News & Updates: June 2023
Legislative Updates
South Carolina’s Certificate Of Need Repeal Is The Largest In Almost Three Decades
The following content is via Forbes:
South Carolina’s 2023 CON repeal is the most comprehensive in the United States since Pennsylvania's repeal in 1996. We believe this repeal campaign provides valuable lessons for how to tackle bigger reforms that have concentrated benefits, but diffused costs which impact patient access. 

During the run-up to repeal (2020-23), policymakers benefited from solid research, articulate legislative champions paired with effective governmental relations professionals, powerful grassroots organizing with statewide townhalls, and digital media. Click here to read the full article.
Exceptions to Naloxone Hydrochloride Prescription Requirement Signed into Law
Previously, all SC physicians were required to write a prescription for naloxone hydrochloride or similar drug for every opioid prescription at 50 or more morphine milligram equivalents, as well as in other high-risk opioid prescribing situations.

A ratified bill was officially signed by Governor McMaster on June 19 with the following changes:

  • An exception for patients with cancer, cancer-related conditions, and recipients of palliative care, meaning that a naloxone hydrocholoride prescription is not needed for those patients. 
  • Also, the statue now provides an exception for clinical judgment if a patient would not benefit from a prescription for naloxone hydrocholoride.

New Language:
This subsection does not apply in the following circumstances:

(a)  patients who are receiving care for cancer or a cancer-related condition, patients in hospice, patients receiving palliative care; or
(b)  any other patients who, in the prescriber's good faith medical judgment, would not benefit from a prescription for naloxone hydrochloride or another drug approved by the United States Food and Drug Administration for the complete or partial reversal of opioid-related respiratory and/or central nervous system depression.
(B) A prescriber is not subject to professional disciplinary actions including, but not limited to, disciplinary actions initiated by any board or licensing agency arising from the prescriber's compliance with the provisions of this section.

Click here to read the full bill.
Support the SC BONE PAC
​​The SC BONE PAC is the voice of orthopaedic surgeons in Columbia, SC. Our non-partisan political action committee engages local legislative leaders to press for policies that enhance the physician-patient relationship and support your ability to practice orthopaedics.

We need your ongoing support to protect South Carolinians from future healthcare policy that compromises patient safety and outcomes.
Regulatory Reminders
New DEA Education Requirement effective June 27, 2023
The new education requirement for all DEA-registered practitioners to complete 8 hours of training on “the treatment and management of patients with opioid or other substance use disorders” was effective June 27, 2023. AAOS has created a member resource center to help you meet this requirement. Click here to view.  
HIPAA & Telehealth
With the expiration of the COVID-19 public health emergency (PHE) on May 11, 2023, the CMS Waivers and Flexibilities issued during the PHE are also ending, though transition periods are in place for many. CMS has prepared a FAQ document to address questions about these Waivers and Flexibilities. 
 
Not included in that fact sheet is the notice that HIPAA enforcement agency Office for Civil Rights (OCR) will resume enforcement of HIPAA rules with respect to providers’ provision of telehealth as of August 9, 2023. During the PHE, OCR used its enforcement discretion to cease imposing penalties for noncompliance with HIPAA Rules in connection with the good faith provision of telehealth so it could quickly be made available to patients. As of August 9, providers will be subject to penalties for HIPAA noncompliance related to the delivery of telehealth. Practices should confirm that their telehealth technology and workflow comply with OCR guidelines. Click here to view the guidelines.
DEA & Telemedicine
On May 9, 2023, the Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) issued the “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications” – a temporary rule that extends telemedicine flexibilities adopted during the COVID-19 public health emergency (PHE).
 
The temporary rule will take effect on May 11, 2023, and extends the full set of telemedicine flexibilities adopted during the COVID-19 public health emergency for six months – through November 11, 2023. For any practitioner-patient telemedicine relationships that have been or will be established up to November 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the COVID-19 PHE will be extended for one year – through November 11, 2024. Keep in mind that state law may be more restrictive. Click here to learn more.
No Surprises Act – New Consumer-Friendly Resources
CMS has launched new consumer-friendly resources designed to make it easier for the average person to understand their rights under the No Surprises Act. Practices may benefit by ensuring business office staff members are familiar with this messaging. Click here to access.
Action Alert Update
View: Congressional Letter Supporting Medicare Payment Reform
Last week, we encouraged you to ask your Congressional representatives to sign a letter to CMS urging prior authorization reform for Medicare Advantage plans. A bipartisan group of 61 U.S. Senators and 233 U.S. House Members signed the letter issued to CMS on June 22 asking CMS “to promptly finalize and implement these changes to increase transparency and improve the prior authorization process for patients, providers, and health plans.” You may access the letter here which includes lawmaker signatures.
Articles of Interest
UnitedHealth Outbids Option Care Health for Amedisys in Deal Valued at More than $3B
UnitedHealth Group’s Optum division will acquire Amedisys, a national provider of home health, hospice and palliative care services. Optum acquired LHC Group, another national home health provider, earlier this year. To read more, click here.
Physicians Call for More Regulation of Health Insurers Using AI
Content via Medical Economics:
"It appears physicians and health insurers agree AI could be helpful in streamlining the prior authorization process for patients, but it remains to be seen exactly how AI will be used.
 
