News & Updates: February 2023
2023 SCOA Annual Meeting
August 3-5, 2023
Sanctuary Hotel
Kiawah Island, SC
Meet the Keynote Speakers:
Felix H. “Buddy” Savoie, III, MD
AAOS President
Chairman, Department of Orthopaedics, Tulane University School of Medicine
Director, Tulane Institute of Sports Medicine
Holly Pisarik
Senior VP of Advocacy and Policy Counsel
SC Medical Association
Previous Roles:
Chief Legal Counsel, Office of Governor Nikki Haley
Call for Abstracts:
The South Carolina Orthopaedic Association is now accepting Member abstract submissions and Resident Research Competition submissions.

Selected abstracts will be presented at the 2023 SCOA Annual Meeting taking place August 3-5, 2023, at The Sanctuary in Kiawah Island, to an audience of established orthopaedic professionals. Don’t miss this opportunity to present your research to seasoned specialists in a collegial and interactive setting.

We’ve posted instructions for submissions on our website. In addition to the abstract information, all submissions must be accompanied by a financial disclosure form. 
In order to be considered by the Program Committee, submissions must be received by March 31, 2023. 
Housing Information:
This year, meeting registration is required to secure housing. Upon registering for the Annual Meeting, you will receive Housing Instructions with your registration confirmation. 

Please note: The room block expires July 5, 2023, but we expect the block to sell out well before that deadline. Register today so you can secure housing early.
Legislative News
Certificate of Need (CON) Update
On February 21, 2023, the SC House 3M Medical sub-committee was joined by members of the full committee to receive testimony on S 164 that would substantially repeal Certificate of Need (CON). S 164 eliminates CON for everything except nursing homes and Ambulatory Surgery Centers (ASC) with more than 8 ORs. Additionally, S 164 prohibits hospitals from imposing non-compete clauses in employment negotiations with physicians.
The hearing lasted three hours, with each speaker being limited to 3 minutes. Testimony was almost equally split among speakers supporting S 164 and those who oppose it. Among other requests, the SC Hospital Association asked the Committee to limit CON exemption to ASCs with no more than 2 ORs and to remove the non-compete language completely. Many hospital administrators testified that revenue from ASC eligible procedures performed on privately insured patients is needed to offset the emergency care they are required to offer to uninsured patients who cannot afford to pay for services.
Upstate SCOA Member Dr. Marc Tanner and Managing Director AnnMargaret McCraw offered comments on behalf of SCOA. Dr. Tanner shared his personal experience with delayed access to upstate ORs and the impact of HOPD cost as compared to ASC for his patients. AnnMargaret shared specific examples of site of service cost differences for Medicare and privately insured patients undergoing a rotator cuff repair. She noted that the increase in high-deductible health plans means many insured patients are not able to cover their out-of-pocket medical expenses so having access to lower cost surgical settings is critically important to them.

Additionally, she reviewed the benefits non-profit hospitals receive precisely because they provide charity care: exemption from federal, state and local property taxes; receipt of federal disproportionate share payments to offset uncompensated care; ability to receive tax-deductible contributions and issue tax-exempt bonds, which lowers their cost of borrowing. None of those benefits are available to ASCs.
Next Steps
The 3M Medical Sub-Committee will meet to discuss S 164 in light of testimony received. At this point, the sub-committee may endorse the Bill as passed by the Senate, recommend amendments to the Bill, or decline to recommend the Bill to the full 3M Committee. The full 3M Committee will undergo a similar process to determine what amendments, if any, will be added to the Bill before it is passed to the full House for debate. The Speaker of the House will determine what priority the Bill is given on the House calendar.

SCOA leadership is convening in Columbia on March 1 and will spend time meeting with legislators to reiterate our support for S 164. We are also monitoring the progress of Scope of Practice bills for physical therapists and advanced practice nurses.

