CNS and AANS Advocate for Streamlining Prior Authorization in Medicare
On Sept. 10, the CNS and the AANS issued a press release highlighting that organized neurosurgery joined nearly 370 national and state-based patient, provider and other health care stakeholder groups in a letter to Congress voicing support for H.R. 3107, the Improving Seniors’ Timely Access to Care Act. Sponsored by Reps. Suzan DelBene (D-Wash.), Mike Kelly (R-Pa.), Roger Marshall, MD, (R-Kan.), and Ami Bera, MD, (D-Calif.), the legislation would protect patients in Medicare Advantage from unnecessary prior authorization practices that limit their timely access to medically necessary care. Joining the CNS and the AANS in supporting the legislation are neurosurgical societies from the following states: Arizona, California, Colorado, Connecticut, Delaware, Florida, Illinois, Iowa, Kansas, Louisiana, Maine, Massachusetts, Minnesota, Montana, Nebraska, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia and Wisconsin.
Additionally, on Sept. 11, the House Small Business Committee held a hearing titled, “Utilization Management: Barriers to Care and Burdens on Small Medical Practice.” The CNS and the AANS submitted a statement for the record. In August, the groups also submitted a letter to the Centers for Medicare & Medicaid Services (CMS) responding to the agency’s request for information (RFI) on ways to improve prior authorization and the Appropriate Use Criteria Program.
Share Your Views on Government-sponsored Health Care
As the debate heats up on Medicare-for-All, the CNS/AANS Washington Committee and Council of State Neurosurgical Societies (CSNS) are seeking your views on the establishment of a new or expanded government-sponsored health insurance program. If you have not already done so, please click here to complete a brief survey so that we can incorporate your feedback into the Washington Committee deliberations.
Contact Congress to Co-sponsor H.R. 3107, the Improving Seniors' Timely Access to Care Act: Tell Your Representative about the Need for Prior Authorization Reform
To bring needed transparency and oversight to the Medicare Advantage (MA) program, the CNS and the AANS are urging Congress to adopt H.R. 3107, the Improving Seniors’ Timely Access to Care Act. If passed, this legislation would reduce the hassles of prior authorization and help curb unnecessary delays for patients covered by MA plans. Click here to send an email message urging your member of Congress to co-sponsor H.R. 3107. A sample message, which can be personalized, is provided.
Coding and Reimbursement
Neurosurgery Comments on Proposed 2020 Medicare Physician Fee Schedule
On Sept.13, neurosurgery submitted a letter to CMS expressing concerns about several reimbursement-related provisions of interest to neurosurgeons contained in the 2020 Medicare Physician Fee Schedule proposed rule. In the letter, the CNS and the AANS:
- Vehemently opposed the agency’s failure to include increases in evaluation and management (E/M) office visit code valuations in the global surgical codes;
- Urged the CMS to review and correct errors in the malpractice (MP) RVUs for neurosurgery; and
- Opposed CMS’ plan to reduce the values for codes for lumbar puncture and closed treatment of vertebral fractures.
Also, the CNS and the AANS joined the Alliance of Specialty Medicine in its letter addressing issues of concern to specialty medicine. CMS is expected to issue the final 2020 fee schedule rule in early November.
CNS and AANS Comment on MIPS Proposals for 2020 and Beyond
On Sept. 6, the CNS and the AANS provided CMS with comments on changes to the Merit-Based Incentive Payment System (MIPS), as outlined in the 2020 Medicare Physician Fee Schedule (PFS) proposed rule. The CNS and the AANS voiced support for the overall goals of CMS’ new MIPS Value Pathways (MVP) framework, which aims to reduce clinician burden, provide for a more meaningful participation experience and better prepare clinicians for alternative payment models (APM). The framework, which could be applied as early as 2021, would rely on specialty-focused episodes with better-aligned measures, reduced reporting requirements and enhanced performance feedback. The CNS and the AANS voiced concern, however, that the framework fails to unify MIPS performance categories and to recognize cross-cutting activities, such as tracking performance through a clinical data registry. In the letter, the CNS and the AANS expressed additional concerns about expanding the use of administrative-based population health measures, changes to how group practices may satisfy improvement activities, CMS’ decision to increase the weight of cost measures and policies that would make it increasingly difficult for specialty societies to maintain qualified clinical data registries (QCDR) for purposes of MIPS.
Neurosurgery Blog Participates in Neurosurgery Awareness Month
Throughout August, Neurosurgery Blog participated in neurosurgery awareness month. This year for #NeurosurgeryMonth, we opened Neurosurgery Blog to guest posts from neurosurgical departments across the county. We shared information, technological developments and patient stories that highlight the amazing work neurosurgeons do, including:
We hope the stories help to spotlight neurosurgical departments across the country and the neurosurgeons who have committed their lives to this elite field. We invite all neurosurgeons to visit the blog and subscribe to it, as well as connect with us on our various social media platforms. This allows you to keep up with the many health policy activities happening in the nation's capital and beyond the Beltway.