The North American Neuromodulation Society (NANS) crafted a letter in response to the CMS Proposed Rule Making (Proposed Rule) on the revisions to Medicare payment policies under the Physician Payment Schedule (PFS) for calendar year (CY) 2025. The letter includes NANS' recommendations and comments regarding the CY 2025 Proposed Conversion Factor, Prior Authorization for Spinal Cord Stimulation (SCS), Telehealth Services under PFS.

According to the American Brain Coalition of which NANS is a member, Congressman Luttrell, co-chair of the Congressional Neuroscience Caucus, has submitted an amendment to the Rules Committee in favor of increasing funding for the BRAIN Initiative (H.R. 9029).

The U.S. Department of Health & Human Services Office of Civil Rights (OCR) has modified a Final Rule updating the HIPAA Privacy Rule. This rule prohibits the use or disclosure of reproductive protected health information (PHI) by covered entities, including hospitals, health plans, health care clearinghouses, and their business associates.

NANS joins national societies and state medical associations in urging Congress to prioritize and advance key bills and legislative proposals that provide greater financial stability to Medicare physicians and reform the Medicare Access and CHIP Reauthorization Act (MACRA).

On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) released its Calendar Year (CY) 2025 Medicare Physician Fee Schedule (PFS) proposed rule, which includes proposals related to Medicare physician payment and the Quality Payment Program (QPP). The proposed rule has a 60-day comment period. Final regulations will be issued on or around November 1 and unless otherwise noted, policies will be effective on January 1, 2025.

NANS will be reviewing the proposed rule and submitting comments in advance of the September 9, 2024, deadline.

In March, we learned about Cigna’s Medical Coverage Policy, characterizing peripheral nerve stimulation (PNS) to treat chronic pain as “not medically necessary.” On behalf of 88,000 physician members in national medical societies, NANS leads the response [PDF letter] objecting to CIGNA’s depiction of the treatment as lacking medical necessity.

On behalf of the 40,000+ members across 10 medical societies, NANS submitted a response (PDF) to draft guidelines for SCS coverage proposed by the Washington State Health Technology Clinical Committee. This historic shift in coverage means that, for the first time ever, patients covered by state insurance will have access to SCS treatment for failed back surgery syndrome (FBSS), nonsurgical refractory back pain (NSRBP) and painful diabetic neuropathy (PDN). This change was only possible due to the tireless advocacy of Washington-based physicians and national medical societies.

In February, Change Healthcare, the nation’s largest processor of medical claims, experienced one of the largest cyberattacks in the healthcare industry. This resulted in the loss of patient and claims data. This breach continues to have significant financial and operating impacts on medical providers across the country.