Reimbursement and Practice Management
On April 14, 2015, Congress repealed the sustainable growth rate (SGR) formula. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) permanently eliminates SGR and provides positive annual payment updates lasting through 2019. Since MACRA significantly changes the way Medicare pays physicians, we have developed a MACRA Resource Page to help educate neurosurgeons about this topic. In addition to our efforts on MACRA, the Coding and Reimbursement Committee is actively involved in bringing or reviewing new or revised CPT codes, is a strong advocate for appropriate valuation of neurosurgical services and neurosurgery’s Rapid Response Team works tirelessly to ensure that third party payors cover necessary neurosurgical services.
Key Resources
Comment Letter
Last updated: June 17, 2024
RE: Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B Dear Chairman Wyden, Ranking Member Crapo, and members of the Senate Committee on Finance: The Alliance of Specialty Medicine (the “Alliance”) represents more than 100,000 specialty physicians and surgeons across 16 specialty and subspecialty societies, and is deeply committed […]
Comment Letter
Last updated: June 17, 2024
Dear Chairman Wyden and Ranking Member Crapo: On behalf of the undersigned organizations representing key stakeholders in the surgical care of Medicare beneficiaries, we write to commend you for the release of the document titled “Bolstering Chronic Care through Physician Payment: Current Challenges and Policy Options in Medicare Part B” and to offer you our […]
Press Release (DC Office)
Last updated: June 12, 2024
FOR IMMEDIATE RELEASE Contact: Katie O. OrricoJune 12, 2024 (703) 362-4637korrico@neurosurgery.org Neurosurgeons Applaud Introduction of Bill to Streamline Prior Authorization in MedicareThe AANS and the CNS are optimistic that Congress will pass this critical legislation this year. Washington, DC—Today, the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) applauded the introduction […]
Comment Letter
Last updated: June 11, 2024
Ms. Chiquita Brooks-LaSure, AdministratorCenters for Medicare & Medicaid ServicesU.S. Department of Health and Human ServicesATTN: CMS-1808-PP.O. Box 8013 Baltimore, MD 21244-1850 Submitted electronically via www.regulations.gov Subject: CMS-1808-P Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals Policy Changes and Fiscal Year 2025 Rates; Quality Programs Requirements; and Other Policy Changes Dear Administrator Brooks-LaSure, On behalf […]
Comment Letter
Last updated: June 10, 2024
Ellen Montz, PhDDeputy Administrator and DirectorConsumer Information and Insurance OversightCenters for Medicare and Medicaid Services7500 Security BoulevardBaltimore, MD 21244-1850 Submitted electronically via: Ellen.Montz@cms.hhs.gov Subject: Biomechanical Interbody Devices and Anterior Cervical Discectomy & Fusion Dear Dr. Montz, On behalf of the American Association of Orthopaedic Surgeons (AAOS), American Association of Neurological Surgeons (AANS), Congress of Neurological […]
Medicare Advantage Data
Last updated: June 10, 2024
Dear Administrator Brooks-LaSure, The Alliance of Specialty Medicine (the “Alliance”) represents more than 100,000 specialty physicians across 16 specialty and subspecialty societies. The Alliance is deeply committed to improving access to specialty medical care by advancing sound health policy. Our organizations write to share collective insights and recommendations in response to CMS’s Request for Information […]
Washington E-Newsletter
Last updated: May 9, 2024
Under the No Surprises Act (NSA), physicians and insurers can use an independent dispute resolution process to determine the payment amount for services. The process was intended to keep patients out of the middle of these billing disputes. Unfortunately, the final rules implementing the law unfairly favor insurers when settling out-of-network payment disputes. Several lawsuits […]
Article
Last updated: June 10, 2024
Robert McDonough, MDSenior Director, Clinical Policy Research and Development Aetna April 26, 2024Dear Mr. Kane and Drs. Marans, Fitzgerald, Moffit and McDonough,The aforementioned societies would like to request a change in Aetna’s policy (https://www.aetna.com/cpb/medical/data/1_99/0016.html) to allow/include coverage for the use of biomechanical interbody devices in all Anterior Cervical Discectomy and Fusion (ACDF) surgeries.Multiple physician societies […]
Comment Letter
Last updated: June 10, 2024
Meena Seshamani, MD, PhDDeputy Administrator and Director, Center for MedicareCenters for Medicare & Medicaid Services7500 Security BoulevardBaltimore, MD 21244 Subject: Medicare Device Payment Policy for Add-on Codes Dear Dr. Seshamani, On behalf of the American Association of Neurological Surgeons (AANS), American Association of Orthopaedic Surgeons, Congress of Neurological Surgeons (CNS), AANS/CNS Joint Section on Disorders […]
Position Statement
Last updated: June 10, 2024
Alliance of Specialty Medicine Statement for the Record Senate Finance Committee Hearing“Bolstering Chronic Care through Medicare Physician Payment” The Alliance of Specialty Medicine (“Alliance”), a coalition of 16 medical specialty organizations representing more than 100,000 specialty physicians, is deeply committed to improving access to specialty medical care through the advancement of sound health policy. We […]
Washington E-Newsletter
Last updated: May 9, 2024
On March 15, the Medicare Payment Advisory Commission (MedPAC) released its March 2024 Report to the Congress: Medicare Payment Policy. For 2025, MedPAC recommended updating Medicare’s base payment rate for physicians by the amount specified in current law plus 50% of the projected increase in the Medicare Economic Index. The commission also recommended that Congress […]
Washington E-Newsletter
Last updated: May 9, 2024