AMA cited a ProPublica review that found in two months of 2022, doctors at health insurer Cigna denied more than 300,000 claims in a review process that used artificial intelligence. The doctors spent an average of 1.2 seconds on each case. AMA’s new policy called for health insurers to require human examination of patient records before denying care." Click here to read the full article.
Get Involved with SCOA
Call for Leadership Council Nominees
The deadline to submit nominations is July 10, 2023.
The South Carolina Orthopaedic Association is seeking nominees for the Leadership Council. Leadership Council members serve alongside the Executive Committee Officers and Board of Councilors members in an advisory role. Although they do not have voting authority, they are encouraged to attend all Executive Committee meetings and their input is valued. Service on the Leadership Council offers SCOA members an opportunity to participate in guiding the organization while deciding if they are interested in pursuing an Officer role in the future. A current list of Executive Committee Officers and Members is posted on our website.
 
The SCOA Executive Committee will prepare a recommended Slate of Officers and Executive Committee members to present to members during the 2023 SCOA Annual Meeting in Kiawah Island.
2023 Annual Meeting
​2023 SCOA Annual Meeting
August 3-5, 2023
Sanctuary Hotel
Kiawah Island, SC
SCOA invites you to join us for three days full of education, collegiality, and networking in Kiawah Island!
Housing Update:

The SCOA Hotel block is sold out, but AnnMargaret McCraw has one hotel room on hold that can be transferred to the first member who requests it. A few villas remain available. Register today to receive instructions for villa reservations. The Sanctuary will offer our members a 10% discount from “standard” room rates based on availability.
New Offering: Yogalates

For the first time ever, we are offering Yogalates during the 2023 SCOA Annual Meeting! Yogalates is a combination of Pilates poses developing core strength and stabilization, and a series of yoga poses to improve flexibility and structure. This combination of yoga and Pilates helps tone and condition major muscle groups and helps build strong abs and back muscles.

Planning to join us for Yogalates on Friday, August 4th, at 6:30 am? Make sure to RSVP during meeting registration. If you've already registered, please send names to Sarah@cobbemanagement.com.
AAOS Orthopaedic Advocacy Week
Save the Date:
2023 Orthopaedic Advocacy Week
Orthopaedic surgeons across the U.S. will come together July 24-28 for a national grassroots advocacy effort. Now is the time to mark your calendar, begin making plans to participate, and encourage your colleagues to join this completely virtual event!

Participants will deliver critical messages to lawmakers and regulators during the event using simple, minute-long activities via social media, pre-written letters, and the Orthopaedic PAC.
Leadership Book Nook
Leading with Your Upper Brain:
How to Create the Behaviors That Unlock Performance Excellence
by Michael E. Frisina, PhD, and Robert W. Frisina, MA
Building on the power of understanding yourself and how you relate to others that’s typically found in personality driven profiles and systems; “Leading With Your Upper Brain” deploys practical, applicable, and proven strategies for how that you can adapt your leadership behavior to help your team operate at maximum potential.
 
In a world that constantly demands our ability to do more with less, we can’t afford for our team to be anything but tight-knit, razor sharp, and ready to gang-tackle whatever the next threat may be. Starting with you, this book will help you bring that potential to life within your team.
Summary submitted by:
Andrew Wade, MBA, FACMPE
Chief Executive Officer
OrthoSC
Have a Book that was Meaningful to your Professional Journey?
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.
Upcoming Webinar
Getting Your House (Practice) in Order: Keys to Optimizing Practice Valuation
WHEN: Thursday, July 13th, 1:00-2:00 PM (ET)
We are living in an age of practice consolidation manifesting as mergers, acquisitions and MSOs at a dizzying pace. Some fueled by private equity; others by traditional funding.
 
Regardless of the funding source or practice model, any group considering realignment should understand the keys to optimizing your practice valuation.
 
Join John Hornberger and other experienced panelists convened by Healthcare Information Services to review the basic elements of transactional due diligence so you can “look under the hood” and address red flags before your potential partners do. Even if you are not pursuing new partners, a little housekeeping may well enhance practice operations, patient satisfaction and overall revenue.
Missed a Webinar? Check out the Webinar Archive!
The webinar is a free educational offering for our members.
Please follow the instructions to register for the event.
After registering, you will receive a confirmation email from Zoom containing information about joining the webinar. If you don't see the email within 24 hours of registering, please check your spam folder.
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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.
Member Benefit: Discover OrthoEvidence
Our members receive complimentary access to OrthoEvidence (OE), which is the global online source for high quality and timely orthopaedic-only evidence-based summaries, pre-appraised by orthopaedic medical experts.
Thank You To Our Corporate Partner:
South Carolina Orthopaedic Association www.scoanet.org
844-234-7800