September 10, 2020

ISASS Comments on Independence Blue Cross Spinal Fusion Policy

ISASS Comments on Independence Blue Cross Spinal Fusion Policy On August 25, 2020, ISASS sent a comment letter to Independent Blue Cross (IBC), the Blue Cross affiliate for the Greater Philadelphia area, regarding their recent Spinal Fusion Policy. The IBC policy calls for attestation of failure of conservative treatment by a physiatrist.  The letter from Dr. Frank Phillips, ISASS president, stated “ISASS believes that this intrusion has already been shown to create significant barriers to efficient care. ISASS questions the Level of Evidence supporting an additional consultation with a physiatrist to document that a patient has exhausted nonsurgical options. ISASS further maintains that the spine surgeon, rather than the physiatrist, is solely capable of the surgical decision making required to […]
August 7, 2020

ISASS Comments on Washington State Health Care Authority Potential Review of Sacroiliac Joint Fusion Policy

ISASS Comments on Washington State Health Care Authority Potential Review of Sacroiliac Joint Fusion Policy On July 23, 2020, ISASS sent a comment letter to the Washington State Health Care Authority (HCA) regarding their sacroiliac joint fusion coverage policy, which is used by the state’s Medicaid and workers’ compensation program for coverage. The ISASS letter asked that the Washington HCA consider review and potential revision of their coverage policy to include minimally invasive sacroiliac joint fusion for joint pain and dysfunction due to degenerative conditions not limited to direct trauma or injury to the pelvic girdle, which would be consistent with ISASS recommendations. The current Washington State HCA policy does not recommend coverage, despite an initial positive finding by the […]
August 7, 2020

ISASS Supports Letter to the HHS Requesting Elimination of Budget Neutrality Adjustments to Physician Payments for 2020

ISASS Supports Letter to the HHS Requesting Elimination of Budget Neutrality Adjustments to Physician Payments for 2020 On July 1, 2020, multiple organizations, including ISASS, sent a letter to Alex Azar, secretary of Health and Human Services (HHS), to remove budget neutrality negative adjustments under the 2021 Medicare Physician Fee Schedule. The organizations indicated support for the actions of the Centers for Medicare and Medicaid Services (CMS) in last year’s Medicare physician payment final rule to utilize the American Medical Association (AMA) Current Procedural Terminology Editorial Panel coding framework, and the AMA Specialty Society Relative Value Scale Update Committee recommended values for office and outpatient visits starting January 1, 2021. The framework was the result of significant collaboration by an […]
August 7, 2020

The HHS Extended the Deadline for Eligible Physicians to Apply for CARES Act Funding Into August

The HHS Extended the Deadline for Eligible Physicians to Apply for CARES Act Funding Into August The Department of Health and Human Services (HHS) extended the deadline for eligible Medicaid and Children’s Health Insurance Program physicians and organizations to submit information and apply for funding from the Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund from July 20 to August 3, 2020. The HHS is distributing approximately $15 billion to eligible physicians who have not previously received a payment from the Provider Relief Fund. The payment amount will be at least 2% of reported gross revenue from patient care, and the final amount will be determined based on submitted data, including the number of Medicaid patients served. The HHS […]