News From ACFAS

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Don’t wait to secure your spot and hotel for the ACFAS 2022 Annual Scientific Conference, February 24-27 in Austin, TX!

Join us to expand your knowledge and skills with four days of cutting-edge sessions, hands-on workshops and reconnecting in person with your friends and colleagues.

Register now, or if you’ve already registered, be sure to book your hotel with our official housing partner, onPeak. Booking through onPeak guarantees you the lowest hotel rate and also protects you from unauthorized third-party vendors or “hotel poachers.” ACFAS will not be responsible for any room reservations or deposits made through other companies or websites, so please book through onPeak for your own safety. Hotel reservations can be made online at acfas.org/Austin, by calling (800) 950-5542 or by emailing acfas@onpeak.com.

Visit acfas.org/Austin to register, book your hotel or get the latest on what to expect at the premier foot and ankle surgery conference in the profession. Get ahead in your coding and billing by attending the popular Coding and Billing for the Foot and Ankle Surgeon preconference program at ACFAS 2022 in Austin, TX!

Join us for an interactive and comprehensive workshop that covers pertinent issues related to properly coding surgical procedures and evaluation and management services. After this course you will leave knowing:

• How to code more efficiently and effectively and will see an increase in reimbursements
• Trends in surgical coding, including how to code for new advances in the practice of foot and ankle surgery
• How to appropriately select modifiers for complex, staged, and multiple procedure cases
• Where higher level E&M codes fit into your surgical practice

By learning how to code just one or two procedures properly, you will cover the cost of this course and see an immediate return on investment in your own practice. Learn more and register today at acfas.org/PracticeManagement. This year’s not even over yet, but the College already has a lot of great things planned for 2022.

We’ll kick things with off at our in-person Annual Scientific Conference in Austin and then jump right into a jam-packed schedule of workshops, learning days and seminars throughout the year.

You’re not going to want to miss it, so be sure to renew your membership by the December 31 deadline. You can renew online, through the mail or via fax. If you have any questions about your membership, email the Membership Department at membership@acfas.org. Plan to join us to celebrate another successful Annual Scientific Conference at the College’s popular Wrap Party being held at the Lustre Pearl—one of Austin’s most popular musical venues—on Saturday, February 26.

There is no better way to wrap up our conference in the Lone Star state then to mingle with friends and colleagues. Visit acfas.org/Austin for all the details and to get your tickets today.

Foot and Ankle Surgery

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A study sought to assess ancillary procedures on total ankle implant arthroplasty (TAA) by comparing preoperative plans on implant alignment based on patient-specific computed tomography images with alignment seen on immediate postoperative radiographs. The authors also measured postoperative joint congruity and evaluated operative ports to see if concomitant procedures performed with total ankle replacement significantly impacted overall alignment. Forty-six out of 47 implants in the patient population were within 1.5 degrees of their anticipated placement in the coronal plane, and all were within two degrees of anticipated placement in the sagittal plane. A spearman's rank-order correlation showed the data did not expose any significant relationship between conducting additional procedures in conjunction with TAA and postoperative congruency of the implant. These results help support the accuracy of ankle implantation using patient-specific instrumentation and back the proper utilization of indicated procedures in conjunction with total ankle replacement to help secure a congruent joint postoperatively.


A case-control study was held to identify factors associated with radiographic healing after treatment of talar osteochondritis dissecans (TOCD) in children, evaluate treatment outcomes and develop a clinically useful nomogram for predicting healing. The researchers held a retrospective review of all TOCD patients 18 years old or younger from a single pediatric institution over 12 years. The authors examined 92 lesions in 74 patients, of which 58 lesions were treated surgically. Complete radiographic healing was observed in 43 lesions. Patients with complete healing tended to be younger, were skeletally immature and exhibited a lower body mass index (BMI) compared to those with incomplete healing. Multivariate regression indicated significant correlation between rate of complete healing and age at diagnosis, BMI and initial surgical treatment. Lesion dimensions were not significantly associated with the probability of healing. The team developed a nomogram based on the independent variables that correlated significantly with the likelihood of complete radiographic healing.

Practice Management

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Federal health officials have unveiled a five-part plan to improve and protect the mental health and well-being of America's healthcare workers (HCWs) and implement sustainable change for next-generation HCWs. The US Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health (NIOSH) intends to research in depth the personal, social and economic burdens HCWs confront each day; absorb this information and develop a repository of best practices, resources and interventions; collaborate with key stakeholders, including the American Hospital Association, the American Nurses Association, National Nurses United and the Joint Commission and recognize and adapt stress-reduction tools for the healthcare workplace. NIOSH Director John Howard said the institute also plans to "generate awareness through a national, multidimensional social marketing campaign to get the word out about stress so healthcare workers don't feel so alone."


