8 Explore New Prior Authorization Resources 6 Prepare Now for January 2023 E/M Revisions 7 AAN Quality Achievement Award Recipients Selected VOLUME 34 ISSUE 9 SEPTEMBER 2022 Visit AAN.com/Covid19 for the latest pandemic information and resources to support you and your crucial work. October 28–30 2023NOWAPPLICATIONSOPENFORAANAWARDS Apply by November 2 Applications are now being accepted through November 2 for the 2023 AAN awards, which recognize outstanding achievements across career levels. The AAN values your unique contributions to the field of neurology and AAN awards offer opportunities to be honored during conferences, receive travel stipends, or present your work to your colleagues. Apply—or nominate a colleague— for a variety of prestigious AAN awards to be celebrated in person during the 75th AAN Annual Meeting in Boston next April 22–27. Visit AAN.com/Awards to learn more and apply or nominate. Continued on page 9 › Secure Early Registration Savings for Fall Conference by September 8 Don’t miss your chance to secure up to $260 in savings by registering for the Fall Conference by September 8. Visit AAN.com/Fall today, then get ready to sharpen your competitive edge in neurology and hone strategies for practice management success when you join your neurology colleagues in person in Las Vegas for this notto-be-missed weekend! October 11 Is Deadline to Submit Abstracts for 2023 Annual Meeting The deadline to submit your best research for presentation at the 2023 Annual Meeting is quickly approaching. Abstracts will be accepted until October 11 at 11:59 p.m. CT in all subspecialties and career levels. The submission fee is $100 for AAN members, $200 for nonmembers, and free for residents and medical students. Visit AAN.com/AMAbstracts to learn more and submit. For questions, contact Katie Anderson at science @ aan.com Abstracts Submit Boston & Virtual • April 22–27
© 2022 Reata Pharmaceuticals, Inc. All Rights Reserved. US-NNU-2100006 05/2022 *There may be additional uncommon symptoms. Think FA FIRST when you see any combination of these symptoms*: Get helpful resources and the latest FA information at ThinkFA.com. Initial symptoms of FA can be vague and overlap with other conditions.2,3 However, FA is the most common inherited ataxia.4 Will you recognize it when you see it? Falls1 (gait ataxia) Imbalance1 (proprioception loss) