Washington Committee: Hot Topics

June 27, 2007

AANS/CNS Support Legislation to Prevent Medicare Cuts -- Neurosurgeons Should Contact Congress to Urge Passage

The House of Representatives is scheduled to vote on H.R. 3162, the Children’s Health and Medicare Protection (CHAMP) Act before the August recess. This bill reauthorizes the State Children’s Health Insurance Program (SCHIP) and contains very important provisions to reform the Medicare physician payment system. The AANS and CNS decided to support this legislation because it included the following key elements:

• Stopping the 10% Medicare payment cut physicians face on January 1, 2008 and the 5% cut in 2009; replacing those cuts with .5% payment increases in both 2008 and 2009;
• Repealing the flawed sustainable growth rate (SGR) formula; replacing it with a system based on six categories of services, including major surgery (10 and 90 day global services), primary and preventive care, other E&M services, imaging, minor and other procedures and anesthesia;
• Eliminating funding for the Medicare Physician Quality Reporting Initiative (PQRI).

BECAUSE TIME IS OF THE ESSENCE, PLEASE CALL YOUR REPRESENTATIVE TODAY AND ASK HIM/HER TO SUPPORT THE CHAMP BILL!

To get through to your Member, call the Capitol Hill switchboard at 202/225-3121 and ask to be connected to your Member of Congress or his/her health legislative assistant. If you do not know who your member is, go to http://capwiz.com/noc/dbq/officials/ and enter your zip code.

You can also send your representative an email letter. At the AANS/CNS Legislative Action Center, you will find an Action Alert and sample letter, which you should edit to tailor to your own personal situation. To send an email letter, please visit http://capwiz.com/noc/issues/alert/?alertid=10050646.

Other provisions in the 450+ page document include:

• In 2010 and 2011, payment cuts could be around 11-12% in each year, but Congress has pledged to continue to find ways to prevent cuts of this magnitude.
• Establishes an “expert” panel to oversee the RUC to identify physicians’ services for which the relative value is potentially misvalued – in other words – overvalued. The Secretary will also be able to identify physician services growing at an unusually high annual rate – and will be able to reduce those values after consultation with the panel.
• Requires CMS to develop a process for providing physicians with feedback on their practice patterns.
• Establishes an accreditation process for facilities that provide diagnostic imaging services and requires that a facility be accredited in order to receive reimbursement for imaging services from Medicare.
• Establishes within the Agency for Healthcare Research and Quality, a Center for Comparative Effectiveness Research to conduct research on the outcomes, effectiveness, and appropriateness of health care services.
• Requires CMS to develop a plan to implement a health information technology system for Medicare.
• Requires the Secretary to designate a national entity to coordinate development of healthcare measures for all health care providers – names the National Quality Forum (NQF) as an example.
• Prevents further expasion of physician-owned hospitals and sets forth strict criteria for those that are currently in existence.

For details of the legislation (including a detailed summary), go to the House Energy and Commerce Committee website at: http://energycommerce.house.gov/CHAMP/CHAMP_index.shtml or the House Ways and Means Website at: http://waysandmeans.house.gov/legis.asp?formmode=item&number=580

If you have any questions about this legislation, please contact Lori Shoaf, Senior Manager for Legislative Affairs, AANS/CNS Washington Office at lshoaf@neurosurgery.org or 202/628-2072.