Advocacy at IASP

August 2014 - ISASS Policy Statement - Minimally Invasive Sacroiliac Joint Fusion

The ISASS Coding and Reimbursement Task Force has been busy addressing our membership's needs while advocating spine access (further projects are in the pipeline). Our past MIS SIJ Policy was created early as MIS SIJ was evolving. The current body of literature is now more robust and a timely educational update for ISASS & IASP membership has been developed.

June 2014 - ISASS Now a Member of AMA House of Delegates

Today after much hard work and diligence, ISASS was awarded a seat at the table of the House of Delegates (HOD) of the AMA. Gunnar Andersson, MD, PhD, ISASS President was handed a clicker and began voting on your behalf. "Today ISASS became a member of the AMA House of Delegates, this gives us a seat at the table of the organization that makes decisions at the [Current Procedural Terminology] and [Relative Value Scale Update] Committees," said Anderrson of this accomplishment.

April 2014 - ISASS Responds to CBS Spinal Fusion Segment

CBS recently highlighted the fact that spinal fusions are increasingly common procedures and that indications in some cases are controversial. Their highlighting of "surgeons they looked into" presents a frightening picture of alleged abuses, of a procedure that in many cases is clinically indicated with excellent results.

April 2014 - ISASS Policy Statement - Cervical Artificial Disc 2014

The ISASS Task Force reached out to Domagoj Coric, MD to provide a timely summation on cervical disc arthroplasty given his special interest and recent IASP championing of this innovative technology to ensure enhanced spine patient access. The ISASS Task Force is pleased with this step towards published ISASS societal policy and applauds Dr. Coric's effort; if ISASS is to continue to succeed we must continually harness the voluntary talents and energies of our members with gratitude.

March 2014 - Statement on Coding Changes for Minimally Invasive SI Joint Fusion 2014

ISASS/IASP is fostering relationships with the payer community to keep them informed of guidelines that impact their members and policy decision making. ISASS/IASP continues to support access of medically necessary procedures to patients and support the spine practices of our member surgeons. The ISASS Statement on Coding Changes for Minimally Invasive SI Joint Fusion 2014 below is another example.

February 2014 - Introduction of SGR Repeal and Medicare Provider Payment Modernization Act of 2014

ISASS staff participated in a conference call conducted by the American Medical Association (AMA) in which the SRG Repeal Legislation was discussed. We felt ISASS members would want to review the information presented.

Staff for the chairmen and ranking minority members of the three Congressional committees of jurisdiction briefed physician groups this afternoon on the results of their bicameral, bipartisan negotiations on repealing the SGR. The “SGR Repeal and Medicare Provider Payment Modernization Act of 2014,” which was introduced by Rep. Michael Burgess, MD (R-TX) in the House as H.R. 4015, addresses only the policy provisions related to eliminating the flawed payment update formula. It does not include financial offsets or any of the usual extender policies.

September 2013 - Spotlight on the Coding and Reimbursement Task Force

In response to continued downward pressure from government and commercial payers on spine surgery coverage and reimbursement, the ISASS Coding & Reimbursement Task Force continues to evaluate policies that may be detrimental to optimal patient care, and that may unnecessarily or punitively reduce physician reimbursement.

September 2013 - Comments on CMS Proposed Rule (CMS-1600-P) – Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B for CY 2014

On behalf of the International Society for the Advancement of Spine Surgery (ISASS), I am writing to submit comments on the proposed Medicare Physician Fee Schedule (MPFS) for CY 2014. [...] Overall, we are very concerned with the proposal to cap payment rates for over 200 physician services at outpatient prospective payment system (OPPS) or ambulatory surgical center (ACS) rates. Such a proposal will reduce payment for some services by more than 50 percent, which will reduce or eliminate their utilization in physician offices, and will thus require patient to obtain such service in a more costly and less convenient setting.

September 2013 - Comments on CMS Proposed Rule (CMS-1601-P) Section III(A) Regarding Changes to IDE Coverage Process

On behalf of the International Society for the Advancement of Spine Surgery (ISASS), below are comments submitted on CMS’ Proposed Rule, Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule and Other Revisions to Part B for CY 2014.

