Issue 27, Winter/Spring 2025

Stay up-to-date on the latest regulatory proposals, congressional activity, and political developments relevant to musculoskeletal care with this quarter’s Advocacy Newsletter.

In this edition, we provide a deeper look at the recently released 2025 Physician Fee Schedule and Outpatient and Provider Services Final Rules, which are currently the top priority for our advocacy committee due to their significant impact on physician practices and the provider community. Additionally, we provide key insights from MedPAC’s recent public meetings and an update on the congressional state of play following elections.

The OrthoForum and our partners at Todd Strategy Group will continue to monitor notable policy developments as the 119th Congress begins and the new administration takes office, particularly focusing on changes to federal healthcare programs and other notable healthcare initiatives impacting physicians and patients alike.

ANNOUNCEMENTS

CPCC Update

The Coalition for Patient-Centered Care continues to investigate the threats to independent medical practice, especially as they interfere with the physician-patient relationship. At the same time, we are using social media to promote the benefits of doctors remaining free from corporate influence.

Our recent efforts have focused on identifying opportunities at the state level to enforce or strengthen the corporate practice of medicine (CPOM) laws. Thirty-four states have CPOM laws, but almost no state is fully enforcing them. We are following (and supporting) various proposed state legislative bills addressing stronger CPOM laws while communicating with state Attorneys General about how existing laws can be better enforced.

We were excited to have Dr. Michael Suk, Chairman of Geisinger’s MSK Institute and the Chair of the AMA’s Board of Trustees, present at one of the Annual Conference networking sessions on Friday, Feb. 22. He discussed the AMA’s concerns and actions regarding the increasing problem of the corporatization of medicine. You may watch his presentation and all presentations from the Annual Conference HERE.

Letter Writing Campaign

The Advocacy Committee sent a letter addressed to congressional leadership urging immediate action to reverse the recent Medicare physician payment cuts and implement a sustainable payment increase that reflects rising practice costs and inflation. To read the letter in its entirety, please see HERE and the Congressional Updates section for more details.

For more information on any of the topics discussed in the newsletter, please contact either the Chair of the OrthoForum Advocacy Committee, Dr. Jeffrey Racca (jracca@theorthoforum.com), OrthoForum’s CEO, Karen Simonton (ksimonton@theorthoforum.com), or one of the Forum’s subcommittee chairs (see contact information below).

Video Update on Physician Liability

The Advocacy Committee completed a video on liability associated with team coverage by our physicians. Dr. Jeffrey Racca interviewed a lawyer from Mag Mutual, Brian Trulock, and Julie Jines from Ortho Risk Partners. The information will help administrators and physicians alike in contracting with teams, preparing for the season, and discussing areas of potential liability.

The video can be viewed here: https://vimeo.com/1056528790. It is password-protected: OF-2025-RM. If you watch this and have any comments, please let us know. We could always do a follow-up video if necessary.

A key takeaway is that, as physicians, we need to be involved in developing an emergency action plan—or, at the very least, know what it is, know how to use the safety equipment, practice the plan with the training staff, clearly delineate our responsibilities, establish a mechanism for handoffs back to the other team physician, and talk with our insurance providers to educate us on our state laws.

If your state does not require EMT presence for football games, you might require it in your contracting with a team or school district. The AAOS has a statement on team physicians that can be shared with everyone who covers teams: AAOS Team Physician Statement.

If you are going to sign an agreement with a team, cover yourself and your group as much as possible. Team physician liability reform may be something to start at the state level and bring to the national level. Many of these games cannot be played without physician coverage.

AAOS Annual Meeting

The AAOS Annual Meeting is March 10–14 in San Diego, which means it is time to think about whom you would like to nominate for the Nominating Committee. Please let Dr. Racca know as soon as possible, and then watch for your AAOS ballot, which follows in about 90 days. We will send out the final list of candidates supported by the OrthoForum. We can make a difference if just 25% of OrthoForum and OrthoConnect members vote. Wilford is helping us tremendously at AAOS, but he could use some help.

Review of the The OrthoForum 2025 Annual Conference in Phoenix

Our Annual Conference in February went well for Advocacy. Dr. Michael Suk, Chair of the Board of Trustees of the AMA, and Dr. Adam Bruggeman, Head of Advocacy for the AAOS, attended and spoke at one of the breakout sessions.

They are both orthopedic surgeons and support private practice. They held a small group discussion with members of the CPCC and our Advocacy Committee, where we shared our concerns at both the legislative and regulatory levels. There is significant agreement on what needs to happen to fix healthcare, and we will continue to build those relationships and work together to ensure the viability of private practice.

The OrthoForum can get a seat at the AMA House of Delegates if 10% of our members are also AMA members. We will be attempting to do this as it will increase our exposure and reach while unlocking numerous resources that will benefit our mission.

Video Update on Medicare

The Advocacy Committee will be producing a video on Medicare that will be available prior to open enrollment. We have received many questions over the last year about Medicare, Medicare Advantage Plans, and Medicare with a supplement.

