Yesterday, representatives from AANEM, AAN, AAPMR, and APTA* traveled to Washington D.C. to meet with Jonathan Blum, director, Center for Medicare Management. Blum listened to the coalition’s concerns about the impact the cuts will have on patient care, but he explained that the 2013 fee schedule has already been established and will be implemented beginning January 1. He noted the significant pressure the administration was under to cut costs and that there had been a substantial increase in the use of the nerve conduction studies (NCSs) codes. Dr. Peter Grant, president of AANEM, noted that we are working hard on abuse issues that affect increased use of NCS codes, and the AANEM would like to offer further input to CMS in the future on how best to curb abuse.**
Blum was sympathetic to the group’s concerns and pledged CMS resources to assist the coalition, using claims data, to prove the impact the cuts have on patient access and care. He stated that to make a change in the fees for 2014, he would need empirical proof of the items outlined in the coalition letter and appeal
. A team of experts from CMS and AANEM is dedicated to working with CMS over the next six months to provide the data needed to mitigate the long term implementation of these cuts.
“We did not achieve what we wanted during our meeting, which was to receive a reduction in the cuts or, at least, a ‘phase in’ of the cuts”, noted Peter Grant, MD. “However, having CMS agree to spend resources to evaluate this issue in 2013 is a victory. Thank you for all your emails and calls to your House representatives. We believe they made an impression on CMS and encouraged them to commit to reviewing the values for 2014. Letters will be sent from the AMA, AANEM, AAN, AAPMR, and APTA by the end of the year, still asking CMS to consider accepting the RUC values and a ‘phase in’ period. We hope that CMS may still consider these changes.”
How you can help.
In the first quarter of 2013, AANEM will begin to analyze claims data as it relates to the impact on patient care. Please be ready to share information to illustrate how patients have been impacted by the cuts. Has the time increased before a Medicare patient is seen? Has the distance that patients travel to EDX providers increased? Has your practice limited or stopped performing EDX testing particularly on Medicare patients? If your practice has had to close completely, where are the Medicare patients being seen? Have you discontinued rotations to rural areas because of the cuts? Thank you, in advance, for your assistance in this effort.
*American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), American Academy of Neurology (AAN), American Academy of Physical Medicine & Rehabilitation (AAPMR), and the American Physical Therapy Association (APTA)
**Example: Laboratory accreditation and identification of groups that only perform NCSs and those that test a high volume of nerves per person for simple diagnoses such as carpal tunnel syndrome.