July 2013 - Statement on Coding Changes for Minimally Invasive SI Joint Fusion

ISASS supports decision making at the physician-patient level based on medical necessity and achieving the best outcomes to address the patient’s medical condition. Medical necessity should not be determined by a mere administrative code reporting system such as CPT. Prior to the July 1st implementation of CPT category III code 0334T, surgeons reported and were reimbursed for ALL sacroiliac joint fusion procedures when medically necessary, including minimally invasive, through the use of CPT code 27280.

May 2013 - Domagoj Coric, MD Responds to BCBSNC “Let’s Talk Cost” Statement on Artificial Discs

I am writing you on behalf of International Advocates for Spine Patients (IASP) as well as the patient population of North Carolina. IASP is an organization supported by physicians and patients dedicated to advocacy for high quality, widely accessible and cost effective spine care for patients around the world. I am on the Board of IASP (a sister organization to the International Society for the Advancement of Spine Surgery-ISASS) which was formed in 2011 to complement ISASS’ educational and scientific mission through direct advocacy efforts on the behalf of spine patients. I have spent the last 30 years in NC, generally working in healthcare or related fields. [...] I am writing to express serious concerns about numerous factual inaccuracies and omissions on the Blue Cross Blue Shield of North Carolina “Let’s Talk Cost” web site.

Spine Safety Alert: Zimmer Spine Issues Urgent Worldwide Medical Device Recall of the Inserter Instrument for the PEEK Ardis® Interbody Spacer »

December 20, 2012—Zimmer Spine, Inc. is initiating a voluntary worldwide recall of all 315 units of the PEEK Ardis® Inserter. The Ardis Inserter is a surgical instrument used during spinal surgery to implant the PEEK Ardis Interbody Spacer. The inserters are being recalled because Zimmer Spine has received reports of PEEK Ardis Interbody Spacer implant breakage when the implant is subjected to excessive lateral and/or off-axis forces from the inserter during surgery. Intra-operative complaint reports received to date indicate an occurrence rate of 0.52%. Observed health risks associated with implant fragments may include dural tears and blood loss. No post-operative complaints have been reported that are attributed to a fractured implant. Patients with concern about their implant should contact their healthcare provider.

November 2012 - Dr. Thomas Errico on What the Obama Reelection Means for Spine Patients »

What's clear is that the re-election of President Obama ensures the ongoing implementation of the Affordable Care Act (ACA). Some of that is good (elimination of pre-existing condition exclusions, elimination of lifetime benefit caps, inclusion of tens of millions of people into the health care system), and some of that is bad (the unchecked power of the Independent Payment Advisory Board, the uncertainly around guaranteed benefits in state health exchanges, and declining physician reimbursements).

September 2012 - Advocacy Alert: Washington State Health Care Authority Seeking Input on Cervical Spinal Fusion for DDD »

The office of Health Technology Assessment in the state of Washington has commissioned a health technology assessment of cervical spinal fusion for degenerative disc disease, in order to compare the clinical benefits, potential harms, and economic impact of cervical fusion procedures to conservative management and other treatment alternatives.

June 2012 - IASP Response to US Supreme Court Ruling on PPACA »

In response to the US Supreme Court's validation of the provisions of the Patient Protection and Affordable Care Act (PPACA), IASP issues the following statement:

International Advocates for Spine Patients (IASP) applauds provisions of the Accountable Care Act that increase patient access to primary and specialty care, and efforts to better coordinate care (and thus save money) through Accountable Care Organizations and State Health Exchanges....

 

About Advocacy at IASP

IASP - International Advocates for Spine Patients - acts on the behalf of spine patients that have been denied coverage or reimbursement for spine care treatments and procedures by either public or private payors.

IASP advocacy efforts are being developed and undertaken by luminaries of the spine surgery community to advocate for the best spine care for patients.

IASP responds to public policy agencies that request information in support of spine procedures and treatments to provide evidence of the efficacy and influence policy decisions.

