South Carolina Orthopaedic Association
News & Updates: January 2022
Certificate of Need Legislative Update 
by Tony Denny
The legislative push to eliminate or reform CON is front and center as the 2022 session of the General Assembly gets under way. SCOA is actively engaged on the issue and playing a key role in the coalition supporting S 290. Thank you to everyone who has contacted your local Senators. Several Senators have told us they have heard from our members back home.
 
Status: The Senate took three important votes last week on S 290, legislation as introduced that would eliminate CON requirements:
1) They set the bill for special order, giving it priority status on the Senate calendar every day until it is resolved.
2) By a vote of 31-9, they tabled an amendment backed by the SC Hospital Association that would have established the SCHA compromise proposal as the working document for future debate.
3) As expected, they adopted an amendment that removes nursing homes from the bill, meaning that nursing homes will still require a CON. This amendment was uncontested.
 
What’s Next: Even though the 31-9 vote was a strong message that Senators agree CON is broken, we may not have the votes for full repeal of CON. When the Senate returns Wednesday, we most likely begin negotiation of a reform bill rather than full repeal. Getting the language right in a reform bill is a lot more complicated than repeal. We continue to advocate for CON repeal while we participate in meetings to support Senator Climer and others in their efforts to obtain meaningful CON reform legislation that benefits patients, your practices, and reduces wasteful costs in the health care system. We will continue to update you as the process progresses. Please let us know if you have additional communication with your Senator.
 
CON News Coverage:
 
 
SCOA Letter to Senators:
Click here to download.
 
Contact Info:
Tony Denny: 803-315-9648 | tony@tonydenny.com
AnnMargaret McCraw: 803-331-6295 | annm@cobbemanagement.com
CMS Announces updated DMEPOS Order & Prior Authorization Requirements
Effective October 11, 2022, for South Carolina, CMS will require face-to-face encounters and written order prior to delivery for 7 new DMEPOS items frequently dispensed by orthopaedic physicians: 
All DMEPOS orders should include the following elements:
 
  • Beneficiary name or Medicare Beneficiary Identifier (MBI) Number
  • Description of the item
  • Quantity, if applicable
  • Treating practitioner name or National Provider Identifier (NPI)
  • Date of the order
  • Treating practitioner signature
 
The items above on the Written Order Prior to Delivery (WOPD) List require a complete order prior to patient’s receipt of the item. All other DMEPOS items require a written order prior to claim submission.
 
Prior Authorization will be required for 5 of those items on the following schedule:
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AMA Toolkit for Physicians: Preparing for Implementation of the No Surprises Act
Info provided by the American Medical Association:
The federal No Surprises Act (NSA) prohibits out-of-network health care providers and facilities from balance billing commercially insured patients, in certain circumstances. The NSA and its implementing regulations set a method for determining the patient cost-sharing for these out-of-network situations, and when state law does not establish a provider payment methodology, the NSA establishes an independent dispute resolution (IDR) arbitration system to establish provider payment.
This toolkit focuses on three operational challenges that physicians will need to address immediately in order to be compliant with the new requirements. Click here to access the toolkit.
Webinar Archive
Replay past webinars & learn on YOUR schedule by visiting the SCOA Webinar Archive!
Past webinar topics include:
  • Attracting and Retaining Awesome Employees – Get It Right The First Time
  • The Top 3 Things to Do Daily to Seize Your Day and Feel More Accomplished, Healthier, and Happier
  • Survive and Thrive with Bundled Payments
  • And more!
Mark Your Calendar!
Member Benefits - 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.
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South Carolina Orthopaedic Association www.scoanet.org
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