<P>8 AANnews • September 2014 the reporting requirements would be able to receive payment for their work, said Gregory J. Esper, MD, vice-chair of the AANs Medical Economics and Management Committee. The AAN spoke with strength and conviction, and I am pleased that CMS listened to us. In addition, CMS projects that overall allowed charges for neurologists will remain neutral in 2015, though payment for individual services that neurologists provide may go up or down. For example, some sleep services and EEG digital analysis see decreases, while some of the nerve conduction studies increase slightly. Wild Card: SGR Last April, Congress again put off the scheduled reimbursement reduction in the Sustainable Growth Rate (SGR), extending the delay to March 31, 2015. However, unless Congress acts, on April 1 the payment rate for physician services will decrease 20.9 percent in accordance with an adjustment to the SGR formula. The AAN will continue to advocate strongly for a satisfactory fix to SGR. Global Surgical Periods CMS is proposing to eliminate global surgical packages by transitioning all 10-day and 90-day global codes to 0-day codes in 2017 and 2018, respectively. A global package is a single payment that includes the procedure and the services typically provided in the periods immediately before and after the procedure. CMS believes this new policy would not only reduce unwarranted payments, but would also eliminate disparities between the payment for E/M services in global periods and those furnished individually. Marc Raphaelson, MD, the AANs RUC representative, agrees with this proposal. For years, the AAN has supported eliminating the global surgical periods and recommended that CMS should instead pay for post-operative follow-up visits as they occur and are documented. Several RUC members from surgical specialties have also supported this change. In fact, several reports by the Office of Inspector General have confirmed that many surgical procedures are not followed by the number of follow-up visits paid for in the global period package. Assuming CMS can withstand the political lightning that this proposal will attract, surgeons will be paid fairly for the care they render, and some funds should be redistributed to the rest of the fee schedule. The AAN is pleased that CMS is proposing to eliminate these global periods and will continue to follow this proposal closely. Transparency in Rate Setting In response to pressure from neurology and other physician groups, CMS is proposing to allow public comment on values for new and revised codes before they are finalized starting with the 2016 rulemaking cycle. The Academy appreciates that CMS is looking at how to make this process more equitable, particularly after neurologists felt the impact of significant cuts to NCS/EMG in the final rule two years ago. Physician Quality Reporting System (PQRS) The Physician Quality Reporting System (PQRS) is a pay-for-reporting program that uses a combination of bonuses and penalties to promote reporting of quality information by physicians. 2014 is the last year to earn a bonus in PQRS as the program transitions to a penalty next year. Physicians who did not successfully participate in PQRS in 2013 will receive a 1.5-percent reduction in all Medicare payments for 2015 and the penalty transitions to 2 percent in 2016 based on 2014 reporting. CMS proposes to retain the following measures for PQRS in 2015: nDementia nParkinsons disease nCounseling for women of childbearing potential with epilepsy In addition, CMS is adding one new measure from the AAN for ALS patient care preferences. For 2015, CMS is proposing to require physicians who see at least one Medicare patient in a face-to-face encounter to report on at least two measures from a newly proposed cross- cutting measure set as a part of the nine individual measures they are required to report on. In other words, two of the nine measures must be a cross-cutting measure. Physician Value-based Payment Modi?er (Value Modi?er) In 2015, all neurologists, including solo practitioners, will be subject to the 2017 value modifier based on the 2015 PQRS performance period. This means that all physicians who do not participate in PQRS in 2015 will automatically receive the value modifiers maximum penalty (4 percent) and the PQRS penalty (2 percent) in 2017. The value modifier uses PQRS quality data and Medicare cost data to determine a physicians overall value score. It functions by rewarding high-performing physicians with increased payments and by reducing payments to low-performing physicians. AANs Advocacy Yields Positive Results in 2015 MPFS Proposed Rule Contunued from cover Practice Gregory J. Esper, MD</p> <UL><LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/1/1/">Front-Cover</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/2/2/">Inside-Front-Cover</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/3/3/">Page-3</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/4/4/">Page-4</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/5/5/">Page-5</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/6/6/">Page-6</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/7/7/">Page-7</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/8/8/">Page-8</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/9/9/">Page-9</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/10/10/">Page-10</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/11/11/">Page-11</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/12/12/">Page-12</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/13/13/">Page-13</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/14/14/">Page-14</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/15/15/">Page-15</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/16/16/">Page-16</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/17/17/">Page-17</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/18/18/">Page-18</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/19/19/">Page-19</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/20/20/">Page-20</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/21/21/">Page-21</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/22/22/">Page-22</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/23/23/">Page-23</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/24/24/">Page-24</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/25/25/">Page-25</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/26/26/">Page-26</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/27/27/">Page-27</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/28/28/">Page-28</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/29/29/">Page-29</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/30/30/">Page-30</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/31/31/">Page-31</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/32/32/">Page-32</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/33/33/">Page-33</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/34/34/">Page-34</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/35/35/">Page-35</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/36/36/">Page-36</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/37/37/">Page-37</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/38/38/">Page-38</a></LI> <LI><a href="http://www.mzines.net/publication/704/lhbdvotqg/39/39/">Back-Cover</a></LI> <LI><a href="http://www.mzines.net/publications/704/x/sitemap.xml" target="_blank">site map</a></LI> </UL>


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