News & Updates: November 2023

Get Involved: Share Your Research & Expertise at the 2024 SCOA Annual Meeting

2024 SCOA Annual Meeting

August 1-3, 2024

The Sanctuary

Kiawah Island, SC​

The South Carolina Orthopaedic Association is now accepting abstract submissions, Resident Research Competition submissions, and Expert Talks submissions to be presented at the Annual Meeting. 

Submit An Abstract
Submit An Expert Talk

About the Annual Meeting

Reconnect with your peers as we seek clinical and professional excellence through dynamic keynotes, expert talks and research presentations. Keynote speakers for the 2023 Annual Meeting include Steven L. Frick, MD, and Milt Lowder, PhD.


Register early and secure your 2024 stay with our group rate! Meeting registration is required to receive the booking ID, which will be required to book in our group block.

Learn More & Register

CMS News

CMS Finalizes Physician Payment Rule

Despite focused and ongoing lobbying by all physician societies, CMS finalized the 2024 PFS conversion factor at $32.7442, a decrease of 3.37%, on November 2, 2023.

 

Additional Final Rule provisions effective as of 01/01/2024:

  • Implementing E/M add-on code G2211 to indicate visit complexity meeting certain criteria and clarifying that it may not be used in conjunction with an E/M visit + modifier -25
  • Defining the “substantive portion” of a split (or shared) E/M visit as more than half of the total time spent by the physician or non-physician practitioner or a substantive part of the medical decision making;
  • Reimbursing telehealth services furnished to patients in their homes at the typically higher, non-facility PFS rate;
  • Allowing PTs and OTs, among others, to continue rendering telehealth services through 12/31/24;
  • Allowing direct supervision by a supervising practitioner via real-time audio and video interaction through 2024;
  • Continuing coverage and payment of telehealth services included on the Medicare Telehealth Services List through 2024;
  • Rescinding the appropriate use criteria program regulations for advanced imaging;
  • Maintaining the performance threshold of 75 points for all three MIPS reporting options;
  • Adding five new MIPS Value Pathways to include rehabilitative support for musculoskeletal care;
  • Making numerous changes to the Medicare Shared Savings Program (MSSP);
  • Ending the 3.5% APM Incentive Payment after the 2023 performance year/2025 payment year, and transitioning to a Qualifying APM Conversion Factor in the 2024 performance year/2026 payment year.

 

Click here to review the CMS 2024 PFS Final Rule Fact Sheet.

Review Your 2023 MIPS Eligibility

Your status may have changed, so CMS encourages you to use the QPP Participation Status Tool to confirm your final 2023 MIPS eligibility status.

 

Eligibility status has been updated based on review of Medicare Part B claims and Medicare Provider Enrollment, Chain, and Ownership System (PECOS) data from the second segment of the MIPS Eligibility Determination Period (October 1, 2022 – September 30, 2023).


  • This status is final unless you participate in an Advanced Alternative Payment Model (APM) and your Qualifying APM Participant (QP) status changes as a result of the third APM Snapshot for the 2023 performance year.
  • Results from the third APM Snapshot will be available in December 2023 and will be announced through the QPP listserv.

DHEC Updates

DHEC Board Approves NPR for R. 61-16 and R. 61-91

On November 9, DHEC staff presented the draft of the proposed regulation for R. 61-16, Minimum Standards for Licensing Hospitals and Institutional General Infirmaries and R. 61-91, Standards for Licensing Ambulatory Surgical Facilities. The DHEC Board voted to approve both for publication in the November 24, 2023, State Register.


After publication, a second public comment period will begin, and additional stakeholder meetings will be scheduled. Additional information will be forthcoming after publication. If you have any questions, email HQRegs@dhec.sc.gov.

Draft SC Health Plan Published for Review & Comments

View the draft plan here.


Comments must be received no later than 5:00 pm on December 27, 2023:

CONinfo@dhec.sc.gov or CON Comment Form


With the advice of the South Carolina State Health Planning Committee, the Department of Health and Environmental Control has prepared a draft South Carolina Health Plan. Interested persons may submit written comments to:


DHEC, Certificate of Need Program

2600 Bull Street,

Columbia, SC 29201


CONinfo@dhec.sc.gov or Certificate of Need Comment Form 


To be considered, the Department must receive comments no later than 5 p.m. on December 27, 2023, the close of the comment period. 


