AAN Keeps Fighting on NCS/EMG Cuts

January 23, 2013

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Catherine M. Rydell

AAN Leadership Update

Catherine M. Rydell, Executive Director & CEO
January 2013

While some have the perception that the AAN was "asleep at the switch" regarding the NCS/EMG coding changes, nothing could be further from the truth. We worked all angles to assure that the long–standing RUC process would develop the best possible outcome on NCS/EMG and IOM codes presented to CMS. This has been a three–year process. While historically CMS has accepted the vast majority of RUC recommendations, in this case they did not. The new codes were published in the Federal Register on November 1, 2012, without an opportunity for the AAN to provide input to the drastic changes before publication. The Academy absolutely recognizes the decreases in nerve conduction and EMG reimbursement and the anticipated impact on patient access and quality of care as a crisis facing neurology practices. The day the codes were made public the AAN intensified its campaign to engage CMS, Congress, and our members on this radical change. Board leadership and key AAN committees recently met jointly to amplify our efforts in advocacy, education, and practice management guidance. As always, contact me if you have any questions or comments.

–Cathy

We’re Fighting for You:

  • The AAN recently met with CMS Director of Medicare Jonathan Blum. AAN President Bruce Sigsbee, MD, FAAN; AAN RUC Representative Marc Raphaelson, MD, and Government Relations Committee Chair Elaine C. Jones, MD, FAAN, as well as partners from AANEM and AAPM&R advocated for changes for 2014
  • More than 130 members sent comment letters to CMS
  • More than 700 members contacted Congress in support of a letter for Congress to send to CMS and AAN staff are meeting with congressional offices
  • AAN delivered the congressional sign–on letter to HHS in December

We’re Helping You Navigate Coding Changes:

What You Can Do:

  • Contact your members of Congress and let them know how this is affecting you
  • Respond to AAN Action Alert requests
  • Apply today to help make our case in Washington at the 2013 Neurology on the Hill—the deadline is Monday, January 21
  • Sign up to participate in RUC surveys

Executive Administration

  • The AAN Nomination Committee, chaired by former president Stephen M. Sergay, MB BCh, FAAN, has announced the slate of nominees for AAN officer and director positions for the 2013–2015 term. The slate will be presented to the voting membership for approval during the 2013 AAN Business Meeting on Monday, March 18, 2013, at 8:00 a.m. in Room 23 ABC at the Annual Meeting in San Diego.
  • The AAN was mentioned by Vice President Joe Biden in this clip, which also aired on CNN, regarding medical organizations his task force met with on gun control. He calls the AAN a “leading organization,” along with the American Academy of Pediatrics and others. AAN President Bruce Sigsbee, MD, FAAN, represented the AAN at the meeting in Washington, DC.

Medical Economics

  • New and revised 2013 CPT codes are now in effect for several neurology services, including nerve conduction studies. Based on feedback received from private insurers, the AAN urges members to check with each of their contracted payers regarding payer–specific coding instructions and updates to related coverage policies. At least one national private payer has indicated to the AAN that it will provide reimbursement for neurologists who report any of several new codes that describe transitional care management and complex chronic care coordination services.

Advocacy

  • Congress passed a one–year fix to the SGR that freezes physician Medicare payments at current levels.
  • The VA has approved $6 million in funding for the Epilepsy Centers of Excellence. At the AAN’s request, Rep. Ed Perlmutter (D–CO) drafted a letter in October 2012 signed by 43 members of Congress asking the VA to continue funding the Centers, which may have closed when congressional authorization was scheduled to “sunset” in October 2013.
  • Thanks to the efforts of AAN member and Palatucci Advocacy Leadership Forum graduate Marianna Spanaki, MD, PhD, MBA, Gov. Rick Snyder of Michigan recently signed legislation allowing physicians to warn third parties regarding a patient’s mental and physical qualifications to operate a motor vehicle and providing the physician with legal immunity.

Membership

  • Job applications through the Neurology Career Center increased by 29 percent in 2012 over 2011, while overall views of job listings in the Career Center were up 61 percent in 2012 over 2011.

