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  • Vol. 75, March 2021 DC E-Newsletter

    • Mar 02, 2021

    Legislative Affairs

    Neurosurgery Thanks Congress for Additional GME Funding

    On Jan. 27, the Congress of Neurological Surgeons (CNS) and the American Association of Neurological Surgeons (AANS) joined the Graduate Medical Education (GME) Advocacy Coalition in thanking Congress for expanding Medicare-supported GME in the Consolidated Appropriations Act, 2021 (P.L. 116-260). The legislation included 1,000 new Medicare-supported GME positions, distributed as follows: 

    • Teaching hospitals in rural areas;
    • Hospitals training residents over their cap;
    • Hospitals in states with new medical schools; and
    • Hospitals that care for underserved communities.

    In the letter, the groups noted that Medicare support for GME had been frozen since 1997. The growing physician shortage and COVID-19 pandemic have “put more pressure on the physician workforce as physicians and providers have mobilized across the country to respond to this public health emergency.” While the U.S. faces a projected physician shortage of between 54,100 and 139,000 physicians by 2033, this additional GME funding is a step in the right direction. The groups applauded this effort to increase federal support for GME.

    Click here to read the letter.

    Neurosurgery Thanks Congress for Preventing Medicare Cuts

    On Feb. 22, the CNS and the AANS joined more than 70 groups in thanking the House and Senate for including language in the Consolidated Appropriations Act, 2021 (P.L. 116-260) that prevented steep Medicare cuts. The letter also pointed out that additional action is necessary to address systemic problems with the Medicare Physician Fee Schedule — including the budget neutrality requirement, which results in arbitrary payment cuts. In the letter the groups urged, “Congress to consider additional policy options in the year ahead to address these shortcomings.”

    Legislation to Extend Medicare Payment Sequester Moratorium Introduced

    On Feb. 2, the CNS and the AANS endorsed H.R. 315, the Medicare Sequester COVID Moratorium Act, bipartisan legislation that would suspend the 2% Medicare payment sequester for the duration of the COVID-19 public health emergency. The current moratorium expires on March 31. Sponsored by Reps. Brad Schneider (D-Ill.) and David B. McKinley (R-W.Va.), this legislation would help ensure that neurosurgeons across the country can keep their practices open and continue to provide quality care to their patients. The CNS and the AANS also signed additional coalition letters supporting Congressional action to extend the moratorium.

    Click here for the CNS/AANS letter; here for the Alliance of Specialty Medicine letter; here for the Federation of American Hospitals-led coalition letter; and here for the American Medical Association-led letter.

    Neurosurgery Urges Funding for National Concussion Surveillance System

    On Feb. 2, the CNS, the AANS and the CNS/AANS Joint Section on Neurotrauma & Critical Care sent letters to House and Senate appropriators requesting $5 million to fund the National Concussion Surveillance System. The groups also joined the National Association of State Head Injury Administrators on a coalition letter with the same request. Currently, there is insufficient data to accurately estimate the incidence of sports-related concussions in youth and subpopulations of youth. Crucial data is also needed to capture all incidences of concussions due to falls, work-related injuries and recreational injuries across our population. This funding will help support efforts to further knowledge on concussions through clinical and basic science research.

    Neurosurgery Endorses Legislation to Permanently Fund CHIP

    On Feb. 10, the CNS, the AANS and the CNS/AANS Joint Section on Pediatric Neurological Surgery endorsed H.R. 66, the Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act. Sponsored by Reps. Vern Buchanan (R-Fla.) and Lucy McBath (D-Ga.), this legislation would permanently extend the Children’s Health Insurance Program (CHIP). Despite widespread support, CHIP remains a temporary program that requires reauthorization every few years, with its current authorization set to expire in 2028.

    Click here to read neurosurgery’s letter endorsing this bill.

    Neurosurgery Urges Funding for MISSION ZERO Program

    On Feb. 11, the CNS and the AANS sent letters to the House and Senate appropriators requesting $11.5 million in funding for the Military and Civilian Partnership for the Trauma Readiness Grant Program. Initially known as MISSION ZERO, the program provides funding to ensure trauma care readiness by integrating military trauma care providers into civilian trauma centers.

    Neurosurgery Endorses Legislation to Increase Rural Access to Specialists

    On Feb. 17, the CNS and the AANS joined the Alliance of Specialty Medicine in supporting H.R.944, a bill to authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialists. Sponsored by Reps. David B. McKinley (R-W.Va.) and Peter Welch (D-Vt.), if enacted, this legislation would improve access to essential health services for many Americans by increasing the number of practicing specialty physicians in rural America.

    Click here to read the Alliance of Specialty Medicine’s letter endorsing the bill.

    Neurosurgery Supports Firearms Safety Research

    On Feb. 16, the CNS, the AANS, the CNS/AANS Joint Section on Neurotrauma and Critical Care and the CNS/AANS Joint Section on Pediatric Neurological Surgery endorsed legislation introduced in the House and Senate to fund firearms safety and injury prevention research. Introduced by Rep. Carolyn B. Maloney (D-N.Y.) and Sen. Edward J. Markey (D-Mass.), the Gun Violence Prevention Research Act (H.R. 825/S. 281) would authorize $50 million in funding each fiscal year for the next five years for the Centers for Disease Control and Prevention (CDC) to study firearm safety and injury prevention.

