June 10, 2020

HHS CMS Releases Proposed Rule for Inpatient Prospective Payment System (IPPS) for 2020/2021

On May 11, the Trump Administration proposed changes for acute care and long-term care hospitals that build on the progress made over the past 3 years and further the agency’s priority to transform the health care delivery system through competition and innovation while providing patients with better value and results. The proposed rule would update Medicare payment policies for hospitals paid under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) for FY 2021. CMS is proposing a separate new hospital payment category for Chimeric Antigen Receptor (CAR) T-cell therapy. CAR-T is the first-ever gene therapy, and it uses a patient’s own genetically modified immune cells to treat people with certain types of […]
June 10, 2020

ISASS Provides Extensive Additional Comments to Anthem on Sacroiliac Joint Fusion Coverage Policy During Call and Response Letter

On May 26, 2020, ISASS sent a comment letter to Anthem regarding their Sacroiliac Joint Fusion Coverage Policy, which is used in many states/regions by Anthem for fee schedule and coverage policies. The ISASS letter asked that Anthem revise their coverage policy to consider inclusion of coverage of minimally invasive sacroiliac joint fusion, which would be consistent with ISASS recommendations for appropriate criteria for sacroiliac joint fusion procedures and criteria on nonsurgical options. The May 26 letter was sent as a follow-up to a call on May 18, 2020, with ISASS Coding and Reimbursement Task Force Chair, Morgan Lorio, MD, and David Polly, MD, and the Anthem Coverage Policy team, led by John Whitney, MD. Read the ISASS 5-26-20 Anthem […]
May 21, 2020

COVID 19: Testing in Orthopedics & Spine Clinical Settings: The Unknown Category

Testing in Orthopedics & Spine Clinical Settings: The Unknown Category As COVID-19 infection rates begin to slow, elective surgery is ramping up and facilities are screening patients for COVID-19. However, it is important to understand COVID-19 testing abilities and limitations in this new reality. Simply utilizing a questionnaire and temperature check are inadequate to screen patients, though due to the significant testing limitations, it tends to serve as the absolute minimum acceptable standard. Many different tests are currently performed, but each should be interpreted with care and caution in order to provide the safest possible environment for patients and staff. Preoperative COVID-19 Screening Tests A recent report from China described 34 cases of patients who were unknown to be positive […]
May 14, 2020

How My Country Confronted COVID-19

How My Country Confronted COVID-19 On Tuesday, April 28, 2020, health care workers in Seoul Medical Center commemorated the 100th day since the first appearance of a COVID-19 patient in South Korea. As of May 6, 2020, the nation’s total number of cases stands at 10,806, with six new imported infections and no new local ones, according to the Korea Centers for Disease Control and Prevention (KCDC). The daily number of confirmed new infections had peaked on February 29 at 909. Also according to the KCDC, as of May 6, the death toll has reached 255, and the fatality rate reached 2.34%. A total of 9,333 people who were confirmed to have had COVID-19 have recovered so far, up 50 […]