Midyear Federal Advocacy Update - August 2026-Session Powerpoint

Session Powerpoint

Pdf Summary

The presentation provided a midyear federal advocacy update focused on how congressional activity and federal regulation may affect orthopedic and musculoskeletal practices. It opened with 2026 congressional outlook issues, noting the main committees of jurisdiction in the House and Senate, along with priorities such as Medicare Advantage reform and price transparency. It also highlighted that election-year shifts, a lame-duck session, and Medicare extenders could shape legislative activity.<br /><br />The largest section covered the CY 2027 Medicare Physician Fee Schedule (PFS) proposed rule. Key dates included publication on July 16, comments due September 14, the final rule due November 1, and most policies taking effect January 1, 2027. The rule proposes a lower conversion factor and an estimated combined payment impact of -8.9% for orthopedic surgery. It also includes proposed reductions in work RVUs for major arthroplasty codes, including shoulder, hip, and knee procedures.<br /><br />Other notable proposals include restrictions and changes to RTM/RPM payment rules, reductions to global E/M payment when billed on the same day as global procedures, changes to QPP/MIPS and APM participation thresholds, and an overhaul of indirect practice expense methodology with a phase-out of the IPCI and a new PE stabilization framework.<br /><br />The presentation also introduced the Ambulatory Specialty Model (ASM), a mandatory model beginning January 1, 2027, targeting certain specialists treating chronic low back pain and heart failure. It would use a performance-based payment adjustment ranging from -9% to 9% in the first payment years.<br /><br />Finally, the session encouraged attendees to become advocates by using AAOE policy resources, subscribing to the Government News Blog, and sharing practice experiences with the AAOE Advocacy Council.

Keywords

federal advocacy

orthopedic practices

musculoskeletal practices

Medicare Physician Fee Schedule

conversion factor

work RVUs

Medicare Advantage reform

price transparency

Ambulatory Specialty Model

MIPS QPP