Public Insurer Relations
(Center for Medicare & Medicaid Services – CMS)

• Medicare Physician Fee Schedule (MPFS) (Show +) Medicare Physician Fee Schedule (MPFS) (Hide -)
  • AAN Comments: Proposed 2012 MPFS (.pdf)
  • Final 2012 Physician Fee Schedule Released with Changes Requested by AAN (November 2011)
  • CMS Releases Annual Physician Fee Schedule (July 2011)
  • AAN Comments: Proposed 2011 MPFS (.pdf)
  • CMS Doesn't Budge on Consults in Final 2011 Physician Fee Schedule
  • AAN Sounds off to CMS about Consult Codes as Part of Proposed 2011 MPFS Comments
  • AAN Summary and Analysis: 2011 Medicare Physician Payment Proposed Rule
  • 2011 MPFS FAQ Document(.pdf)
  • AAN Comments: Proposed 2010 MPFS (.pdf)
  • Academy Works to Defend Neurology by Opposing New Medicare Practice Expense Bill
  • AAN Comments: Proposed 2009 MPFS (.pdf)
• 2013 Medicare Fee Schedule RVU and Dollar Values for Neurology Codes (.pdf)
• AAN's Participation in AMA Current Procedural Terminology (CPT) Coding Efforts
• View AAN Advocacy Efforts Surrounding Medicare Payment

The Center for Medicare and Medicaid Innovation, or the 'CMS Innovation Center', is a body within the Department of Health and Human Services (HHS) charged with testing innovations in payment and care delivery to improve the quality and lower costs of care for Medicare, Medicaid, and Children's Health Insurance Program (CHIP) beneficiaries.

The Innovation Center was created by Congress under the Affordable Care Act. The Center's mandate provides $10 billion in direct funding in fiscal years 2011 through 2019 to evaluate innovative payment and delivery models that reduce expenditures, while enhancing the quality of care.

The following is a list of current CMI initiatives:

• Partnership for Patients (Patients Safety, Community-based transitions)
• ACOs( Pioneer, Advanced Payment)
• Comprehensive Primary Care Initiative
• Bundled Payments for Care
• Financial Models to support State Efforts to coordinate Care for Dual Enrollees
• Demonstration to Improve Quality of Care for Nursing Facility Residents
• Healthcare Innovation Challenge (to develop new models)
• Million Hearts Campaign
• Innovation Advisors Program

The AAN reached out to Richard J. Gilfillan, MD, the Acting Director of the Innovation Center, who asked the AAN to propose two ideas for the Innovation Center to consider — one aimed at bending the cost curve and reducing variation in stroke care and another addressing Alzheimer's care.

The Academy developed a model of care for Alzheimer's disease that reflects the role of the neurologists amid a team-based approach that would facilitate better coordination of care between providers in multiple settings for not only patients, but highlights the importance of caregiver support as well. Combined with other approaches, the model suggests that payments be made for existing care coordination codes.

Read the Alzheimer's idea. (.pdf)

Read the AAN comment letter on the draft National Plan To Address Alzheimer's Disease. (.pdf)

The Academy also developed a model of for stroke care. The proposed innovations encourage coordinated stroke care services, including strengthening the role of the neurologist in the diagnosis of stroke and initiation of appropriate therapy based on implementation of decision support tools.

Read the stroke idea. (.pdf)

Visit the CMI home page.

• Physician Quality Reporting System (PQRS)
• AAN Quality Measures Page

• Identify my Part A/B Medicare Administrative Contractor (MAC) (.pdf)
• Provider Enrollment, Chain, and Ownership System (PECOS) (Show +) Provider Enrollment, Chain, and Ownership System (PECOS) (Hide -)
  • Don't Forget to Enroll in PECOS by January 3, 2011!
  • List of Referring and Ordering Physicians in PECOS is now Available Online
  • EHR Incentive Program Requires PECOS Enrollment
  • CMS Pushes Date By Which All Physicians Who Refer or Order Must be Enrolled in PECOS to January 3, 2011
  • Academy Urges CMS to Push Back PECOS Enrollment Date
  • Medicare Enrollment Update for Referring Ordering Physicians: PECOS
  • Communicating Issues in the Medicare Enrollment Process
  • Find Additional Resources on CMS's PECOS page
• Participation/Non-Participation/Private Contracting (Show +) Participation/Non-Participation/Private Contracting (Hide -)
  • Know Your Medicare Participation Options
  • CMS Releases Enrollment Guidance for Physicians that Infrequently Receive Reimbursement from the Medicare Program
  • Tips to Facilitate the Medicare Enrollment Process (.pdf)
• Current Medicare Contractor Provider Satisfaction Survey (MCPSS)

• Recovery Audit Contractors (RACs) (Show +) Recovery Audit Contractors (RACs) (Hide -)
  • Learn About RACs (.pdf)
  • Find my RAC
  • Paperwork, Timing are Essential when Appealing RAC Audit (May 2010, page 7, .pdf)
  • Must-Have Information to Prepare for Possible RAC Audit (April 2010, page 12, .pdf)
  • RACs Become a Reality
  • Neurologists to Medicare: Modify Audit Program
• How to Perform a Physician Practice Internal Billing Audit (.pdf)
• How to Prepare for an Health Insurer Retrospective Audit (.pdf)

• How To Appeal a Medicare Claim Denial (.pdf)
• The Medicare Appeals Process: Five Levels to Protect Providers, Physicians, and Other Suppliers (.pdf)

• Neurology Carrier Advisory Committee (NeuroCAC) (Show +) Neurology Carrier Advisory Committee (NeuroCAC) (Hide -)
  • Find out who the NeuroCAC Representative is in your state
  • Q&A document about the NeuroCAC (.pdf)
  • Search and view carrier Local Coverage Determinations (LCDs)
  • Carrier Advisory Committee Needs Neurologists' Input (May 2009, page 5, .pdf)
• State Neurology Societies

• Red Flags Rule
• Stark Law – What Neurologists Need to Know
• CMS Resources (Show +) CMS Resources (Hide -)
  • Sign up to Receive Regular CMS Correspondence
  • Medicare Learning Network: CMS National Educational Products
  • National Provider Identifier (NPI) Registry
• Medicare Part D
• Independent Testing Facilities (IDTF) (.pdf)
• Lessons for Neurologists from Medicare QRUR
• AAN Comments on the Proposed 2013 Inpatient Prospective Payment System (IPPS) (.pdf)