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On April 14, 2015, Congress repealed the sustainable growth rate (SGR) formula.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 10, 2024
Dear Secretary Becerra and Administrator Brooks-LaSure: We write to thank the U.S. Centers for Medicare & Medicaid Services (CMS) for taking action toward ensuring timely access to health care by proposing rules to streamline prior authorization (PA) protocols for individuals enrolled in federally-sponsored health insurance programs, including Medicare Advantage (MA) plans.1, 2, 3 We urge […]
Comment Letter
Last updated: June 10, 2024
Dear Secretary Becerra and Administrator Brooks-LaSure: We write to thank the U.S. Centers for Medicare & Medicaid Services (CMS) for taking action toward ensuring timely access to health care by proposing rules to streamline prior authorization (PA) protocols for individuals enrolled in federally-sponsored health insurance programs, including Medicare Advantage (MA) plans.123 We urge CMS to […]
Position Statement
Last updated: June 11, 2024
Surgical Coalition’s Plan for Reforming the Medicare Physician Payment System The Centers for Medicare & Medicaid Services (CMS) continues to put forth annual regulations that exacerbate the underlying problems within the broken Medicare physician payment system. Furthermore, these policies negatively impact the ability of physician practices to invest in quality improvement efforts to benefit Medicare […]
Letter of Support
Last updated: June 11, 2024
Dear Chair Smith and Ranking Member Neal: Thank you for your ongoing leadership on expanding access to virtual care and for your commitment to considering a pathway for permanent policy around telehealth beyond the COVID-19 public health emergency. We appreciate that the Committee is bringing the Telehealth Expansion Act of 2023 (H.R.1843/S. 1001) forward as […]
Comment Letter
Last updated: June 10, 2024
Dear Chairpersons Smith and McMorris Rodgers and Ranking Members Neal and Pallone: The undersigned medical professional organizations write to you in strong opposition to H.R. 2713, the “Improving Care and Access to Nurses Act,” or the “I CAN Act.” This legislation would endanger the quality of care that Medicare and Medicaid patients receive by expanding […]
Comment Letter
Last updated: June 10, 2024
Dear Chairman Blumenthal and Ranking Member Johnson, We write today to thank you for holding your May 17 hearing titled “Examining Health Care Denials and Delays in Medicare Advantage” and to urge you to continue your oversight of Medicare Advantage plans, particularly regarding their use of prior authorization and other utilization management tools that inappropriately […]
Comment Letter
Last updated: June 11, 2024
John G. Finkenberg, MD, PresidentNorth American Spine Society7075 Veterans Blvd.Burr Ridge, IL 60527 SUBJECT: NASS Cervical Laminectomy and Laminoplasty Draft Coverage Policy Dear Dr. Finkenberg: On behalf of the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS) and the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves (DSPN), […]
Comment Letter
Last updated: June 10, 2024
Subject: Delays and Denials in Medicare Advantage Plans Dear Chairs Blumenthal and Peters and Ranking Members Johnson and Paul: As the Alliance of Specialty Medicine (Alliance), a coalition of 16 medical specialty societies representing more than 100,000 physicians and surgeons, our mission is to advocate for sound federal health care policy that fosters patient access […]
Comment Letter
Last updated: June 10, 2024
Dear Senators Murkowski, Hassan, Marshall, and Rosen: Thank you for your leadership of S. 652, the Safe Step Act, legislation that would create guardrails for patients subjected to step therapy protocols. The 60 undersigned medical organizations write to share our endorsement of this timely legislation, communicate how this bill will benefit our patients and our […]
Letter of Support
Last updated: June 11, 2024
Re: Support of H.R. 2474, the Strengthening Medicare for Patients and Providers Act Dear Representatives Ruiz, Bucshon, Bera, and Miller-Meeks: As patient and physician advocates, the Alliance of Specialty Medicine (Alliance) writes in support of your legislation, H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which would provide an annual inflationary update for […]
Letter of Support
Last updated: June 10, 2024
RE: Support for S. 652, the Safe Step Act Dear Senators Murkowski, Hassan, Marshall, and Rosen: As patient and physician advocates, the Alliance of Specialty Medicine (Alliance) writes in support of your legislation, S. 652, the Safe Step Act, which would provide patients and providers with a clear and transparent appeals process when subject to […]
Letter of Support
Last updated: June 10, 2024
RE: Support for H.R. 2630, the Safe Step Act Dear Representatives Wenstrup and Ruiz: As patient and physician advocates, the Alliance of Specialty Medicine (Alliance) writes in support of your legislation, H.R. 2630, the Safe Step Act, which would provide patients and providers with a clear and transparent appeals process when subject to step therapy […]
Letter of Support
Last updated: June 11, 2024
Dear Representatives Ruiz, Bucshon, Bera and Miller-Meeks: On behalf of the undersigned physician and non-physician organizations, representing more than one million clinicians and the patients they serve, thank you for introducing H.R. 2474, the Strengthening Medicare for Patients and Providers Act. The legislation applies a permanent inflation-based update to the Medicare Physician Fee Schedule (MPFS) […]
