On Oct. 31, the AANS and the CNS responded to the Request for Information issued by Reps. Ami Bera, MD, (D-Calif.); Larry Bucshon, MD, (R-Ind); Kim Schrier, MD, (D-Wash.); Michael Burgess, MD, (R-Texas); Earl Blumenauer (D-Ore.); Brad Wenstrup, DPM, (R-Ohio); Bradley Schneider (D-Ill.) and Mariannette Miller-Meeks, MD, (R-Iowa) seeking feedback on ways to improve the Medicare Access and CHIP Reauthorization Act (MACRA). The neurosurgical groups urged Congress to stabilize Medicare payments in the short term by:
- Preventing the scheduled 4.42% Medicare physician fee schedule cut by adopting H.R. 8800, the Supporting Medicare Providers Act;
- Providing an inflation update for at least 2023 based on the Medicare Economic Index;
- Waiving the 4% Statutory Pay-As-You-Go Act sequester cut; and
- Directing the Centers for Medicare & Medicaid Services (CMS) to adjust the post-operative portion of the 10- and 90-day global surgery codes to reflect recent increases in the office/outpatient evaluation and management visit codes.
Long-term solutions for reforming the system should incorporate a core set of principles — Characteristics of a Rational Medicare Physician Payment System — that the AANS and the CNS helped develop and fully support. Detailed actions Congress should take include:
- Adopting an annual inflationary update for Medicare physician services;
- Modifying Medicare’s budget neutrality requirements;
- Directing CMS to use the American Medical Association/Specialty Society RVS Update Committee to address any misvalued global surgery codes;
- Streamlining MACRA’s Quality Payment Program (QPP) and enhancing the use of clinician-led clinical data registries; and
- Repealing Medicare’s Appropriate Use Criteria (AUC) program for advanced diagnostic imaging and incorporating AUC into the QPP.
Click here to read the letter.