    Grassroots Alert

    Contact Congress to Prevent 2% Medicare Sequester Payment Cut

    The Consolidated Appropriations Act, 2021 (P.L. 116-260) suspended the automatic 2% Medicare sequester payment cut through March 31. Bipartisan legislation — H.R. 315, the Medicare Sequester COVID Moratorium Act — would suspend the sequester for the duration of the COVID-19 public health emergency. This bill would provide critical financial support to help ensure that neurosurgeons across the country can keep their practices open and continue to provide quality care to their patients. Please contact Congress and ask your representative to co-sponsor H.R. 315 and encourage its inclusion in the next COVID-19 relief package.

    Click here to go to neurosurgery’s Advocacy Action Center to send an email to your elected officials asking them to take action on H.R. 315. A sample message, which can be personalized, is provided.

    Contact Congress to Permanently Extend the Children’s Health Insurance Program

    The Comprehensive Access to Robust Insurance Now Guaranteed (CARING) for Kids Act (H.R. 66) would permanently extend CHIP. With as many as 15% of children lacking health insurance coverage at the time, CHIP was established in 1997 to address this national health care crisis. Despite widespread support, CHIP remains a temporary program that requires reauthorization every few years, with its current authorization set to expire in 2028. This uncertainty is a constant threat to the wellbeing of children, their parents and the providers who care for them. The possible interruption of crucial health care treatments can cause severe, unintended consequences. Please contact Congress and ask your representative to co-sponsor H.R. 66.

    Click here to go to neurosurgery’s Advocacy Action Center to send an email to your elected officials asking them to co-sponsor H.R. 66. A sample message, which can be personalized, is provided.

    Contact Congress to Provide Funding for Firearms Injury Prevention Research

    The Gun Violence Prevention Research Act (S. 281/H.R. 825) would authorize $50 million in funding each fiscal year for the next five years for the CDC to conduct firearms research. This research aims to provide data to help determine strategies for preventing tragic injuries and death from firearms, as unintentional injury was the number one cause of death in 2019 for all Americans under the age of 44. Please contact Congress and ask your Senator and Representative to co-sponsor S. 281 and H.R. 825.

    Click here to go to neurosurgery’s Advocacy Action Center to send an email to your elected officials asking them to co-sponsor S. 281 and H.R. 825. A sample message, which can be personalized, is provided.

    Coding and Reimbursement

    CGS to Expand Coverage for MRI Guided Focused Ultrasound

    Effective March 8, CGS Administrators, LLC (CGS) — the Medicare Administrative Contractor for Kentucky and Ohio — has expanded its coverage policy for Magnetic-Resonance-Guided Focused Ultrasound Surgery (MRgFUS) to include Tremor-Dominant Parkinson’s Disease (TDPD). The CNS and the AANS support expanded coverage for MRgFUS.

    Biomedical Research

    Washington Office Staff Meets with NINDS Officials

    On Jan. 19, as a member of the National Coalition for Heart Disease and Stroke, CNS/AANS Washington Office staff participated in a meeting with National Institutes of Health (NIH) personnel. Walter Koroshetz, MD, director of the National Institute of Neurological Disorders and Stroke (NINDS), among others, provided an update on the current research funding programs. Dr. Koroshetz noted the following: 

    • NINDS received a 1.5% increase for FY 2021;
    • Grant applications have increased by 10%, and the average grant is $35,000 for a duration of eight years;
    • Funding will continue to target three areas: the Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative, the Helping to End Addiction Long-Term (HEAL) Initiative and the National Institute on Aging;
    • NINDS is studying the science of COVID-19 and its effects on the brain will use the $1 billion appropriated by Congress to investigate post-COVID-19 treatments;
    • StrokeNet, which began in 2013, now has 27 recognized regional coordinating centers with more than 500 participating hospitals; and
    • NINDS continues to develop its strategic plan and is seeking comments on the latest draft by March 15.

    Click here for more information on NINDS activities.

    State Affairs

    New State Legislative Dashboard Available from ACS

    Neurosurgeons who are fellows of the American College of Surgeons (ACS) now have access to a new state legislative dashboard to view activity in their state legislatures. The dashboard includes all the state bills and issues that the ACS is tracking, broken down by state, legislative issue, bill status and more. The dashboard is a live page with links to issue specific dashboards that automatically update as new bills are added or as bills move along in the legislative process. Most of these issues are also of importance to the CNS and the AANS, so we encourage neurosurgeons to track this information

    Click here to visit the dashboard.

    Of Note

    President Biden Nominates Chiquita Brooks-LaSure as CMS Administrator

    On Feb. 19, President Joseph R. Biden, Jr. announced the nomination of Chiquita Brooks-LaSure to serve as the Administrator for the CMS, a $1 trillion agency that oversees health care programs — including Medicare and Medicaid. Ms. Brooks-LaSure previously led the agency’s implementation of the Affordable Care Act coverage and insurance reform policy provisions. She has more than 20 years of experience in health policy.

    Communications

    Join the Conversation on Social Media

    Connect with the CNS/AANS Washington Committee and Washington Office on various social media platforms to keep up with the many health policy activities happening in the nation’s capital and beyond the Beltway.

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