6 Top Advocacy Issues for North American Spine Society

In case you missed this week’s Becker’s Spine Review article, featuring an interview with NASS Advocacy Committee Chairman Dr. John Finkenberg, right, you can view it by clicking here. In this interview, Dr. Finkenberg[1]Finkenberg discusses NASS’ top six advocacy priorities and how the organization is pursuing these issues.

Senate Democrats Unveil Plan to Delay Sequester

Senate Democrats released a plan recently to avert nearly $85 billion dollars in cuts to the federal budget as a result of sequestration. The plan, the American Family Economic Protection Act, would delay the sequestration through January 2, 2014 by increasing revenues through the elimination of tax-loopholes and splitting cuts between defense and domestic spending. Congress has until March 1 to pass legislation before a 2 percent reduction in Medicare reimbursements goes into effect.

The Republicans in the House of Representatives have indicated that this bill is dead on arrival in the House and expressed their unwillingness to negotiate with the President on budgetary matters that involve mechanisms to raise revenues. Sources from Capitol Hill inform NASS that the general consensus among Members of Congress is that sequestration will go into effect. Lawmakers may take up this issue once again in late March when the next budget battle is expected to take place over funding the remainder of FY 2013 (Continuing Resolution). At that point, many believe that the public pressure to delay these cuts will be high enough to force Congress to pass legislation to delay sequestration for the remainder of this year.

Details of the American Family Economic Protection Act can be found here.

‘Choosing Wisely Campaign’ Release List of Top Tests to Avoid

Specialty Societies representing more than 500,000 physicians released the Five Things Physicians and Patients Should Question lists this week, in an attempt to improve quality care by eliminating unnecessary tests. The Choosing Wisely Campaign, an initiative headed by the American Board of Internal Medicine Foundation (ABIM), has worked with over 20 specialty societies to identify at least five evidence-based recommendations for patients and their physicians to discuss the most appropriate care based on a patients individual condition.

Some examples of unnecessary tests put-forth by medical societies include: eliminating electroencephalography (EEG) for headaches, eliminating imaging of the carotid arteries for simple syncope without other neurologic symptoms, only using opioid or butalbital treatment for migraine except as a last resort and eliminating computed tomography (CT) scan of the head/brain for sudden hearing loss.

The release of these lists comes at an opportune time, as Congress is currently looking for ways to reduce health care spending and reform the Medicare reimbursement system. In addition, the development of these lists could serve as a framework by which medical societies could begin to develop performance measures that will then be used to identify best practices and enhance physician accountability.

To view the Choosing Wisely list, please click here.

HHS Issues Final Rule on Essential Benefits

On February 20, 2013, the Department of Health and Human Services (HHS) released a final rule outlining the essential health benefits (EHB’s), actuarial value (AV), and accreditation requirements of the Affordable Care Act. The department says that these rules are intended to help consumers shop for and compare health insurance options in the individual and small group markets and limit their out of pocket expenses.

The Affordable Care Act requires non-grandfathered health plans in the individual and small group market must include items and services within at least the following 10 categories: Ambulatory patient services, Emergency services, Hospitalization, Maternity and newborn care, Mental health and substance use disorder services, including behavioral health treatment, Prescription drugs, Rehabilitative and habilitative services and devices, Laboratory services, Preventive and wellness services and chronic disease management, and Pediatric services, including oral and vision care.

A copy of the final rule can be found here.