capitol hill report: RESPONDING TO MEDICARE ‘CLIFF,’ PROPOSED FEE SCHEDULE, MORE
September 20, 2021
Latest Advocacy News
- The AAN sent a letter to congressional leaders urging them to act before the end of the year on several key priorities, including:
- Extending COVID-19 relief and ensuring Medicare program sustainability
- Ensuring continued access to telehealth
- Strengthening the health care workforce
- Streamlining prior authorization
- Increasing diversity in clinical trials
- Lowering prescription drug prices and reducing costs to patients
- Investing in medical research
- Physician Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) are circulating a "Dear Colleague" letter to urge congressional action to avert the upcoming "Medicare Cliff" in 2022, when physician payments are scheduled to be reduced by 9.75 percent. The AAN has been advocating against these payment cuts for several months, including at Neurology on the Hill. Learn more about the policies scheduled to go into effect and email your congressional representative to sign onto this letter.
- Reps. Mark DeSaulnier (D-CA) and Pete Stauber (R-MN) introduced the Protecting Student Athletes from Concussions Act (H.R. 5216), a bill to promote awareness of sports-related concussions and create comprehensive, evidence-based concussion response strategies. Their press release cited the AAN’s support and quoted AAN President Orly Avitzur, MD, MBA, FAAN.
- The AAN was quoted in a Medpage Today article, describing our work fighting against step therapy in Medicare Advantage (MA) plans. The AAN joined a large coalition asking the US Department of Health and Human Services to revisit the policy allowing for step therapy on Part B drugs in MA plans. In the article, the AAN stresses its continued opposition to regulatory burdens like step therapy and prior authorization.
- The AAN joined a letter with more than 200 organizations led by the Leaders Engaged on Alzheimer’s Disease (LEAD) Coalition urging Congress to pass the Concentrating on High-Value Alzheimer’s Needs to Get to an End (CHANGE) Act (S. 1692/H.R. 3354).
Issue In Focus
On July 13, the Centers for Medicare & Medicaid Services (CMS) published the 2022 Medicare Physician Fee Schedule Proposed Rule. Each year, CMS proposes an update to the physician fee schedule as a vehicle for a wide variety of regulatory updates, this year ranging from Appropriate Use Criteria (AUC), evaluation and management (E/M) coding and billing, reimbursement levels, MIPS Value Pathways (MVPs), telehealth, and more. The AAN always takes advantage of the 60-day comment period to review the proposed rule, engage members and fellow stakeholders, and ultimately draft comments for CMS.
On September 1, the AAN submitted those comments. These comments are crafted with the intention of advancing the practice of neurology both in the areas CMS highlight in their proposed rule as well as those areas most important to our members. This year, our comments were particularly focused on telehealth and E/M changes that will have an outsized impact on the practice of neurology. The AAN has encouraged CMS to gear its telehealth changes towards creating a glide path out of the public health emergency (PHE), where many telehealth regulations were necessarily eased, into a modern regulatory framework that keeps pace with the great strides being made in the technology and methodology of telehealth.
After the significant contributions of the AAN to last year’s implementation of new outpatient E/M policies, the AAN has continued its advocacy for timely and appropriate updates to E/M policies that reflect the value of consultation-based visits in inpatient settings. The AAN is now awaiting the final rule from CMS incorporating comments from the Academy and other stakeholders. That rule is expected in November.
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