Vol. 37, May 2015 CNS DC E-Newsletter

Legislative Affairs

President Obama Signs the Medicare Access and CHIP Reauthorization Act

On April 16, 2015, President Obama signed into law the, “Medicare Access and CHIP Reauthorization Act,” which repealed Medicare’s sustainable growth rate (SGR) physician payment system and prevented a 21 percent pay cut. In addition, the legislation:

  • Consolidates the current Physician Quality Reporting System (PQRS), Electronic Health Record (EHR) and Value-Based Payment Modifier (VM) programs, and eliminates the penalties associated with these programs;
  • Includes positive incentives for quality improvement payment programs that allow all physicians the opportunity to earn bonus payments;
  • Enhances the ability of physicians — rather than the government — to develop quality measures and clinical practice improvement activities;
  • Clarifies that quality improvement program requirements do not create new standards of care for purposes of medical malpractice lawsuits;
  • Reverses the CMS decision to eliminate the 10- and 90-day global surgery payments; and
  • Extends the Children's Health Insurance Program (CHIP) for two years.

The American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) will now focus on guiding this legislation through the implementation process to ensure that the Center for Medicare and Medicaid Services (CMS) develops the new Medicare physician payment system as directed and intended by Congress.

Neurosurgery and 500 Other Groups Urge Congress to Repeal IPAB

On May 7, 2015, the AANS, CNS and several of state neurosurgical societies, joined the Healthcare Leadership Council and over 500 national and state-based healthcare organizations, in sending a letter urging Congress to repeal the Independent Payment Advisory Board (IPAB). The IPAB is a board of 15 unelected, and largely unaccountable government bureaucrats, whose primary purpose is to cut Medicare spending. Repealing the IPAB is one of organized neurosurgery’s top legislative priorities.

CNS and AANS Support Graduate Medical Education Legislation

On May 4, 2015, the CNS and AANS joined the Alliance of Specialty Medicine in endorsing S. 1148, the "Resident Physician Shortage Reduction Act of 2015." Introduced by Sens. Bill Nelson (D-Fla.), Harry Reid (D-Nev.) and Charles Schumer (D-N.Y.), S. 1148 would increase the number of Medicare-funded graduate medical education (GME) residency positions by 15,000 over the next five years. The Alliance also endorsed the House companion bill, H.R. 2124, introduced by Reps. Joseph Crowley (D-N.Y.) and Charles Boustany, MD (R-La.).

Senate Finance Health Subcommittee Holds Hearing on Medical Device Tax

On April 23, 2015, the Health Subcommittee of the U.S. Senate Finance Committee held a hearing on the impact of the medical device tax on jobs, innovation and patients. Created by the Affordable Care Act, the medical device tax is a 2.3 percent excise tax that applies to the gross sales of medical device products. This tax imposes over $30 billion in new taxes and is adversely affecting medical innovation and patient care. Repealing the medical device tax is among neurosurgery’s top legislative priorities, and the CNS and AANS issued a press release applauding the committee for its efforts to abolish this arbitrary tax.

If you have questions about these or other legislative issues, please contact Katie Orrico, director of the CNS/AANS Washington Office at korrico@neurosurgery.org.  

Coding and Reimbursement

CMS Releases Proposed 2016 Medicare Hospital Payment Rule

On April 30, 2015, the Centers for Medicare & Medicaid Services (CMS) published the 2016 Medicare Hospital Inpatient Prospective Payment System (IPPS) Proposed Rule. Of particular interest to neurosurgeons, the rule included a request for four new MS-DRGs for endovascular procedures, separating the procedures from the MS-DRGs for open cerebrovascular procedures. In addition, CMS plans to revise the titles of MS-DRGs for spinal fusions to more closely correspond to the ICD-10 wording by changing the current title of “9+ Fusions” to “Extensive Fusions.” Furthermore, CMS is proposing to continue the new technology add-on payments for the responsive neurostimulator system, which the CNS and AANS have supported.

If you have any questions regarding these or other reimbursement issues, please contact Cathy Hill, CNS/AANS senior manager for regulatory affairs, at chill@neurosurgery.org.

CSNS Spotlight

ABC’s about PQRS

What do neurosurgeons need to know to prepare for quality reporting? What is the physician quality reporting system? What quality measures are reportable? How can you avoid negative adjustments? The Affordable Care Act (ACA) Task Force of the Council of State Neurosurgical Societies (CSNS) has developed a short presentation to help answer these questions. Changes to this document are likely, given passage of the, “Medicare Access and CHIP Reauthorization Act.” Members of the CSNS ACA Task Force will provide updated information on quality reporting requirements as changes occur.  

Communications

Subscribe to Neurosurgery Blog Today!

The mission of Neurosurgery Blog is to investigate and report on how healthcare policy affects patients, physicians and medical practice, and to illustrate how the art and science of neurosurgery encompass much more than brain surgery. Over the past few months, Neurosurgery Blog has ramped up its reporting efforts to include multiple guest blog posts from key thought leaders and members of the neurosurgical community. Listed below are some recent blog posts on topics including SGR repeal, medical device tax and stroke.

We invite you to visit the blog and subscribe to it, as well as connect with us on our various social media platforms. This will allow you to keep up with the many health-policy activities happening in the nation's capital and beyond the Beltway.

If you are interested in these communications activities, please contact Alison Dye, CNS/AANS Senior Manager of Communications, at adye@neurosurgery.org.