Practices that implement appropriate email safeguards can avoid violating the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA says the email encryption requirement is "addressable," meaning it is only necessary if a risk assessment determines it is required for managing protected health information (PHI) risk. PHI transmitted electronically should be encrypted "whenever deemed appropriate." Covered entities that do not designate encryption the best course of action must document their reasoning and deploy equivalent PHI safeguards, although there is no alternative as effective as encryption. Sending HIPAA-compliant email requires a comprehensive encryption solution that protects all outgoing messages both at rest and in transit. Continuous employee cybersecurity training is vital, and it should cover subjects like cybersecurity policies and procedures, safe use of electronic devices and recognizing and blocking malicious emails. Finally, inbound email security can help prevent data breaches.


A new whitepaper from health IT company Censinet outlines seven ways in which physician practices can protect themselves from ransomware attacks, the first of which is maintaining constant visibility into their operations. This involves knowing exactly who has access to what and where the most sensitive data is. The second tip is to always have a backup plan and execution strategy, while the third is to accelerate and automate patching when new flaws are discovered in clinical and business applications, medical devices and other patient care and delivery systems. The fourth tip entails regularly vetting and restricting access to critical assets, and the fifth involves conducting security and awareness training. The sixth tip is to deploy new systems to manage vendors and risk. The seventh and final tip is to participate in threat and information sharing with other healthcare organizations and threat intelligence organizations.

Health Policy and Reimbursement

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US Vice President Kamala Harris announced that the Biden administration is investing $1.5 billion from the coronavirus aid package to solve the healthcare worker shortage in underserved communities. The funding will be channeled into the National Health Service Corps, Nurse Corps and Substance Use Disorder Treatment and Recovery programs, which all offer scholarship and loan repayments for healthcare students and workers if they commit to working in underserved and high-risk communities. The money will support over 22,700 providers, the largest-ever number enrolled in these programs. "Our nation must invest in a healthcare workforce that looks like America and provide access to equitable healthcare for all Americans," Harris declared. She also campaigned for passage of President Biden's nearly $2 trillion social safety net and climate change package, which would provide funding to temporarily bridge the Medicaid coverage gap and expand access to health insurance marketplace subsidies through 2025.


Some hospitals, nursing homes and other healthcare providers are preparing to operate without up to one-third of their staff at the start of next year if those workers don’t comply with a federal mandate to get vaccinated against COVID-19. The White House is requiring facilities that receive funding from the US Centers for Medicare and Medicaid Services to have workers vaccinated by 4 January. But two dozen states are challenging the requirement in court, while many healthcare providers in those states and beyond are reviewing requests for medical and religious exemptions. Some healthcare employers are setting a hard line against exemptions, but others are being more permissive, and still more are looking to hire workers who have left or been denied exemptions at other hospitals and clinics. The decisions add up to a major operational threat for some healthcare providers amid a labor shortage.


According to a report from the US Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation (ASPE), millions of Americans with private health insurance experience some kind of surprise medical billing. Surprise medical bills can average more than $1,200 for services provided by anesthesiologists, $2,600 for surgical assistants, and $750 for childbirth-related care. Consumers expect their employer-sponsored insurance to shield them from high out-of-pocket costs for emergencies, but the ASPE report reveals that an estimated 18 percent of emergency room visits by individuals with large employer coverage resulted in one or more out-of-network charges, and this percentage varies greatly by state, ranging from a low of 3 percent in Minnesota to a high of 38 percent in Texas. Moreover, the report found that patients who receive a surprise bill for emergency care paid physicians more than 10 times as much as patients without a surprise bill for emergency care.


States have allowed residents to conduct some medical appointments virtually or by phone over the last two years, and insurers were required to pay the same for virtual visits and in-person appointments. US Centers for Disease Control and Prevention data found telehealth visits were 154 percent higher in the last week of March 2020 versus a year earlier, and a McKinsey report in July showed that demand for telehealth continued to rise through 2021. Yet health insurers began scaling back coverage allowances made during the pandemic in fall 2020, and some state provisions have expired or will do so in 2022. Healthcare providers are campaigning to make telehealth services permanent because it expands access to care and treatment. However, the Justice Department in September charged 138 providers in connection with a combined $1.4 billion fraud largely involving telemedicine, and some are worried that telehealth could encourage further fraud.

Medicine, Drugs and Devices

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The pharmaceutical industry is bracing for the most significant expansion of government regulation of drug prices in decades despite some success in watering down proposals that would have gone much further. The US House of Representatives approved an approximately $2 trillion social-spending and climate bill supported by US President Biden that requires the government to negotiate prices for some older high-cost medicines covered by Medicare. The bill also caps annual drug price increases at the rate of inflation. The measures reduce federal drug spending—and industry revenue—by $128 billion over 10 years, according to the US Congressional Budget Office. So far the industry has not mobilized in force against the bill after its passage in the House, though some industry officials hope Senate Republicans might derail some parts of the package. The Senate plans to take up the bill in December. Few changes are expected to be made to the drug-pricing provisions, which were hammered out in a compromise pact among Democratic lawmakers earlier this month, according to people familiar with the matter. After years of bipartisan efforts to rein in drug prices, analysts said the bill will have a relatively limited impact on the industry. Under the proposals, companies will retain the power to set new prices on new products and only face negotiation on drugs that are big sellers long after their launch. The package opens the door to further government drug price negotiations in the future.