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November 7, 2022

Latest Advocacy News

The 2023 Neurology on the Hill application is open! Join us in Washington, DC, March 5–7, to lay the groundwork for tomorrow’s successes. You don’t need a background in public policy, just passion for making a positive change! The application closes November 21.
On October 26, the AAN submitted comments in response to a Request for Information (RFI) released by the Centers for Medicare & Medicaid Services Office of Burden Reduction and Health Informatics seeking public input on access to health care and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency. Read the AAN’s comments, which provide recommendations related to provider burnout, telehealth, prior authorization burden, and more.
The AAN also submitted comments in response to a congressional RFI regarding strategies to stabilize the Medicare payment system. The comments highlighted several areas of MACRA that could be improved, including more timely MIPS data, the creation of more Advanced Alternative Payment Models (Advanced APMs) relevant to neurologists, and more regular review of evaluation and management (E/M) codes. Read the full letter containing our comments and requests.

Issue in Focus

On November 1, 2022, CMS issued a final rule updating payment policies and rates for physicians paid under the Medicare Physician Fee Schedule in 2023. The final rule illustrates the importance of the AAN’s regulatory advocacy efforts on behalf of neurologists and their patients. The AAN previously submitted 50 pages of detailed comments in response to the various proposals made by CMS in July.

Due to budget neutrality requirements, CMS is projecting that the overall impact of changes finalized in this rule will result in a -1 percent change in payments to neurology as a specialty broadly. The expiration of temporary pandemic-related relief measures at year-end has forced CMS to finalize a reduction in the fee schedule conversion factor of nearly 4.5 percent. The AAN is committed to payment reform efforts to promote a sustainable payment system and to working with regulators and legislators to ensure that CMS appropriately values the work done by neurologists. Working with Congress to avert the impending cuts before the end of the year will continue to be a top priority for the AAN. The AAN strongly urges you to tell your representatives to take action before the end of the year to prevent impending cuts.

Key policy changes impacting neurology include:

In a significant win for AAN advocacy, CMS is delaying implementation of a controversial change to split (or shared) billing requirements that could significantly disrupt neurologist-led team-based care practice patterns in facility settings to allow for further dialogue
New coding and payment structures for inpatient and other E/M services that are largely in alignment with AAN recommendations
Implementation of AAN recommendations relating to neuromuscular ultrasound and EEG
Continued inquiry into potential revaluation of the global surgical packages, which has been a long-held priority for the AAN
In alignment with our advocacy, CMS is implementing updates to telehealth policies to allow for critical flexibilities to remain in place for 151 days following the expiration of the COVID-19 public health emergency
Implementation of three new MIPS Value Pathways for neurologists beginning in 2023. The AAN actively engaged with CMS during the development process for these MVPs and provided the agency with feedback throughout.

To learn more about the 2023 Medicare Physician Fee Schedule Final Rule, please review the AAN’s full summary.

What We're Reading

Exposure to environmental toxins may be root of rise in neurological disorders (The Guardian)
Why daylight-saving time is worse for your body than standard time (The Washington Post)
Medicare Fines for High Hospital Readmissions Drop, But Nearly 2,300 Facilities Are Still Penalized (KHN)