in APMs will result in punitive compensation cuts for their services," they wrote, noting that hip and knee surgeons participate in programs at the highest rate of any subspeciality. Instead, the members of Congress strongly urged CMS to accept new data from the AAOS and the American Association of Hip and Knee Surgeons which recognizes the valuable work in APMs, validates current funding levels, and supports the goal of increasing APM participation. Read the congressional letter on potentially misvalued codes…

AAOS Submits Comments on Proposed Changes for CJR Model
On June 23, the AAOS submitted formal comments in response to proposed changes to the Comprehensive Care for Joint Replacement (CJR) Model on behalf of members and several orthopaedic specialty and state societies. Primarily we suggested that the extension of the current Performance Year 5 be further expanded until December 31, 2021, given that participants may not have had the opportunity to perform elective lower-extremity joint replacement surgeries during the COVID-19 pandemic. We also expressed support for updating CJR policy for extreme and uncontrollable circumstances and applying equal financial safeguards for both fracture and non-fracture episodes during the pandemic. Our primary concerns with the rule reiterated similar issues we raised in February including the mandatory nature of the model, the extension period not applying to voluntary participants, the lack of guidance to hospitals for sharing gains with orthopaedic surgeons, the potential for driving higher risk patients to the lower cost outpatient setting now that outpatient hip and knee replacements are included, as well as the potentially destabilizing effects of multiple target price calculation changes. See AAOS' full comments on the proposed rule...

New Flexibilities Announced for the Quality Payment Program
The Centers for Medicare & Medicaid Services (CMS) announced that clinicians participating in the Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) who were significantly affected by the COVID-19 pandemic may submit an extreme and uncontrollable circumstances application to entirely opt-out of data submission to the MIPS program for the 2020 performance year. Alternatively, they can apply to have any or all MIPS performance categories reweighted. MIPS-eligible clinicians can also still receive credit for the new COVID-19 clinical trials improvement activity if they (1) participate in a COVID-19 clinical trial and enter the data into a platform or (2) care for COVID-19 patients and submit these data to a clinical data registry to be used for future study. Learn more and/or apply for the exception...

Webinar: Updates from the Hill with Rep. Raul Ruiz, MD (CA-26)
Tomorrow, July 1 at 8 p.m. ET, AAOS members have the opportunity to hear directly from U.S. Rep. Raul Ruiz, MD (CA-26) in this last webinar in a collaborative series presented in partnership with the American Association of Neurological Sciences (AANS), Congress of Neurological Surgeons (CNS) and the North American Spine Society (NASS). Rep. Ruiz will be interviewed by representatives of NASS on the congressional response to COVID-19 as well as additional advocacy initiatives to advance musculoskeletal care. Previous webinars featured U.S. Rep. Larry Bucshon, MD (IN-8) being hosted by the AAOS and U.S. Rep. Phil Roe, MD (TN-1) being interviewed by AANS/CNS. Attendees are encouraged to submit questions in advance via Watch the webinar...

Call for Council on Advocacy Chair Applications
The AAOS Committee Appointment Program (CAP) is now accepting applications for the position of Council on Advocacy Chair which reports to the Association Board of Directors. The term begins in March of 2021 and ends in March of 2023, with the option to renew for another two-year term. The position will oversee the Council on Advocacy in working to achieve its overall purpose/mission to plan, organize, direct, and evaluate the Association's legislative, regulatory, and health policy programs and initiatives. Please see the CAP website for application instructions, and note that all applications must be received no later than July 6, 2020. Apply for the Council on Advocacy Chair position...

What We're Reading

  • Black Medicare Patients With COVID-19 Nearly 4 Times As Likely To End Up In Hospital (NPR, 6/22)
  • Alternative Payment Models—Victims of Their Own Success? (JAMA, 6/22)
  • Hospitals lose HHS lawsuit over price transparency (Modern Healthcare, 6/23)