In the video testimonial below, Dr. Morgan Lorio responded to the US-based Agency of Healthcare Research and Quality request for comments on spinal fusion for painful lumbar degenerative disc or joint diseases:

 

IASP is taking on the task of expanding advocacy efforts for spine patients through advocacy activities that are outside the scope of the educational mission of our sister organization ISASS.

Advocacy at ISASS

ISASS - The International Society for the Advancement of Spine Surgery - supports spine patient advocacy efforts through the development of public policy statements supporting spinal procedures based on evidence based efficacy. This role includes the establishment of the ISASS Coding and Reimbursement Task Force and the rapid dissemination of Advocacy Alerts to develop and assist grass-roots advocacy efforts at the local level.

Recent Advocacy News at ISASS

December 2012 - Advocacy Alert: Member Input Needed: Federal AHRQ to Review Comparative Effectiveness for Spinal Fusion

The US Agency for Healthcare Quality and Research (AHRQ) has taken up a comparative effectiveness review of "Spinal Fusion for Treating Painful Lumbar Degenerated Discs or Joints." They recently released a draft report and have provided a public comment period with a deadline of December 18, 2012. ISASS is encouraging our members to provide comments to AHRQ.

November 2012 - Advocacy: 2013 Physician Fee Schedule Finalized - CMS Assigns Valuation to Pre-Sacral Fusion Code »

ISASS Thanks our Members for Stepping Up

On November 1st, the Centers for Medicare & Medicaid Services (CMS) released the 2013 Medicare Physician Fee Schedule final rule.

Of particular note to ISASS members is CMS' decision to assign a valuation ('relative value units') to a recently approved Category I CPT® code 22586: pre-sacral interbody fusion at L5-S1. Earlier this year, ISASS supported the transition of this procedure code to Category I status from its Category III status since the procedure had satisfied the criteria necessary for such a code transition. After the Editorial Panel had voted in favor of establishing the Category I code for pre-sacral interbody fusion, other spine-related medical societies declined to participate in a member RUC survey to establish physician valuation for the procedure. ISASS however realized the importance of appropriately valued procedures to its spine surgeon members, and agreed to conduct a survey of our members to collect the appropriate data for CMS to establish valuation for this procedure.

October 2012 - Advocacy: ISASS Joins the AMA and 100+ Medical Societies in SGR Transition Principles Letter »

The AMA and more than 100 state and medical specialty societies - including ISASS - issued a set of principles that can support a federal transition from the sustainable growth-rate formula to a “higher performing Medicare program.” In an Oct. 15 letter to Congressional Leaders, the groups called for lawmakers to repeal the Medicare physician payment formula, arguing that eliminating the SGR formula is essential to the development of a high performing Medicare program.

September 2012 - Advocacy Alert: Washington State Health Care Authority Seeking Input on Cervical Spinal Fusion for DDD »

The office of Health Technology Assessment in the state of Washington has commissioned a health technology assessment of cervical spinal fusion for degenerative disc disease, in order to compare the clinical benefits, potential harms, and economic impact of cervical fusion procedures to conservative management and other treatment alternatives.

July 2012 - The Spine Movement - Spine ASCs and Meeting The Existence Theorem »

From the June 2012 ASC Special Issue of the ISASS monthly newsletter The Spine Movement: Dr. Morgan Lorio, Chair of the ISASS Coding & Reimbursement Task Force tackles a few of the larger issues in spine ambulatory surgery.

June 2012 - The Spine Movement - Coding Challenges Loom Large in 2012 »

From the June 2012 Special Advocacy Edition of the ISASS monthly newsletter The Spine Movement: Dr. Morgan Lorio, Chair of the ISASS Coding & Reimbursement Task Force, gives a look at concrete examples of the increasingly difficult environment for spinal procedures.

June 2012 - The Spine Movement - Important Changes to the CPT Coding of Minimally Invasive Surgery »

From the June 2012 Special Advocacy Edition of the ISASS monthly newsletter The Spine Movement: Dr. Choll Kim examines the ever trickier coding landscape as it relates to Minimally Invasive Surgery.

More ISASS Public Policy and Advocacy Information »

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