The target audience will be our patients, and the goal is to provide them with information so they can choose the plan that is best for them. If you would like to make any comments or suggest questions, please email jracca@theorthoforum.com.

ADMINISTRATION UPDATE

The transition to the new administration in January 2025 has brought significant changes to the federal health policy landscape. A broad federal funding freeze was implemented in the administration’s first week, raising immediate questions about continuity for existing public health programs and time-sensitive NIH research grants.

The Department of Health and Human Services (HHS) is continuing to take shape with its leadership transition, as HHS Secretary nominee Robert F. Kennedy Jr. cleared the Senate Finance Committee in a narrow, party-line vote, with a full Senate confirmation vote scheduled for next week. Additionally, Dr. Marty Makary and Dr. Mehmet Oz were nominated by President Trump to lead the FDA and CMS, respectively, as key appointments within HHS. Confirmation processes are expected to pick up again and continue through the spring.

A month into his second term, the “Department of Government Efficiency” (DOGE) is a key feature of President Trump’s agenda, being prominently referred to on a nearly daily basis by the President and the press. The new DOGE is foundational to the first two years of President Trump’s second term and will be the arena for impactful executive-branch actions implementing the Trump agenda, especially on issues related to federal expenditures.

Also of note, although a series of layoffs within federal agencies have been carried out since President Trump took office, agencies continue to move forward with annual rulemaking processes. The OrthoForum will continue monitoring potential shifts in regulatory oversight and program implementation across the healthcare sector as it relates to patients, physicians, and practices under the new administration.

Federal Advisory Update

MedPAC kicked off the quarter with the commission’s January Public Meeting, where commissioners reviewed several recommendations impacting physician payments, hospital inpatient and outpatient services, ambulatory surgical center services, Medicare Advantage, and critical access hospitals.

Throughout the meeting, the commission’s deliberations emphasized the critical balance between ensuring adequate physician compensation through targeted payment updates and safety net add-ons while grappling with broader concerns about Medicare payment methodology, access to care, and the growing challenges of regulatory compliance across healthcare sectors. The OrthoForum will continue to track the commission’s work leading up to the next public meeting and beyond.

January Public Meeting

During the January Public Meeting, commissioners recommended replacing current law updates with a single update equal to MEI minus 1 percentage point (projected 1.3% increase) and implementing previously recommended safety net add-on payments, resulting in an estimated combined 3% increase in payments.

The commission also addressed hospital payments, recommending a current law plus 1% update for 2025 Medicare base payment rates and redistributing DSH and uncompensated care payments through the Medicare Safety-Net Index with an additional $4 billion.

Other significant topics included concerns regarding Medicare Advantage prior authorization practices and market concentration and a recommendation to reduce beneficiary cost-sharing for outpatient services at Critical Access Hospitals.

Congressional Update

With the House and Senate still working toward a reconciliation agreement, legislative priorities remain in flux as government funding approaches its March 14th expiration date. Both chambers continue negotiations on spending priorities, with President Trump having weighed in on the approach for “one big, beautiful bill” rather than two separate bills.

The Senate is currently advancing a narrower bill focused on energy, defense, and immigration, while the House is advocating for a comprehensive package that could include potential Medicaid reductions.

Negotiations between Republicans and Democrats remain preliminary, complicated by concerns regarding Elon Musk’s DOGE activities, staffing cuts and layoffs, and potential impacts on congressionally appropriated funds. As discussed in the Administration Update, several key nominations will proceed to Senate confirmation votes in March, including appointees for CMS, FDA, and NIH leadership positions.

Notable Legislation Impacting Physicians: the Medicare Patient Access and Practice Stabilization Act

On January 31, Reps. Greg Murphy, MD (R-NC), and Jimmy Panetta (D-CA) reintroduced the Medicare Patient Access and Practice Stabilization Act (H.R. 879) with bipartisan support from Reps. Mariannette Miller-Meeks, MD (R-Iowa), Raul Ruiz, MD (D-Calif.), Kim Schrier, MD (D-Wash.), John Joyce, MD (R-Penn.), Claudia Tenney (R-NY), Carol Miller (R-WV), Raja Krishnamoorthi (D-IL), and Ami Bera, MD (D-Calif.).

The legislation would eliminate the proposed 2.8% Physician Fee Schedule reimbursement cut and implement a 6.6% payment increase for 2025, starting in April, to make up for reduced payments in January, February, and March. Congressional supporters are actively working to include this legislation within the March government funding package as negotiations continue.

As noted in the Announcements section of this newsletter, the Advocacy Committee sent a letter (HERE) to congressional leadership urging immediate action to reverse the recent Medicare physician payment cuts and implement a sustainable payment increase that reflects rising practice costs and inflation.

The letter voices The OrthoForum’s support for the bipartisan Medicare Patient Access and Practice Stabilization Act (H.R. 879), which, as discussed above, would reverse harmful 2025 payment cuts and ensure stability for independent medical practices.

The letter requests that congressional leadership support the inclusion of H.R. 879 in the upcoming March appropriations package to protect patient access and maintain a strong physician workforce.