Modern Healthcare: Providers at odds over CMS joint replacement proposal

Posted on September 14, 2017

A recent article from Modern Healthcare covered the debate over a Centers for Medicare & Medicaid Services (CMS) proposal that would allow total knee replacement surgeries to be performed in an outpatient setting such as  hospital outpatient departments or ambulatory surgical centers for Medicare patients.

The article quoted Marilyn Litka-Klein, the MHA’s vice president of health finance, about the MHA’s objections to the provision, which is included in the 2018 OPPS proposed rule. The MHA does not believe it is clinically appropriate for these procedures to be done in the outpatient setting for Medicare patients due factors that often make the procedure much more complicated. Nearly 50 percent of all Medicare beneficiaries live with four or more chronic conditions and one-third have health issues that limit their ability to function independently.  In addition, spinal anesthesia is often used for these procedures which results in it taking hours for full sensation to return. Pain management, particularly in the immediate postoperative period, also remains a challenge which is best controlled in the inpatient setting.

"These factors often make a simple procedure much more complicated," said Litka-Klein.

Comments about the proposed rule were due on Sept. 11, and the MHA’s entire comment letter is available for review. A final rule is expected by Nov. 1.

Read the Article



Tags: Medicare, OPPS, proposed rule, CMS, FFS, comments

Posted in: MHA In The News

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