CSNS Update
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Transcript of CSNS Update
CSNS mission:to provide a national forum for the State
Neurosurgical Societies of the United States, for the discussion, consideration, and
proposals of action regarding socioeconomic issues concerning Neurological Surgery.
Chairman’s Report: Dr. Mark Linskey
• Update on goals presented at Fall 2013 CSNS Meeting
• Success of Winter 2014 Washington Committee meeting
• Legislative and payer policy monitoring• Formal links between CSNS and state
societies; attendance at state society meetings by CSNS officers
• Reestablishment of CSNS associations with NERVES, AANN, & ANSPA
• Additional CSNS representative section
New Initiatives CSNS to participate in NREF review of socioeconomic grants,
including TBI grant
Affordable Care Act and proactive monitoring; Medical Practices and YNRS to proactively anticipate implications and process with evaluations to CEC for review by CNS/AANS
Development of a medical business training simulator; CEC to form a working group to submit a feasibility study
Neurosurgical Medical Directors Ad Hoc Committee to address needs and issues of Neurosurgeons as leaders
Patient Advocacy Ad Hoc committee and Long-Range Planning Committee processes
Passed Spring 2013 Resolutions Resolution to support ongoing study of insurance denials in MN in
order to promote transparency in denial practices and to ascertain denial rationale(s)
Collation of data on anticoagulant and antiplatelet agents, particularly with regard to emergent reversal, and online distribution of this data
Regarding CSNS Processes: Resolution-writing tutorials and previously submitted resolutions are to
be reviewed before submitting new resolutions Scholarly works pertaining to socioeconomics by CSNS members and
resident fellos in particular will be displayed at future CSNS plenary sessions
Transparency of Conflicts of Interest of CSNS members
Referred Spring 2013 Resolutions Creation of resident safety protocol
Creation of a pilot program of organized neurosurgery engaging insurance companies in open dialogue and bidirectional education on approval and denial practices and rationale.
Rejected Spring 2013 Resolutions
Broad CSNS evaluation and review of neurosurgical Conflicts of Interest
Resolution calling for removal of CME requirements for maintaining membership in CNS and AANS
Development of educational materials and efforts to minimize wrong-side, wrong-level surgeries
2013 Meeting Highlights:
“New Frontiers for Neurosurgeons in the Era of the Affordable Care Act: The Geisinger Experience”
Steven A. Toms, MD, MPH, FAANS, FACS
Washington Committee Highlights:John Wilson, MD and Katie Orrico, JD
Sustainable Growth Rate (SGR) UpdateOne-year “doc fix” (HR 4302) implemented to avoid 24% cut in Medicare payments
Increased Medicare pay by 0.5%
Delays ICD-10 implementation to October 1, 2015
Delays implementation of “2-midnight rule” 6 months
Provides improved Medicare payments to rural hospitals and ambulance services
Reduces payments to SNFs by $2B over 10 years
Authorizes “mis-valued code analysis” to decrease spending by 0.5%/yr
Washington Committee HighlightsJohn Wilson, MD and Katie Orrico, JD
Quality Improvement:Physician Quality Improvement System (PQRS): physicians eligible for 0.5% incentive bonus payment; 2% penalty starting in 2016 for not satisfying reporting requirements
Increased public reporting for Group Practice Reporting Option and Accountable Care Organization participants on the Physician Compare website
EHR: 2014 is the last year eligible professionals can qualify for payment incentives for meaningful EHR use. 1% penalty starts in 2015. EHRs must meet 2014 Edition criteria (encouraging information exchange and improved interoperability)
Accountable Care Organizations (ACOs): data on first 2 rounds of ACO payments released by CMS. 54/114 ACOs saved money (net $128M), 29 to receive bonus payments.
Washington Committee Highlights:John Wilson, MD and Katie Orrico, JD
Affordable Care Act
Enrollment started slowly in Fall/Winter 2013
1-year delay in small business marketplace announced in November 2013
Individual mandate dropped for those with cancelled health plans in December 2013
Employers with 50-100 employees given to 2016 to offer coverage in February
7M enrollment goal met on 31 March 2014- lower than hoped for “first time enrollees”- only 1M “young adults”
Member Activities:
Resident fellows: 13 fellows were selected for 2014-2015. Applications for the
fellowships are available at csnsonline.org
The outgoing 2013-2014 fellows were afforded a unique meeting with the editors-in-chief of Neurosurgery, Journal of Neurosurgery, and AANS Neurosurgeon
HIPAA, PEDs, and you: Look before you tweet! Kimmel KT, Srinivasan V, Colen CB
How CSNS Can Help Achieve Milestones Park MS, Gard AP, Rosenbaum B, Pilitsis JG
Updates on Prior Resolutions:• Medical Student Fellowship: Travis Ladner, Vanderbilt, Quality
of Life Instrument of Chiari Malformation
• Needle-stick injuries during the 80-hour work week, Dr. Chaim Colen
• Resolution V – 2011 F: Neurosurgical Practice DisparitiesDr. David Connor presented data on neurosurgical
coverage in Louisiana, and found coverage to be lacking outside the major academic centers in New Orleans and Shreveport
• Resolution XIV – 2013S: Establishing neurosurgical coverage between academic and non-academic neurosurgical practices, Dr. Abou-Samra
Special ReportsMilestones, Status, and Timeline for
Amalgamation of MD and DO Neurosurgery Training Programs, Dr. Batjer
The Leibrock Lifetime Achievement Award was presented to Russel H. Patterson, Jr., MD
Upcoming Meetings