7 Procedures Removed From IPO List – Total Knee Arthroplasty Only Receives “Honorable Mention”

 Annually, using established criteria, the CMS reviews the “inpatient only” (IPO) list to determine which, if any, procedures are to be removed. In a previous newsletter, we mentioned how Total Knee Arthroplasty may be removed from the Medicare Inpatient Only list. The winners for CY 2017 are five spine procedures along with two laryngoplasty procedures. Total knee arthroplasty (TKA) procedures did not make the final cut.

Total Knee Arthroplasty

Illustration of a Total Knee Arthroplasty procedure

The CY 2017 OPPS/ASC final rule discussed comments it received regarding the removal of (TKA) from the IPO list. Despite the overwhelming support for its removal, the CMS did not propose making an immediate change, but “will consider all of these comments in future policy making.”

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COPN – THE BIG PICTURE

Plus Virginia Reform Efforts

Certificate of Public Need (COPN) programs are a fact of life in 36 states (Virginia included) as well as the District of Columbia. These laws require government consent before a health care facility may expand, offer a new service or purchase certain medical devices.

The Case for Certificate of Need Laws

The initial intent of COPN programs was to contain health care facility costs through coordinated government/private enterprise planning of facility construction and added services. The assumption was to limit facilities to provide only enough capacity to meet actual need or demand in a given geographical area. Presumably, that would avoid price increases by health care accommodations that were struggling to meet overhead not funded by sufficient patient loads.

Source: NCSL, August 2016

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