The Department will be conducting regional public hearings pursuant to S.C. Code § 44-7-180(C) to allow public review and comment regarding the draft of the South Carolina Health Plan. A court reporter will be present for anyone wishing to make a public comment. It is recommended, but not required, that anyone wishing to make a comment bring a written version of their comment for the court reporter. DHEC will conduct these public hearings beginning at 10:30 a.m. at the locations listed below according to the following schedule and agenda.

Agenda


  • Call to Order – 10:30 a.m.
  • DHEC Presentation
  • Explanation of the Public Hearing Process
  • Receipt of Public Comment
  • Adjournment

Medicare Advantage Data

Kaiser Family Foundation (KFF) Medicare Data

With 43 Medicare Advantage plans available to Medicare beneficiaries during 2024 Open Enrollment, the impact to patients, physicians and our nation is hard to grasp.

 

KFF has compiled meaningful research and reporting on the Medicare page of its website.

CMS Medicare Advantage Monthly Enrollment by Plan

Each month, CMS publishes Medicare Advantage enrollment by State, County and Plan here.

 

You can download the master file and then filter by your state and relevant counties to determine how many people are enrolled in each MA plan in your area. This information may prove helpful in contracting decisions.

Articles of Interest

More Provider Orgs Have Value-Based Contracts With Private Payers

Content via Revcycle Intelligence:

More provider organizations are participating in value-based contracts outside Medicare, as three-quarters of respondents were under contracts with commercial and Medicare Advantage plans in 2022, a study published in the American Journal of Managed Care found. To read more, click here.

Regulatory Burdens in Healthcare Take Away from Patient Care

Content via Revcycle Intelligence:

Regulatory burdens in healthcare, such as prior authorizations, surprise billing requirements, and audits and appeals, are taking resources away from patient care as practices face more oversight, according to MGMA’s latest “Annual Regulatory Burden Survey." Click here to read more.

Leadership Book Nook

Have a Book that was Meaningful to your Professional Journey? Please Share!

Please consider sharing a short paragraph about lessons learned from a book that has shaped you as a leader. Send your summary to Sarah Thompson.

Past Recommendations Include:

  • The Five Dysfunctions of a Team by Patrick Lencioni
  • Strength to Strength: Finding Success, Happiness and Deep Purpose in the Second Half of Life by Arthur C. Brooks
  • The Powerful Purpose of Introverts: Why the World Needs YOU to be YOU by Holly Gerth
  • Leading with Your Upper Brain: How to Create the Behaviors That Unlock Performance Excellence by Michael E. Frisina, PhD, and Robert W. Frisina, MA
  • Give and Take by Adam Grant
  • The 6 Types of Working Genius by Patrick Lencioni
  • The 48 Laws of Power by Robert Greene
  • Impact Players: How to Take the Lead, Play Bigger and Multiply Your Impact by Liz Wiseman
  • Quiet: The Power of Introverts in a World That Can't Stop Talking by Susan Cain
  • What Exceptional Leaders Know & Exceptional Leaders Playbook by Tracy Spears and Wally Schmader
  • Dare to Lead by Brené Brown
  • The Traveler’s Gift: Seven Decisions that Determine Personal Success by Andy Andrews
  • Essentialism: The Disciplined Pursuit of Less by Greg McKeown
  • Multipliers by Liz Wiseman
  • Daring Greatly by Brené Brown
  • The Infinite Game by Simon Sinek
  • The Power of Moments by Chip & Dan Heath

Is Your Administrator a Member of SAOE?

SC Orthopaedic Practice Administrators, Ortho Service Line Directors, and emerging leaders in both private and hospital settings are encouraged to join the Southeastern Association of Orthopaedic Executives (SAOE). SAOE offers ortho practice leaders from South Carolina, Georgia, and Tennessee a unique opportunity to collaborate, network and learn from one another. SAOE membership and attendance at the annual meeting is an affordable and sound investment in your administrative team members.
View Member Benefits
Thank You To Our Corporate Partner:
South Carolina Orthopaedic Association www.scoanet.org
844-234-7800
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