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Capitol HIll report: AAN PRESSES CMS ON PROPOSED E/M CHANGES

October 12, 2020

AAN presses cms on proposed e/m changes

Recommendations Made to Support Fee Schedule Changes

On September 23, the AAN submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the 2021 Medicare Physician Fee Schedule Proposed Rule. In 2021, CMS expects payments across the specialty of neurology to increase by six percent with variations depending on the individual provider’s practice. The AAN’s comments urged the agency to move forward with its planned implementation of a new coding and payment structure for evaluation and management services (E/M), without modification or delay, and offered a number of recommendations to the agency on key provisions of the agency’s E/M policies. The AAN also submitted robust comments on the telehealth provisions of the proposed rule, recommending that the agency permanently implement changes to promote expanded access to telehealth services. Specifically, the AAN calls on the agency to permanently add a number of services to the Medicare telehealth list, provide coverage for audio-only telephone E/M services, ease restrictions on other communication technology-based services, and make modifications to several other restrictions on the provision of telehealth services. The comments also provide the agency with experiential feedback from neurologists from across the country on the use of telehealth services both before and during the COVID-19 public health emergency and provide an overview of the developing literature surrounding the benefits of telehealth. The comments also addressed other key changes including annual updates to the Quality Payment program. You can read AAN President, Dr. James Stevens’ recent op-ed on the importance of the E/M changes here.

 

Academy Raises Opposition to Expansion of PA Requirements

Additionally, on October 1, the AAN submitted comments in response to the 2021 Hospital Outpatient Prospective Payment System proposed rule. The comments oppose a recent expansion of prior authorization (PA) requirements for botulinum toxin injections within the Medicare program. The AAN’s comments also offered recommendations for alternative solutions that do not impose burdensome PA requirements on providers. The AAN has previously met with CMS to raise our concerns with the new requirements and offer evidence contradicting the need for additional PAs.

 

Other Advocacy Updates

  • President Trump signed into law a continuing resolution (CR) which extends FY 2020 government funding levels through December 11. The CR does not include additional funds for NIH but does include language allowing NIH to provide no-cost extensions to specific grants available for obligation through FY 2015 and set to expire on September 30, 2020. The CR also extends the deadline to repay loans from the Medicare Advance and Accelerated Payments program. The AAN continues to advocate for neurology research funding priorities for FY 2021.
  • The AAN joined an open letter led by the Alliance for Aging Research urging federal health care agencies to prioritize science over politics in response to COVID-19. The AAN also joined a letter led by the Infectious Diseases Society of America to the FDA regarding COVID-19 vaccine safety.
  • The House Oversight and Government Reform Committee continued its 18-month drug pricing probe with two days of hearings including testimony from six large pharmaceutical companies. Teva’s multiple sclerosis therapy, Copaxone, and Mallinckrodt’s recently acquired inflammation drug, ActharGel, were targeted for their rapidly increasing prices and the connection to higher revenue levels in recent years. The AAN continues to follow the drug pricing battle on Capitol Hill and advocate for patient access to lifesaving therapies that should not be negatively impacted by the exorbitant cost of drugs.
  • Did you know that physicians have historically voted at a lower rate than the rest of the population? VoteHealth 2020 is a nonpartisan group encouraging physicians and other health care professionals to make sure they are registered to vote and do so in the 2020 elections.