Washington Report

Through advocacy, policy development, and public relations, the AANS/CNS Joint Washington Committee and Washington Office work vociferously to defend and protect the ability of neurosurgeons to practice medicine freely, and help to ensure the continued advancement of the specialty of neurological surgery. Throughout the year, the Washington Office staff are in the halls of Congress or working with government agencies and other health care stakeholders advocating on behalf of neurosurgery. As a result of these interactions, organized neurosurgery has achieved a variety of advocacy successes.

Adopting a New Washington Committee Strategic Plan

The CNS spent a considerable amount of energy developing a strategic plan for the Washington Committee. At the end of this process, the CNS adopted new mission and vision statements and a set of initial strategic goals that are based on an analysis of the strengths, weaknesses, opportunities, and threats facing the specialty of neurological surgery.

Fighting for Fair Reimbursement

The CNS has been on the front lines helping to monitor the “Medicare Access and CHIP Reauthorization Act” (MACRA) legislation through the implementation process to ensure that CMS gets this right and develops the new Medicare physician payment system as directed and intended by Congress.

  • The CNS has aggressively addressed other third-party payer coverage policies, which limit reimbursement for many common neurosurgical procedures.
     
  • The Coding and Reimbursement Committee, along with representatives from the National Quality Council (NQC), Joint Guidelines Committee, the Joint Sections and Washington Committee work together to respond to these coverage issues to provide a balanced assessment of the current literature and experience with procedures under review.
  • The CNS, working with the CRC’s Rapid Response Teams and the Council of State Neurosurgical Societies (CSNS), established a quarterly information tool, which informs neurosurgeons about significant local coverage policies, allowing our members to track and respond to these to ensure that neurosurgical patients get access to the full range of treatment options for neurosurgical care.

Regulatory Relief

Faced with an ever-growing morass of regulations with which neurosurgeons must comply, the CNS, through the Washington Committee and Washington Office, has been working with Congress and regulators to reduce the burdens associated with practicing medicine by:

  • Continuing to oppose Medicare’s “two-midnight” inpatient-hospital policy due to concerns about increased physician hassles and audit exposure, as well as increased beneficiary financial burdens.
     
  • Promoting advocacy efforts that helped secure the inclusion of a provision in MACRA, which suspended the Recovery Audit Contractors (RAC) program related to the two-midnight rule for an additional two years. Ultimately, CMS announced its plans to scrap the program altogether and allow hospitals to seek corrective reimbursements.
     
  • Successfully advocated for changes to Medicare’s existing Electronic Health Record (EHR) Incentive Program, otherwise known as meaningful use (MU).

Washington Committee chair, Shelly D. Timmons, MD, PhD, with Rep. Larry Bucshon (R-Ind.) at the Alliance of Specialty Medicine’s 2016 legislative conference in Washington, DC.

Reforming the Reform

While the Affordable Care Act (ACA) is the law of the land, the CNS has not ceased in advocating for changes to this landmark health care reform law.

  • A top priority remains abolishing the Independent Payment Advisory Board (IPAB). In leading the Physician IPAB Repeal Coalition, the CNS was instrumental in getting funding for IPAB eliminated for FY 2016 as part of the $1.15 trillion comprehensive spending and tax extenders package (Public Law 114-113).
     
  • To ensure continued forward progress with medical innovations, the CNS supported the repeal of the 2.3 percent excise tax levied on the sales of medical devices.
     
  • Due in part to the advocacy efforts of the CNS, the $1.15 trillion comprehensive spending and tax extenders package (Public Law 1 14-113) included a two-year suspension of the 2.3 percent excise tax.

Graduate Medical Education

An appropriate supply of well-educated and trained physicians is an essential element to ensure access to quality health care services for all Americans. Through the continued advocacy of the CNS, policymakers are beginning to understand that there are significant shortages of physicians in both primary and specialty care.

  • The CNS worked with the Association of American Medical Colleges (AAMC), the Alliance of Specialty Medicine and others, to successfully advocate for the introduction of legislation to provide additional Medicare funding for graduate medical education (GME). This includes the introduction of the “Resident Physician Shortage Reduction Act (H.R. 2124/S. 1148) and the “Training Tomorrow’s Doctors Today Act,” (H.R. 4774). Momentum continues to grow for both bills, which would expand Medicare funding for an additional 15,000 slots over a five-year period.
     
  • Neurosurgery Blog hosted a graduate medical education (GME) awareness month. The CNS planned this initiative around Match Day, March 18, 2016. Dubbing March as “GME Month,” organized neurosurgery launched the hashtag #gmemonth on Twitter. Neurosurgery Blog and other communications outlets hosted multiple guest blog posts from Atul Grover, MD, executive vice president of the AAMC, and Rep. Joe Crowley (D-N.Y.), vice chair of the House Democratic Caucus and a member of the powerful Ways and Means Committee.

Geoffrey T. Manley, MD, PhD, past chair of the CNS Section on Neurotrauma and Critical Care testifies at a U.S. House Energy and Commerce Oversight Subcommittee hearing on concussions.

Neurosurgery Advocates for Trauma Care

Working to improve the nation’s trauma and emergency care systems, the CNS participated in several Congressional briefings:

  • Geoffrey T. Manley, MD, PhD, past chair of the CNS Section on Neurotrauma and Critical Care, served as a lead witness at the U.S. House Energy and Commerce Committee’s initial roundtable discussion reviewing 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.
     
  • CNS past president, P. David Adelson, MD, represented the CNS in a Congressional briefing convened to highlight the challenges facing pediatric trauma patients and the need to find bipartisan solutions to ensure adequate trauma care for children. As a result of this hearing, several prominent members of Congress established the Pediatric Trauma Caucus.

CNS past president, P. David Adelson, MD (on right), represents organized Neurosurgery at a Congressional briefing focusing on pediatric trauma. He is pictured here with Rep. Richard Hudson (R-N.C.), the chair of the Congressional Pediatric Trauma Caucus.

Communications Outreach

The Washington Office’s traditional media/communication efforts include Op-eds, letters to the editor, radio “tours” and desk side briefings with reporters from the Wall Street Journal, Washington Post, CBS, NBC, Politico, and others. Since December 2012, the Washington Office has generated 126 traditional media hits reaching an audience of nine million. In addition to traditional media, the CNS digital media platforms continue to see a significant expansion and have garnered over 170 million individual impressions. Furthermore, these media platforms have amassed a subscription audience of 65,000. These communication tools include:

  • Neurosurgery Blog: More Than Brain Surgery, a web-based opinion and perspective column, through which CNS offer insights and perspective on contemporary health issues as they relate to organized neurosurgery.
     
  • An @Neurosurgery Twitter feed that is used to gain greater visibility for neurosurgery’s advocacy efforts. The Twitter feed focuses primarily on health policy updates and provides links to positive stories about neurosurgery.
     
  • Our YouTube channel features clever animations designed to engage the public in a fun, visually appealing manner while providing clearcut, high-level facts centered on neurosurgery’s top legislative issues.
     
  • Facebook, LinkedIn, Tumblr, and Google+ sites help drive health policy influencers to information on Neurosurgery Blog and the Twitter feed, while also spotlighting CNS news-making successes and initiatives.