Legislative, political, and health policy activity directly affects our practices and our patients. Read below to stay up-to-date on the current issues affecting our specialty.
The ENT Advocate
To read the latest version of The ENT Advocate, click here.
FDA Pursues Restrictions on Flavored E-Cigarettes, Menthol Cigarettes, and Flavored Cigars
On November 15, the FDA announced new restrictions on the sale of certain flavored e-cigarettes in convenience stores, gas stations, and online. The agency will also pursue a ban on menthol flavors in traditional combustible cigarettes, as well as a ban on flavored cigars. The AAO-HNS, as a member of the PARTNERS coalition, has supported such efforts to help address the sharp increase in underage use of tobacco and nicotine-delivery products.
CMS Releases CY 2019 OPPS and ASC Final Rule
On November 2, CMS released a final rule implementing changes to the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for Calendar Year 2019. CMS continued its drive toward site neutrality for outpatient services, specifically clinic visits for outpatient settings. While the proposed rule had recommended the equalization in payment occur in CY 2019, the OPPS final rule describes phasing in this change over two years.
Advocacy in Action: CMS Heeds AAO-HNS Concerns on 2019 Physician Fee Schedule
On November 1, CMS released a final rule implementing changes to the 2019 Medicare Physician Fee Schedule. In response to AAO-HNS advocacy and coordinated efforts across the House of Medicine, CMS opted to rescind its proposal to apply an MPPR/Modifier 25 reduction for procedures reported on the same day as an E/M service. In addition, the agency delayed and modified its broad-reaching proposed changes relating to coding and payment for E/M services for new and established patient office visits. Beginning in 2021, which allows more time for stakeholder input, CMS will maintain the billing code for the most complex patients and collapse the current E/M coding system into three tiers. While the AAO-HNS continues its review of the 2,400-page final rule, James C. Denneny III, MD, AAO-HNS EVP/CEO, provided a preliminary analysis. Academy members can view the final rule here and the AAO-HNS comment letter on the proposed rule here.
Preparations Are Underway for the 2019 State Legislative Sessions: Additional Trackers Needed!
The AAO-HNS State Tracker program has grown to include more than 140 volunteers covering 46 states. However, more Trackers are needed, especially in Idaho, Nevada, North Dakota, and South Dakota. Previous experience with state legislation is not required! The Academy’s Advocacy team can work with you and your state society to ensure issues affecting ENT patients and your profession are heard by the state legislatures. The first nationwide conference call with our volunteer State Trackers will be held on December 19, to discuss the upcoming 2019 sessions. Contact firstname.lastname@example.org to sign up or learn more!
AAO-HNS Pushes Back on EHR Data Blocking
The AAO-HNS is actively working to end the obstructive practice by some EHR vendors who refuse or make it difficult to transfer patient data to clinical data registries, such as Reg-entSM. Combining both legislative and regulatory advocacy efforts, the AAO-HNS recently signed onto a coalition letter urging HHS to streamline its quality reporting and promote data sharing in MIPS. Additionally, the AAO-HNS has submitted comments and joint letters to CMS, the Office of the National Coordinator for Health Information Technology, and Congressional leadership addressing information blocking by EHR vendors and the burden of Medicare reporting requirements on physicians. Click here to view AAO-HNS supported letter from Congress to HHS.
Visit the Advocacy Booth in Atlanta
Are you attending the AAO-HNSF 2018 Annual Meeting & OTO Experience? If so, stop by the AAO-HNS Advocacy Booth located in the GWCC, International Boulevard Entrance, Registration Hall, to learn more about the Academy’s legislative, political, health policy, and grassroots programs. Morning and afternoon snacks will be available for ENT PAC donors, the specialty’s political action committee. Learn more.
Medicare CY 2019 Hospital Outpatient Proposed Rule
On September 24, the AAO-HNS submitted a comment letter to CMS regarding the CY 2019 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. The Academy’s comments included support for Medicare’s proposed changes to reduce site of service disparities, as well as removal of CPT 31241 (Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery) from the Inpatient Only List. Read more.
AAO-HNS Advocates on Balloon Sinus Ostial Dilation
On September 25, the AAO-HNS submitted a comment letter to the Blue Cross Blue Shield Federal Employee Program opposing its position designating Balloon Ostial Dilation for Treatment of Chronic Sinusitis as investigational. The letter highlighted the procedure as consistent with the standard of care and the recently-released AAO-HNSF Clinical Consensus Statement: Balloon Dilation of the Sinuses on the procedure. Learn more.
AAO-HNS Joins AMA Coalition Letter on Medicare’s Proposed E&M Coding Changes
On August 24, an AMA coalition letter signed by the AAO-HNS was sent to CMS Administrator Verma regarding E&M coding and payment recommendations included in the 2019 proposed Medicare Physician Fee Schedule rule. The letter, which included 170 signatories, expressed concerns regarding the proposed collapse of payment rates for office visit services for new and established patients, as well as opposition to payment reductions for procedures reported on the same day as an E&M service. Read more.
U.S. House Committee Examines Regulatory Burden on Providers in Medicare
The U.S. House Committee on Ways and Means and its Subcommittee on Health released a report discussing findings and potential next steps to reduce some of the burdensome regulations providers face as part of the Medicare program. The report is the latest development from the Committee’s ongoing “Medicare Red Tape Relief Project” examining the excessive regulatory burden placed on providers. Learn more.
AAO-HNS Sponsors Capitol Hill Visit to NIH
The AAO-HNS recently co-sponsored a Friends of the Congressional Hearing Health Caucus tour of the NIH’s National Institute on Deafness and Other Communication Disorders (NIDCD). The event, which included Congressional staff members and representatives from the hearing health community, featured an overview of the NIDCD’s intramural research program, followed by tours of labs conducting research on hereditary deafness and research on cochlear development. Read more.
Advocacy in Action: UHC to Cover Hybrid Cochlear Implants
In response to March 2018 comments submitted by the AAO-HNS, United Healthcare (UHC) has updated its Cochlear Implant medical policy. The Academy’s review included literature to support the benefits of hybrid cochlear implants, the population of patients who benefit from these technologies, and the value of low frequency hearing to patients. Effective August 1, UHC now considers hybrid cochlear implants proven and/or medically necessary in certain circumstances. Learn more.
Last Updated 11/16/2018