Letter of Support
Last updated: June 11, 2024
Dear Representatives Ruiz, Bucshon, Bera, and Miller-Meeks: The undersigned national physician specialty societies and state medical associations commend you for introducing H.R. 2474, the Strengthening Medicare for Patients and Providers Act. This bipartisan legislation advances the ongoing need to provide financial stability to physician practices in order to preserve access to care for Medicare beneficiaries. […]
Comment Letter
Last updated: June 11, 2024
David CordaniChairman and Chief Executive OfficerThe Cigna Group900 Cottage Grove RoadBloomfield, CT 06002 Dear Mr. Cordani: On behalf of the undersigned organizations representing physicians and health care professionals across the country, we request that Cigna immediately rescind its policy requiring submission of office notes with all claims including evaluation and management (E/M) Current Procedural Terminology […]
Comment Letter
Last updated: June 11, 2024
David E. Mino, MD, MBASenior Medical DirectorCigna Healthcare, Clinical Performance and QualityNational Medical Director, Orthopaedic Surgery and Spinal Disorders150 S. Warner Ave, #310King of Prussia, PA 19406 SUBJECT: Cigna Coverage Policy for Intraoperative Neurophysiologic Monitoring #0509 Dear Dr. Mino: On behalf of the American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons (CNS) […]
Comment Letter
Last updated: June 11, 2024
Dear Speaker McCarthy, Majority Leader Schumer, Minority Leader McConnell, and Minority Leader Jeffries: On behalf of the American Medical Association (AMA) and the undersigned organizations representing the vast majority of physicians practicing in the United States, we urge Congress to provide physicians with much needed fiscal stability by passing legislation that provides an annual inflation-based […]
Letter of Support
Last updated: June 10, 2024
Chiquita Brooks-LaSureAdministratorCenters for Medicare & Medicaid ServicesDepartment of Health and Human ServicesAttention: CMS-0057-PP.O. Box 8016Baltimore, MD 21244-8016 RE: Advancing Interoperability and Improving Prior Authorization Processes for Medicare Advantage Organizations, Medicaid Managed Care Plans, State Medicaid Agencies, Children’s Health Insurance Program (CHIP) Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally-facilitated […]
Comment Letter
Last updated: June 10, 2024
Filed Electronically Chiquita Brooks-LaSureCMS Administrator200 Independence Avenue, SWWashington DC Re: Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, Medicare Parts A, B, C, and D Overpayment Provisions of the Affordable Care Act and Programs of All-Inclusive Care for the Elderly; […]
Comment Letter
Last updated: June 10, 2024
Chiquita Brooks-LaSureAdministratorCenters for Medicare & Medicaid ServicesDepartment of Health and Human ServicesAttention: CMS-4201-PP.O. Box 8016Baltimore, MD 21244-8016 RE: Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, Medicare Parts A, B, C, and D Overpayment Provisions of the Affordable Care Act […]
Comment Letter
Last updated: June 10, 2024
The Honorable Chiquita Brooks-LaSureAdministratorCenters for Medicare & Medicaid ServicesU.S. Department of Health and Human ServicesHubert H. Humphrey Building, Room 445–G200 Independence Avenue, SWWashington, DC 20201 Dear Administrator Brooks-LaSure: On behalf of the undersigned organizations representing physicians across the country, we thank you for listening to our concerns, as well as those of our patients, and […]
Comment Letter
Last updated: June 11, 2024
Tamara Syrek Jensen, DirectorJoseph Chin, MD, Deputy DirectorCoverage and Analysis GroupCenters for Medicare & Medicaid Services7500 Security Blvd.Baltimore, Maryland 21244 SUBJECT: Request for Reconsideration of CMS National Coverage Determination (NCD) 20.7: Percutaneous Transluminal Angioplasty (PTA) Dear Ms. Syrek Jensen and Dr. Chin: On behalf of the American Association of Neurological Surgeons (AANS), the Congress of […]
Comment Letter
Last updated: June 10, 2024
Chiquita Brooks-LaSureAdministratorCenters for Medicare & Medicaid ServicesDepartment of Health and Human ServicesAttention: CMS-9899-PP.O. Box 8016Baltimore, MD 21244-8016 RE: Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2024 Dear Administrator Brooks-LaSure, The Alliance of Specialty Medicine (the “Alliance”), representing more than 100,000 specialty physicians from sixteen specialty and subspecialty societies, […]
Comment Letter
Last updated: June 11, 2024
Dear Senator/Representative, On behalf of the undersigned physician and non-physician organizations, representing more than one million clinicians and the patients they serve, welcome to the 118th Congress. Our combined memberships represent a significant portion of the clinicians in this nation, and we remain committed to ensuring America’s seniors have access to high-quality care. Reforming the […]
Comment Letter
Last updated: June 11, 2024
Dear Congressional Leadership: On behalf of the undersigned organizations representing surgeons and anesthesiologists, we are extremely disappointed in the language related to Medicare physician payment included in the omnibus bill that was released early this morning. The decision by congressional leadership to allow Medicare to cut physicians’ payment will further exacerbate the significant financial hardships […]