Clinical Practice

  • The recent Physician Fee Schedule final rule included several AAN–developed measures for neurologic conditions as part of the 2013 Physician Quality Reporting System measure list including measures for stroke, epilepsy, Parkinson’s disease, and dementia. One cognitive assessment for dementia is also included in the clinical quality measure list for Meaningful Use 2.
  • The epilepsy measure “Women of childbearing potential who were counseled about epilepsy and how its treatment may affect contraception and pregnancy” developed by the AAN is expected to receive final National Quality Forum (NQF) endorsement by March 2013. Of the 18 AAN measures reviewed by the NQF, this is the only one to pass the NQF Neurology Steering Committee approval for endorsement.

Annual Meeting

  • The early registration deadline of February 20 is approaching fast. The 2013 Scientific Abstract Listing and Annual Meeting Information will be available at the end of January.
  • The 2013 Patient Safety Colloquium will focus on the three stages of medical error: prevention, immediate aftermath, and long–term effects. It will feature a guest presentation by a medical–legal expert from Thomas Jefferson School of Law.
  • Four Electronic Health Record (EHR) User Group meetings will be conducted at the 2013 Annual Meeting. Epic, eClinicalWorks, Integrity, and AthenaHealth EHR users are encouraged to attend their respective User Group meeting to provide feedback, learn best practices, and network with neurologists who use the same EHR software.
  • The Annual Meeting mobile application will be live at the end of January on iOS (iPhone®/iPad®) and Android® platforms in addition to a mobile website version. At launch, the application will allow attendees to browse the program, search the abstracts, access full abstract content, and begin connecting with other attendees. In early March, the app will be updated to allow attendees to customize their itinerary, access program materials including syllabi and presentation slides, submit program evaluations, and more.

Science

  • The topics and speakers have been identified for the 2013 Hot Topics Plenary Session. The speakers are John Hardy, MD; John Q. Trojanowski, MD, PhD; David B. Clifford, MD, FAAN; and Michelle Monje, MD, PhD. The topics include genetics of protection and risk in Alzheimer’s disease, degenerative brain diseases of templating (prion disease), fungal meningitis outbreak, and effects of cranial radiation on stem cell memory.
  • The Science Committee approved the concept of a Moderated Platform Session for the 2013 Annual Meeting. The new session will take place on Wednesday, March 20, 4:00 p.m.–5:30 p.m. Special closing discussions will follow abstract presentations to contextualize the findings and demonstrate how to take basic scientific research and apply it clinical practice.
  • Approximately 2,300 abstracts were accepted for this year's meeting. All 2013 Annual Meeting abstract authors that were accepted have been notified. All the 2013 Annual Meeting abstracts will be available online on January 16 at 3:00 p.m. CT.

Education

  • The Education Committee met January 11 to 12 to discuss strategic planning aspects of its educational resources and Learning Across Your Lifetime. A joint session was held with the Executive Committee on Sections to brainstorm opportunities for education initiatives for Sections and special interest groups.
  • At its December meeting, the Science Committee discussed ways to bring science to the regional meetings. The Education and Science committees will investigate the options.

Public Outreach

Publications

  • The January 1 issue debuted the new face of Neurology®. Going forward, the cover will showcase an image from an article within the issue or a submission to the Visions section. The new design will set each issue apart and transfer well to electronic media, such as the iPad®.

American Brain Foundation

  • A nationwide campaign reminding the public to enter the 2013 Neuro Film Festival was launched this month. The deadline is January 31. Public voting will begin in early February.
  • Registration is now underway for the Brain Health Fair, Saturday, March 16, in San Diego. Patients, families, and friends are encouraged to register in advance at BrainHealthFair.com.

Development

  • The American Brain Foundation staff giving campaign raised more than $42,000, with 93 percent of staff participating in the campaign.

Dates and Deadlines

Application Deadline: 2013 Neurology on the Hill
January 21

Application Deadline: 2014 A.B. Baker Award for Lifetime Achievement in Neurologic Education
January 31

Webinar: Correcting Common Mistakes in ICD, E/M, and CPT Coding
February 5

Annual Meeting Housing Deadline
February 12

Annual Meeting Early Registration Deadline
February 20