On Feb. 21, the AANS and the CNS joined the American Medical Association in writing a letter to convey ongoing concerns with the Department of Veterans Affairs (VA) effort to develop National Standards of Practice (NSP) through the Federal Supremacy Project. The letter urged the VA to address flaws in the NSP development process, including […]
Washington E-Newsletter
Last updated: May 9, 2024
On March 18, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) published an “impact brief” highlighting the OIG’s work on Medicare Advantage (MA) plan prior authorization issues. The report notes that MA organizations deny over one million prior authorization requests yearly. In 2019, an estimated 13% were for services […]
Washington E-Newsletter
Last updated: May 9, 2024
On March 26, the Centers for Medicare & Medicaid Services Office of Burden Reduction & Health Informatics hosted an information session on the agency’s prior authorization final rule. The recording (password: 5PAMV^vN) and slides from the information session are available online. To learn more about the final rule, visit the Federal Register and read the […]
Amicus Brief
Last updated: June 10, 2024
Case No. 23-40605 IN THE UNITED STATES COURT OF APPEALSFOR THE FIFTH CIRCUIT TEXAS MEDICAL ASSOCIATION; TYLER REGIONAL HOSPITAL, L.L.C.;DOCTOR ADAM CORLEY,Plaintiffs-Appellees/Cross-Appellants, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES; OFFICE OF PERSONNEL MANAGEMENT; UNITED STATES DEPARTMENT OF LABOR; UNITED STATES DEPARTMENT OF TREASURY; XAVIER BECERRA, SEC’Y, U.S. DEP’T OF HEALTH AND HUMAN SERVS.; KIRAN […]
Comment Letter
Last updated: June 10, 2024
Submitted electronically to EdandWorkforceRFI@mail.house.gov RE: Reforms to Increase Affordability and Quality in Employer-Sponsored Health Coverage Dear Chairwoman Foxx, Ranking Member Scott, and members of the House Committee on Education and Workforce: The Alliance of Specialty Medicine (Alliance) represents more than 100,000 specialty physicians and surgeons across 16 specialty and subspecialty societies. The Alliance is deeply […]
Comment Letter
Last updated: June 10, 2024
Dear Senate Majority Leader Schumer, Minority Leader McConnell, and Speaker Johnson, and House Minority Leader Jeffries: Thank you for your ongoing leadership in ensuring access to health care delivered virtually, and for your commitment to considering permanent telehealth policies. We write today to urge Congress to make permanent important telehealth flexibilities well in advance of […]
Letter of Support
Last updated: June 10, 2024
Subject: Support for the No Fees for EFTs Act Dear Representatives Murphy, Griffith, Bera, Miller-Meeks, Kilmer, and Schrier, On behalf of the Regulatory Relief Coalition (RRC), a coalition of national physician specialty organizationsseeking to reduce regulatory burdens that interfere with patient care, we are pleased to support the No Fees forEFTs Act (H.R. 6487). The […]
Comment Letter
Last updated: June 10, 2024
Subject: Support for the No Fees for EFTs Act Dear Senators Cassidy and Cantwell, On behalf of the Regulatory Relief Coalition (RRC), a coalition of national physician specialty organizations seeking to reduce regulatory burdens that interfere with patient care, we are pleased to support the No Fees for EFTs Act (S. 3805). The RRC applauds […]
Comment Letter
Last updated: June 10, 2024
Dear Speaker Johnson, Leader Schumer, Leader McConnell, and Leader Jeffries: The undersigned national medical organizations and state medical societies write to strongly urge Congress to quickly pass legislation to reverse the 3.37 percent Medicare physician payment cuts that took effect on January 1, 2024. Failure to reverse these cuts will be harmful to the continued […]
Comment Letter
Last updated: June 10, 2024
Re: Medicare Physician Payment Cuts Dear Speaker Johnson, Majority Leader Schumer, and Minority Leaders Jeffries and McConnell: The Alliance of Specialty Medicine represents more than 100,000 specialty physicians and is deeply committed to improving access to specialty medical care through the advancement of sound health policy. The Alliance urges Congress to take immediate steps to […]
Comment Letter
Last updated: June 10, 2024
Ms. Chiquita Brooks-LaSure, AdministratorCenters for Medicare & Medicaid ServicesDepartment of Health and Human ServicesAttention: CMS-9895-PMail Stop C4-26-057500 Security BoulevardBaltimore, MD 21244-1850 Submitted electronically via regulations.gov Re: Notice of Benefit and Payment Parameters for 2025 Dear Administrator Brooks-LaSure: The Alliance of Specialty Medicine (the “Alliance”) represents more than 100,000 specialty physicians from 16 specialty and subspecialty […]
Comment Letter
Last updated: June 10, 2024
Filed Electronically The Honorable Chiquita Brooks-LaSureAdministratorCenters for Medicare and Medicaid Services200 Independence Avenue, S.W.Washington, DC 20201 Re: [CMS-4205-P]; RIN 0938-AV24; Medicare Program; Contract Year 2025 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Health Information Technology Standards […]
Congressional Testimony
Last updated: June 10, 2024
Dear Leader Schumer, Leader McConnell, Speaker Johnson, and Leader Jeffries: We write today as a bipartisan group of lawmakers urging you to act quickly to prevent a 3.37% cut to Medicare reimbursement payments that will occur on January 1, 2024. We in Congress must continue our partnership with the physician and provider community to ensure […]
Comment Letter
Last updated: June 10, 2024
Via email: don_liss@horizonblue.com SUBJECT: Horizon Blue Cross Blue Shield of New Jersey Distinct Procedural Service Modifiers (59, XE, XP, XS, XU) Medical Policy Number 0016 “Back Pain – Invasive Procedures” Dear Drs. Liss and Berman: On behalf of the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS) and the AANS/CNS Joint […]
