Vol. 42, March 2016 CNS DC E-Newsletter

Legislative Affairs

U.S. House Energy and Commerce Committee Hosts Concussion Roundtable

On March 14, 2016, the U.S. House Energy and Commerce Committee hosted a roundtable to conduct a broad review surrounding the causes, effects and treatments for concussions. The meeting brought together experts from the medical, military, athletic and research communities to increase collaboration and expand the body of knowledge to help improve the diagnosis and treatments of concussions. Geoffrey T. Manley, MD, PhD, FAANS, past-chair of the AANS/CNS Section on Neurotrauma and Critical Care, chief of Neurosurgery at San Francisco General Hospital and professor of neurosurgery at the University of California at San Francisco, participated in the roundtable. The AANS and CNS issued a press release applauding the committee for its leadership on the issue of concussions.

Training Tomorrow’s Doctors Today Act Introduced in the House

On March 17, 2016, Rep. Kathy Castor (D-Fla.) introduced H.R. 4774, the “Training Tomorrow’s Doctors Today Act,” which would increase the number of graduate medical education (GME) residency positions by 15,000 over the next five years to tackle the severe physician manpower shortage. The AANS and CNS joined with the Association of American Medical Colleges and others in backing this bill and along with the Alliance of Specialty Medicine, sent a letter supporting the legislation.

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

Coding and Reimbursement

AANS and CNS Nominate Neurosurgeon to Medicare Commission

The AANS and CNS have nominated Gregory J. Przybylski, MD, FAANS, for a position on the influential Medicare Payment Advisory Commission (MedPAC). MedPAC is an independent agency established to advise Congress on issues that affect the Medicare program. A practicing neurosurgeon from New Jersey, Dr. Przybylski is a past chair of the AANS/CNS Coding and Reimbursement Committee and currently serves as organized neurosurgery’s representative on the AMA/Specialty Society Relative Value Update Committee (RUC). During his tenure on the RUC, Dr. Przybylski has led some important initiatives, including heading up the Professional Liability Insurance Workgroup. His nomination is supported by more than 30 national medical societies, the Partnership to Improve Patient Care and key members of Congress.

To help bolster Dr. Przybylski’s nomination, the AANS and CNS also spearheaded a congressional letter writing campaign. Led by Reps. Larry Bucshon, MD (R-Ind.); Tom Price, MD, (R-Ga.); and Phil Roe, MD (R-Tenn.), this campaign is calling on the Government Accountability Office (GAO) to appoint a surgeon to MedPAC. The letter, which was signed by 23 members of the House of Representatives, highlights the need for a surgeon’s expertise on the commission to provide crucial input from those who are well versed in Medicare payment systems, including fee-for-service. 

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

Quality Improvement

Physician Groups Receive Medicare Quality Payment Adjustment                           

In March 2016, the Centers for Medicare & Medicaid Services (CMS) released payment adjustment results related to the implementation of the 2016 Physician Value-based Payment Modifier (VM). The 2016 VM, based on 2014 performance, is being applied to physicians in groups of 10 or more eligible professionals. Most physician groups met the minimum reporting requirements, and their Medicare payments will remain unchanged. Medicare Administrative Contractors have begun paying claims based on these updated payment amounts since March 14, 2016, and groups will start seeing the adjustments on their claims within the next six weeks. CMS will reprocess any CY 2016 claims with dates of service that were paid before this date. Click here for information about individual practice quality and cost performance reports.

Health Affairs Study Highlights Physicians Spend $15.4 Billion on Quality Reporting

According to a new study (subscription required) published in the journal Health Affairs, physicians are spending hundreds of hours reporting clinical quality measures to Medicare, Medicaid and private insurers at an estimated cost of $15.4 billion per year. The authors point out that while much is to be gained from quality measurement, the current system is unnecessarily costly, and greater effort is needed to standardize measures and make them easier to report.

If you have any questions regarding these or other quality-related issues, please contact Rachel Groman, Vice President for Clinical Affairs and Quality Improvement at Hart Health Strategies, via email at rgroman@hhs.com.

Graduate Medical Education

Organized Neurosurgery Testifies at ACGME Resident Duty Hours Congress

On March 16-17, 2016, the Accreditation Council for Graduate Medical Education (ACGME) convened the “Resident Duty Hours in the Learning and Working Environment Congress“ in Chicago. In his capacity as president of the Society of Neurological Surgeons (SNS), AANS past president Robert E. Harbaugh, MD, FAANS, testified on behalf of the SNS, AANS, American Board of Neurological Surgeons and the Congress of Neurological Surgeons (CNS). Other neurosurgeons attending included AANS president H. Hunt Batjer, MD, FAANS; CNS president Russell R. Lonser, MD, FAANS; and AANS/CNS Washington Committee chair Shelly D. Timmons, MD, PhD, FAANS. Neurosurgical resident Maya Babu, MD, presented testimony on behalf of the American College of Surgeons Residents and Associate Society. Dr. Harbaugh testified on the need for flexible resident duty hours and reiterated key points from organized neurosurgery’s detailed written comments.

If you have questions about this issue, please contact Katie Orrico, director of the AANS/CNS Washington Office, at korrico@neurosurgery.org  

Drugs and Devices

CMS Updates 2014 Open Payments Data; Prepares for June 2016 Data Release

On Jan.19, 2016, CMS updated the Open Payments dataset, which contains industry payments to physicians and teaching hospitals previously released on June 30, 2015. Each year, CMS will “refresh” the Open Payments data at least once to include updates from disputes and other data corrections made since the initial publication of the data. In the upcoming months, neurosurgeons will be able to review and challenge their 2015 data, and manufacturers will make any corrections before the June 30, 2016, data release date. CMS will hold a conference call on April 12, 2016, from 2:30-3:30 p.m. EDT to educate physicians, teaching hospitals and physician office staff on the process for reviewing 2015 data. Individual physician data may be found using the Open Payments search tool. For more information about Open Payments, click here.

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

Communications

Neurosurgery Hosts GME Awareness Month in March

During the month of March, Neurosurgery Blog is hosting graduate medical education (GME) awareness month. In order to maximize attention on GME and physician workforce issues, we planned our efforts around Match Day, which occurred on March 18, 2016. Dubbing March as “GME Month,” the AANS and CNS launched the hashtag #gmemonth on Twitter. Neurosurgery Blog and other communications outlets will focus on GME-related topics throughout the month, with multiple guest blog posts. Our first guest post was authored by Atul Grover, MD, PhD, executive vice president of the Association of American Medical Colleges. Another guest post was written by Rep. Joe Crowley (D-N.Y.), vice chair of the House Democratic Caucus and a member of the powerful Ways and Means Committee.

We invite all neurosurgeons to join the conversation — using the #gmemonth hashtag — so we can grow awareness through social media. In the meantime, if you have not already done so, we also encourage you to subscribe to Neurosurgery Blog to stay informed on this and other important topics facing neurosurgery. Simply click here to enter you email address, confirm your subscription and away you go!

Dr. Alex B. Valadka Pens Guest Column for The Hill 

On Feb 17, 2016, The Hill newspaper published an op-ed by Alex B. Valadka, MD, FAANS, spokesperson for the Alliance of Specialty Medicine, which provided an overview of critical issues concerning the meaningful use of electronic health records (EHRs). In the piece, Dr. Valadka wrote:

Despite its many flaws, Meaningful Use will be a cornerstone of the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA), which is intended to focus less on compliance with arbitrary rules and more on paying for value and better patient care. However, unless immediate and significant changes are made to the Meaningful Use program and the interoperability of EHRs is addressed, value and better patient care facilitated by health IT will remain unattainable ideals.

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