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capitol hill report: CMS PROPOSES CHANGES TO TELEHEALTH, E/M, QPP, MORE

July 11, 2022

Latest Advocacy News

  • On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released the 2023 Medicare Physician Fee Schedule proposed rule. This proposed rule contains annual updates to Medicare policies impacting physician payment. Read the AAN’s full summary.
  • Key policy changes include:
    • In a significant win for AAN advocacy, CMS is proposing to delay policies impacting split (or shared) E/M visits that were set to go into effect on January 1, 2023, until January 1, 2024, to allow for further dialogue with stakeholders. The AAN has been leading efforts to modify policies impacting split (or shared visits) finalized in the 2022 Physician Fee Schedule that would detrimentally impact team-based care.
    • The agency is soliciting comments regarding strategies for improving global surgical package valuations. The AAN has long held concerns related to inappropriate valuations of these packages and the subsequent fiscal redistributions stemming from budget neutrality requirements.
    • In alignment with the AAN’s advocacy, CMS is implementing provisions of the Consolidated Appropriations Act of 2022 that extend certain critical telehealth flexibilities in place during the Covid-19 Public Health Emergency (PHE) for 151 days after the PHE ends.
    • A one-percent payment decrease, with variations depending on individual neurology practice due to budget neutrality requirements, and a 4.5 percent cut to the conversion factor, due to expiration of temporary relief measures. The AAN will continue its work with Congress to avert impending cuts.
    • Implementation of three new MIPS Value Pathways (MVPs), focused on stroke, episodic conditions, and neurodegenerative conditions, for neurologists beginning in 2023. These MVPs were developed in consultation with the AAN.
  • As prior authorization continues to pose challenges across the nation, the AAN works tirelessly to advocate for you. Join a panel of AAN members on August 3 from 6:00 p.m.–7:00 p.m. ET to learn more about their experiences dealing with prior authorizations and how the AAN is helping you. Our panel of experts includes Kavita Nair, PhD; Tyler Allison, MD; and Donald Shook, MBA.
  • The House Energy and Commerce Committee hosted a hearing on June 28 focused on oversight of Medicare Advantage plans, during which a prominent theme was the need to reform the prior authorization process. During the hearing, staff from the Department of Health and Human Services Office of Inspector testified about its recent report that found that a high number of inappropriate denials of services occur in Medicare Advantage.

Issue in Focus

All 12 appropriations packages have passed through the House Appropriations Committee and will head to the full House floor in the coming months. These bills include a significant number of AAN federal priorities, including:

  • NIH is funded for FY23 at $47.5 billion, an increase of $2.5 billion from FY22.
  • BRAIN Initiative is funded for FY23 at $620 million, maintaining level funding from FY22.
  • NINDS is funded at $2.883 billion, $222 million above FY22 funding.
  • Significant language promoting the Department of Veterans Affairs (VA) Neurology Centers of Excellence, including:
    • Headache Centers of Excellence are funded at least $15 million, a $5 million increase compared to FY22.
    • Epilepsy Centers of Excellence met the AAN requested funding request at $19 million for FY23, a $9 million increase compared to FY22.
    • A report is commissioned about the feasibility, advisability, and cost of a significant expansion of the Parkinson’s Centers of Excellence.
  • Alzheimer’s Disease and Related Dementias are funded at $3.7 billion, a $200 million increase compared to FY22.
  • The new Advanced Research Projects Agency for Health (APRA-H) is funded at $2.75 billion, an increase of $1.75 billion. The bill would also make ARPA-H an independent agency within HHS, taking it out of NIH where it currently resides.
  • Telehealth expansion and research is appropriated $37.05 million, with an additional $5.2 billion for telehealth and connected care within the VA.
  • While graduate medical education does not have a specific amount of money appropriated, the Appropriations Committee “urges CMS to prioritize applications in fiscal year 2023 from any hospitals seeking to establish or expand residency training in certain needed specialties, such as primary care, geriatrics, and general surgery, as had been the priority with previous GME slot distribution programs.”

October 1 is the deadline for all appropriations bills to pass both chambers to avoid a continuing resolution, where no new programs can be funded. The Senate has not yet released their timeline for appropriations. Negotiations are expected to continue until the end of the calendar year, with an expected continuing resolution to pass around October to fund the government in the interim.

While this is an important first step, it is important to note that the House bills were decided on a party line vote, so it is possible and likely to see varying figures when the Senate takes up their process.

What We're Reading

  • Gene discovery may explain why more women get Alzheimer’s disease (CNN)
  • Medicare data errors impede health equity efforts, OIG says (Healthcare Dive)
  • RECOVER Researchers Express Hope and Frustration in Their Study of Long COVID (Medpage Today)