By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506–7468, email@example.com
Reps. Peter Roskam (R–IL) and Dutch Ruppersberger (D–MD) have drafted a letter asking Department of Health & Human Services Secretary Kathleen Sebelius to reconsider the Center for Medicaid and Medicare Services drastic cuts to needle EMG and nerve conduction studies.
The letter is the result of a campaign we have waged in Washington over the last two weeks to raise awareness among members of Congress of the impending cuts, how they will impact patients, and how the process gave AAN and others no opportunity for notice and comment. A second letter signed by over 140 organizations has also been sent to key house committee leaders raising awareness of this issue.
Several patients groups, including the ALS Association and Parkinson’s Action Network, have joined our effort to encourage members of Congress to sign on to letter prior to December 14, when it will be sent to Secretary Sebelius.
You should have received an Action Alert from AAN on the evening of December 5. We have less than a week to get as many House members on the letter as possible. If you haven’t sent your message to your representative yet, please do so as soon as possible as the letter will close on Friday, December 14.
Unfortunately, the only progress made was a suggestion by CMS to pursue a CMS Review Panel, but even success there wouldn’t affect the cuts until 2014.
We are working to schedule meetings with higher level CMS staff.
The AAN held a webinar on December 4 to discuss the CMS decision to slash reimbursement. Almost 1,000 AAN members called into the meeting. If you weren’t able to make it, please watch a replay here.
Unfortunately, the Congressional Budget Office revised its cost analysis of the SGR fix, putting it at $25 billion. This means that Congress will have to find $25 billion to offset the cost, which is a significant increase over the $11 billion that it had called for in its last analysis.
One of the “pay–fors” is certain to be the same one used for the last fix, which is to create parity between the Medicare payments for evaluation and management (E/M) services provided by physicians and by hospital outpatient services. Needless to say, hospitals are again upset, but they have a hard time explaining why they should be paid more for providing identical services.
Another potential pay–for is a provision yet to be implemented in Obamacare that will pay Medicaid providers Medicare rates for 2013–2014. Medicare typically pays one–third more than Medicaid. In another example of the absurdity of the effort to improve the practice climate for primary care providers but not include cognitive physicians like neurologists, CMS declared that the Medicaid provision would apply to all internal medicine subspecialists. This, of course, continues to leave out neurologists.
It also leaves out patients. A physician for a child with juvenile diabetes will qualify. A physician for a child with epilepsy won’t.
We have sent a letter to CMS objecting to the exclusion of neurologists, but this is a problem with the health care bill. We are strongly considering asking that legislation be introduced in the next Congress to right this error. It is only a two–year program, but it is sure to get interest in renewal so an early start could help us with the entire cognitive care question.
We have also been assured by our follow medical specialties like the American College of Physicians that they will support our efforts, just as they have in supporting the elimination of the list of eligible specialties for improved E/M payments in the HR 5707 that was introduced by Reps. Allyson Schwartz (D–PA) and Joe Heck, DO (R–NV).
It is pretty clear that we will be fighting these same issues in 2013, so how about joining your colleagues at Neurology on the Hill? The application process is open now, so put your name in and come bring your stories to your members of Congress.
Disclaimer: The opinions expressed in this posting are those of the author only and do not represent the views of the American Academy of Neurology or any of its affiliated subsidiaries.
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