To access a recording of the 3M Committee hearing on CON, click Video Archives on this page.
Articles of Interest
CMS Prior Authorization Proposal Aims to Streamline the Process and Improve Transparency
by Kaye Pestaina, Justin Lo, Karen Pollitz, and Rayna Wallace of KFF
The Center for Medicare and Medicaid Services (CMS) has issued a proposed rule designed to address the administrative hassles of prior authorization by requiring certain payers to implement an automated process, meet shorter time frames for decision making, and improve transparency. The proposal applies to payer processes mainly in public programs, with more limited application to health insurance marketplaces and no requirements on employer-sponsored coverage. Click here to review this helpful summary of the Proposed Rule’s provisions.
HHS Office for Civil Rights Delivers Annual Reports to Congress on HIPAA Compliance and Breaches of Unsecured Protected Health Information
Last week, OCR delivered 2 Reports to Congress on HIPAA Compliance and Breaches of Unsecured Protected Health Information in 2021.
Notably as in the previous three years, hacking/IT incidents remain the largest category of breaches affecting 500 or more individuals, and affected the most individuals, comprising 75% of the reported breaches. Network servers is the largest category by location for breaches involving 500 or more individuals.
Recent Study Finds Care Rendered by APRNs without Physician Oversight Increases Cost
By Brett Kelman and Blake Farmer, Nashville Public Radio
A working paper, published in October by the National Bureau of Economic Research, analyzed roughly 1.1 million visits to 44 ERs throughout the Veterans Health Administration, where nurse practitioners can treat patients without oversight from doctors.
Researchers found that treatment by a nurse practitioner resulted on average in a 7% increase in cost of care and an 11% increase in length of stay. Click here to read the full article on the KHN website.
DEA Announces Proposed Rules for Telehealth Prescribing
Last week, the DEA issued proposed rules to permanently govern prescriptions for controlled substances issued to patients via a telehealth visit who the medical provider has never evaluated in-person. The rules would permit a 30-day supply of Schedule III-V non-narcotic controlled medication and a 30-day supply of buprenorphine for the treatment of opioid use disorder. The rules would require an in-person evaluation prior to prescribing narcotic medication. For more information about the proposed rules, click here.
Note that telehealth prescribing is subject to federal and state laws. If a state law is more restrictive than federal law, the state law prevails. Click here for a list of state requirements for telehealth prescribing.
Is Your Administrator a Member of SAOE?
SC Orthopaedic Practice Administrators, Ortho Service Line Directors, and emerging leaders in both private and hospital settings are encouraged to join the Southeastern Association of Orthopaedic Executives (SAOE). SAOE offers ortho practice leaders from SC, GA, TN and AL a unique opportunity to collaborate, network and learn from one another. SAOE membership and attendance at the annual meeting is an affordable and sound investment in your administrative team members.
Leadership Book Nook
The Five Dysfunctions of a Team
by Patrick Lencioni
A master storyteller, Patrick Lencioni uses modern fables to share leadership truths in an easy-to-read, relatable and immediately applicable style. Woven within a compelling fictional story that will resonate with all practice leaders, the five dysfunctions include Absence of Trust, Fear of Conflict, Lack of Commitment, Avoidance of Accountability and Inattention to Results.
Aren’t sure you want to invest the time to read the book? Check out Lencioni’s podcast on this topic first.
Summary submitted by:
AnnMargaret McCraw
Have a Book that was Meaningful to your Professional Journey?
Please consider sharing a short paragraph about lessons learned from a book that has shaped you as a leader. Send your summary to Sarah Thompson.

Check out past Leadership Book Nook recommendations here.
Learn On Your Schedule
Webinar Offerings Include:
  • Hiring and Retaining Talent
  • Strategies to Assess & Mitigate Unstable Patient Behavior
  • Stocking Stuffers from CMS and Other New Year’s Surprises
  • Information Sharing Under the Information Blocking Regulations: What Healthcare Providers Need to Know
  • Lunch, Laugh, Learn & Lead featuring ​comedian Robert Mac!
  • Replay AI in MSK Care Delivery: Potential vs Risk
  • Marketing, Social Media, & The Physician Practice: Legal Implications
  • Physician Financial Relationships & Conflict of Interest Policies
  • And more!
Member Benefit: Discover 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.
Thank You To Our Corporate Partner:
South Carolina Orthopaedic Association