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Comment Letter

Neurosurgery Urges CMS to Eliminate Unnecessary Add-on Code Driving Medicare Pay Cuts

Chiquita Brooks-LaSure, MPPAdministrator Centers for Medicare & Medicaid Services  Attention: CMS-1784-PP.O. Box 8016Baltimore, MD 21244-8016 RE: Medicare and Medicaid Programs; CY 2024 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Advantage; Medicare and Medicaid Provider and Supplier Enrollment Policies; and Basic Health […]
  • Reimbursement and Practice Management
Comment Letter

Neurosurgery Leads Effort to Rescind Edit for Spinal Decompression Codes

Pamela Villanyi, MD, Medical OfficerCenters for Medicare & Medicaid ServicesCMS NCCI Program TeamAudits and Vulnerabilities GroupCenter for Program Integrity7500 Security BoulevardBaltimore, MD 21244-1850Pamela.villanyi@cms.hhs.gov Submitted electronically via NCCIPTPMUE@cms.hhs.gov SUBJECT: NCCI PTP Edits for Column 1 CPT codes 22630, 22632, 22633 and 22634 with Column 2 CPT codes 63052 and 63053 Dear Dr. Villanyi: On behalf of […]
  • Reimbursement and Practice Management
Washington E-Newsletter

Neurosurgeon Pens Op-Ed on Misuse of Prior Authorization

On May 16, The Lincoln Star published an op-ed titled “When Insurance Fails” by neurosurgeon Jeremy Hosein, MD. The op-ed discusses the misuse of prior authorization, which delays care, prolongs suffering and adds significant administrative costs to health care. According to Dr. Hosein, prior authorization is increasingly used to deny or delay basic medical care such as blood tests, imaging […]
Washington E-Newsletter

Legislation Introduced to Fund Additional GME Slots

The Resident Physician Shortage Reduction Act (S. 1302/H.R. 2389) has been reintroduced in the U.S. House and Senate. Sponsored by Sens. Robert Menendez (D-N.J.), John Boozman, OD, (R-Ark.), Charles E. Schumer (D-N.Y.) and Susan Collins (R-Maine) in the Senate, and Reps. Terri A. Sewell (D-Ala.) and Brian Fitzpatrick (R-Pa.) in the House, this neurosurgery-endorsed legislation would provide 14,000 new Medicare graduate medical education (GME) slots over […]
Washington E-Newsletter

Congress Urges CMS to Finalize Prior Authorization Rules

Nearly 300 bipartisan members of Congress signed letters urging the Centers for Medicare & Medicaid Services (CMS) to finalize proposed regulations to increase transparency, streamline and standardize prior authorization (PA) in the Medicare Advantage (MA) program. Sixty-one senators and 233 members of the House of Representatives signed the letters to U.S. Department of Health and Human Services Secretary Xavier Becerra and CMS Administrator Chiquita […]
Washington E-Newsletter

Congress Continues to Shine Light on Health Plan Abuses

On May 17, the Senate Homeland Security & Governmental Affairs Committee, Permanent Subcommittee on Investigations, chaired by Sen. Richard Blumenthal (D-Conn.), held a hearing on “Examining Health Care Denials and Delays in Medicare Advantage.” Among the witnesses was a widow whose husband had difficulty getting medically necessary treatment, despite the efforts of their neurosurgeon. The AANS and CNS submitted […]
Washington E-Newsletter

CMS Proposed Edit for Decompression Add-on Codes Rescinded

On June 23, staff for the Centers for Medicare & Medicaid Services (CMS) National Correct Coding Initiative (NCCI) reached out to the AANS and the CNS, stating that as of July 1, NCCI edits would be implemented that restrict the reporting of spinal fusion codes 22630, 22632, 22633 and 22634 with add-on decompression codes 63052 and 63053. […]
Washington E-Newsletter

AMA to Conduct Survey of Physician Practice Expenses

The American Medical Association (AMA) has contracted with Mathematica, an independent research company, to survey randomly selected physicians regarding practice expenses. Mathematica will contact the selected practices from July 2023 to April 2024. The AANS and the CNS urge members to complete the survey if contacted. The AMA Physician Practice Information Survey aims to understand better the […]
Washington E-Newsletter

AMA Launches Website to Fix Medicare Payment System

The American Medical Association recently launched fixmedicarenow.org, a one-stop-shop for all the information, resources and ways to make your voice heard to ensure that Congress works to address the critical issues physicians and their patients face due to the flawed Medicare physician payment system. Physicians are the only providers whose Medicare payments do not automatically receive […]
Washington E-Newsletter

AANS and CNS Urge Congress to Fund MISSION ZERO Program

On May 18, the AANS and the CNS submitted a statement to the Senate Subcommittee on Labor, Health and Human Services, Education, and Related Agencies asking for $11.5 million to fund the Military and Civilian Partnership for the Trauma Readiness Grant (MISSION ZERO) Program for Fiscal Year 2024. The MISSION ZERO program was signed into law in […]