To keep our membership informed of the activities and health of the association, we are posting our most recent collection of NERVES committee reports. In this issue you will find the CSNS Committee Report, the Education Committee Report, the Membership Committee Report, the Survey Committee Report, and the Washington Liaison Report.

CSNS Committee Report

By Derek Cantrell, CSNS Liaison

During the CSNS most recent Winter Meeting, I updated the committee on current NERVES membership in total, by region and by practice type. I updated the EC on high-level statistics for the 2023 NERVES Survey which was published last week and I will work with Dr. Wakefield to send a draft communication to AANS (Katie O’ricco) for dissemination to the AANS membership describing the purpose and benefits of NERVES membership. We will also send a draft for dissemination regarding the 2024 NERVES Survey and the benefits of participation.

There has been much discussion at the last two EC meetings regarding physician leadership opportunity within this council and how to allow more participation in the organization. Also, there is a concerted effort to get the states that do not have active neurosurgery societies to step up and engage. The CSNS is the “grass roots” of organized neurosurgery and depends on state society participation. NERVES can play a part in helping to make state societies robust and engaging.

Education Committee Report

By Galyn Damiani, Education Committee Chair

Chair: Galyn Damiani. Members: Kathy Tobin, Jim Shea, Alex Palleschi, Stacey Snodgrass, Carrie Bennett, Jason Philip, Mark Vorherr, Ellyce Patton, Kelly Hornbacher, Melissa Klingberg

The Education Committee’s planning efforts for 2024 are well underway with five webinars and a November mini conference already in development to include our annual, historically highest attended webinar discussing the top coding mistakes in neurosurgery along with topics such as spinal robotics programs, quality metrics and scorecards, site of care shifts, and diversity in leadership. These exciting topics will incorporate a variety of experts to engage with our membership to provide insights into industry trends and best practices in neurosurgical care and programmatic development.

In 2023, the committee hosted five webinars with an average of 44 attendees registering for each webinar. The 2023 mini-conference held steady with 44 registered attendees.

I’m proud to collaborate with our committee members who are truly experts in the industry and are committed to bringing educational content that will add value to our current membership and attract further attendees and engagement. Please take a moment to thank our members for their thought leadership and dedication to offering valuable content to you!

Membership Committee Report

By Sheryl Conticello, Membership Committee Chair

Our Membership Committee update:

• RosmanSearch has partnered with NERVES to promote membership by offering to pay for new member dues for their 1st year. 15 new members have joined through this promotion.
• Mentorship Program – working well. Scheduling a meet up in Chicago of the group for feedback and introductions.
• Developed the informational flyer to broadcast NERVES to increase awareness and value of NERVES:
• CSNS committee member has written a letter for NERVES support.
• Working on process to deliver the letter through the CSNS representatives for support in their state.
• Working through next steps for how CSNS will work with AANS & CNS.

Survey Committee Report

By Brent E. Patterson, CPA, NERVES Survey Chair

The Survey Committee is happy to announce that the 2023 NERVES Socio-Economic Survey was released on Wednesday, February 28th. We are proud to report that this year’s survey captured data from 52 practices representing 569 Neurosurgeons and 576 Advanced Practice Providers, which is a 55% increase in participation on both fronts. The Survey Committee will get together on Wednesday morning, May 1st, in Chicago in advance of the Annual Meeting to review the results of the 2023 survey and begin planning for 2024. If you have any input for the Committee or have an interest in serving on the Committee, please reach out to Brent Patterson, Survey Committee Chairman, at [email protected].

Washington Liaison Report

By Rachel Groman and Rebecca Ruegg Cowan

1. 2024 Merit-based Incentive Payment System (MIPS) Updates
1. 2024 MIPS Quality Measure Benchmarks -- CMS recently released the historical quality measure benchmarks that it will use to score physicians under the 2024 Merit-Based Incentive Payment System (MIPS).
2. Washington’s Response to the Change Healthcare Cyberattack
1. Advocacy at Work - AMA Letter to CMS regarding Change Healthcare Cyberattack - the AMA sent a letter to CMS urging the agency to provide relief from MIPS penalties for clinicians impacted by the Change Healthcare cyberattack since it coincides with the 2023 MIPS data submission window. The letter also expressed concern that many physician practices would not have the resources to timely submit MIPS data and asks CMS to automatically apply the Extreme and Uncontrollable Circumstances (EUC) hardship exception to all MIPS eligible clinicians for the 2023 performance period, or, at a minimum, to re-open the 2023 hardship exception application (which closed Jan. 2, 2024) and to allow clinicians to claim an exception due to the cyberattack.
2. CMS’ Response to Change Health Care Cyberattack
1. 2023 MIPS Data Submission Extension to April 15, 2024 -- In response to the Change Healthcare cyberattack, the Centers for Medicare & Medicaid Services (CMS) has extended the data submission period for MIPS eligible clinicians who participated in the 2023 performance year of the Quality Payment Program (QPP) from April 1, 2024 to April 15, 2024.
2. 2023 MIPS ECU Application Reopened until April 15, 2024 -- In response to the Change Healthcare cyberattack, the Centers for Medicare & Medicaid Services (CMS) has reopened the 2023 MIPS Extreme and Uncontrollable Circumstances (EUC) Exception Application to provide relief to MIPS eligible clinicians impacted by this cybersecurity incident.
3. CMS Releases Final Interoperability and Electronic Prior Authorization Regulation -- In late January, CMS released its Advancing Interoperability and Improving Prior Authorization Processes final rule, which aims to improve the electronic exchange of health care data and streamline processes related to prior authorization through new requirements for Medicare Advantage (MA) organizations, state Medicaid and Children’s Health Insurance Program (CHIP) fee-for-service (FFS) and managed care plans, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs). Beginning in 2026, impacted payers will be required to send prior authorization decisions within 72 hours for urgent requests and seven calendar days for non-urgent requests. The rule also requires all impacted payers to include a specific reason for denying a prior authorization request and to publicly report prior authorization metrics, similar to metrics that Medicare FFS already makes available. Legislation is also being considered in Congress that would cement some of these and other prior authorization processes into law, ensuring more transparency and less administrative burden for patients and provider.
4. CMS Posts Procedure Volume Data -- In January, CMS also expanded its public reporting efforts by adding procedure volume to clinician profile pages on the Medicare.gov compare tool. This initial release of data covers 12 procedures, including spinal fusion, and reflects procedures that were performed for original Medicare and Medicare Advantage patients in the last 12 months.
5. CMS Updates AUC -- CMS recently released an article informing billing staff about recent changes to the program. CMS decided to pause the program for re-evaluation and rescinded the program regulations in the 2024 PFS final rule. As noted in the latest CMS transmittal, effective January 1, 2024, providers and suppliers should no longer include AUC consultation information on Medicare claims. However, claims containing AUC-related codes with dates of service in 2023 and 2024 will continue to process.

If you have any questions about policy development and advocacy for neurosurgery, please reach out to NERVE’s Washington Committee Liaison – Rebecca Ruegg Cowan – at [email protected].