Message from the VOS President
What VOS is Accomplishing
By John Mann III, MD
President, Virginia Orthopaedic Society
Dear Virginia Orthopaedic Society Members,
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John Mann III, MD VOS President |
The VOS Board met in Richmond on January 29 to review how to proceed with the Workers' Compensation bills that are before the General Assembly. We remain adamantly opposed to a workers' compensation fee schedule based on the seemingly arbitrary Medicare conversion factor. We defeated this bill (HB 946, Hugo) for the year on February 4. The insurance industry continues to push for this fee schedule to “cut costs” in the Commonwealth, even though we have the fourth lowest workers' compensation rates in the country.
The Virginia Auto Dealers Association sought out a compromise with the VOS and Medical Society of Virginia (MSV) as an alternative to a Medicare-based fee schedule, with the pledge to continue to explore reforms and improvements. Included are provisions that require prompt payment for clean claims, create a statute of limitations for clawbacks, adopt nationally-recognized coding guidelines, and limit assistant reimbursements. In review of the coding guidelines, the National Correct Coding Initiative (NCCI) was chosen as the option most familiar to providers. While it is not perfect, it will allow for coding of multiple procedures without a mandated reduction in fees. Some procedures may be bundled with one another, but our orthopaedic providers are able to continue to set their own fee schedule as they deem appropriate. The first assistant fee would be negotiated to be 50% of the primary surgeon’s fee; non-physician assistants will be limited to 20% of primary surgeon. The compromise reform bill (HB 1083, Ware/Kilgore) includes prompt pay requirements, a major system improvement and something that payors currently do not follow. It has passed the House of Delegates and is now being considered by the Senate.
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From left: Douglas A. Wayne, MD; Cyrus Kump MD; Steve Reece, MD; Ralph S. Northam, MD; Newly elected Lt. Governor of Virginia, Hugh M. Bryan III, MD, Past President of MSV and John Mann III, MD, VOS President. |
The political pressures of the legislative process demand compromise. There have been some surgeons who are not happy with this approach, but we, as a Board, have been fighting this battle for the past four years with the great assistance of the MSV, the hospital association, and our lobbying team. We felt that to be too rigid and fight for “all or nothing” in this situation would result in a fee schedule, as exists in most states. Legislators recognize that we are reasonable stakeholders.
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Delegate Chris Head (left) of the 17th District, representing Roanoke County with John Mann III, MD, VOS President. |
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Dr. Mann reviews VOS position on workers' compensation with Delegate Head. |
We appreciate everyone’s turnout this year for White Coats on Call on January 30. We had a very good turnout from around the state. Visiting with our Delegates and Senators and the letters that we have written to them in the last few months seems to have made a significant impact with compensation issue. I would like to especially thank the VOS members who attended the hearings and to the practice administrators who have been valuable experts and coordinators or the grassroots communications with legislators. The public discussion about workers' compensation care is not over.
We are excited about the upcoming VOS meeting in Roanoke this year. Highlights of the meeting include a talk from our AAOS President, Dr. Azar and honoring Dr. Wilford Gibson for his service to our Society and tothe AAOS as President of the Board of Counselors. We hope that as many members as possible will be able to come to our meeting. Please bring your Physician’s Assistant or Nurse Practitioner. We have breakout sessions for them at the meeting. Next year, we have moved the meeting time back one week to the last week of April so that we can also include office managers at our Annual Meeting.