AAOS encouraged by CMS proposal, but 'much work left to be done'

Alan Condon -   Print  |
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Halting the elimination of CMS' inpatient-only list and returning the 298 musculoskeletal services to the list are two of the most notable changes proposed by the agency this week.

Daniel Guy, president of the American Academy of Orthopaedic Surgeons, said he is encouraged that CMS has heeded the academy's concerns about patient safety as well as the abrupt elimination of the inpatient-only list, according to a July 22 statement.

"We continue to support the removal of procedures which have been proven to be done safely in the outpatient setting; however, there is much work left to be done to clarify what these changes mean in order to avoid widespread confusion and unintended consequences for patient care," Dr. Guy said.

He pointed to "dramatic" shifts in recent years — CMS' removing total knee arthroplasty from the inpatient-only list in 2018, total hip arthroplasty in 2020, and all musculoskeletal procedures in 2021 — and the challenges they can create for safe and timely orthopedic care.

Dr. Guy urged CMS to place more emphasis on physicians leading these decisions and prioritizing patient choice.

"CMS must also be careful to avoid creating new regulatory barriers to determine the appropriate setting of care as an overcorrection to the policy reversal — especially now after the country has benefited from such flexibilities and individualized medicine during the COVID-19 pandemic," he said.

The association said it will comment on the CMS proposal in greater detail later.

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