Surgeons speak out: Advocacy efforts from spine, orthopedic physicians in 2021

Carly Behm -  

Spine and orthopedic surgeons banded together to voice their opinions on legislation concerning CMS, surprise billing and more in 2021.

Here are high-profile key times physicians spoke out:

1. In April, stakeholders including the Medical Device Manufacturers Association, the North American Spine Society and the American Academy of Orthopaedic surgeons urged CMS to roll back new prior authorization requirements that were set to go into effect July 1.

2. In September, the American Association of Orthopaedic Surgeons issued formal comments to CMS on the agency's proposed payment policy changes for 2022. The association focused on two key proposed changes reversing the elimination of the inpatient-only list and pulling back the 298 procedures, including 266 musculoskeletal procedures that were removed from the list Jan. 1.

3.The final 2022 rule set in November walked back its proposed elimination of the IPO list and returning the services removed from it in 2021, excluding CPT codes 22630 (lumbar spine fusion), 23472 (reconstruct shoulder joint), 27702 (reconstruct ankle joint) and their corresponding anesthesia codes.

4. In October, the American Association of Neurological Surgeons and the Congress of Neurological Surgeons voiced support for a Senate bill addressing prior authorizations for some patients. The bill, called the Improving Seniors’ Timely Access to Care Act, is sponsored by Sens. Roger Marshall, MD, R-Kan.; Kyrsten Sinema, D-Ariz.; and John Thune, R-S.D., according to an Oct. 20 news release. The legislation would apply to patients in Medicare Advantage and would protect them from unnecessary prior authorization practices.

5. The American Association of Orthopaedic Surgeons in December called on federal regulators to update the process for resolving out-of-network medical billing disputes to be more closely aligned with the No Surprises Act.

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