Washington E-Newsletter

Neurosurgery Responds to RFI on Medicare Payment and Quality Program Improvements

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.