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Regulatory Relief Coalition Archives - Neurosurgery Blog

Cross-Post: Streamlining the Process of Prior Authorization for Medical and Surgical Procedures

By Cross Post, Health Reform, Prior Authorization, Regulatory ReliefNo Comments

From time to time on Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they hit the mark on an issue. Today’s post originally appeared in The Hill on Jan. 14, 2021. In the op-ed, Richard Menger, MD, MPA, assistant professor of neurosurgery and political science at the University of South Alabama in Mobile, Ala., highlights the need to streamline the cumbersome process of prior authorization for medical and surgical procedures performed through the Medicare Advantage program. Prior authorization is a tool insurance companies use to limit the services they provide for their customers. “Reducing the footprint of prior authorization bends the arc towards that proper direction of reform,” according to Dr. Menger.

Click here to read Dr. Menger’s full article in The Hill.

Editor’s Note: We encourage everyone to join the conversation online by using the hashtags #FixPriorAuth and #RegRelief.

2020 — A Year in Review

By Advocacy Agenda, Congress, Health Reform, Medical Innovation, Medical Liability, Prior AuthorizationNo Comments

While 2020 is a year that most people want to forget, the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) made significant strides in accomplishing its legislative and regulatory agenda, thus ensuring that neurosurgical patients continue to have timely access to quality care. Following are some highlights of these advocacy efforts.

Congress Prevents Steep Medicare Cuts

On Jan. 1, the Centers for Medicare & Medicaid (CMS) implemented the new CPT guidelines to report office and outpatient visits based on either medical decision making or physician time. These evaluation and management (E/M) services are valued in line with the AMA/Specialty Society RVS Update Committee (RUC) recommendations. Unfortunately, to comply with Medicare’s budget neutrality requirement, any increases must be offset by corresponding decreases, and CMS estimated that the 2021 policies would increase Medicare spending by approximately $10.6 billion. This necessitated significant cuts for many specialties, including an overall 6-7% payment cut for neurosurgery. Read More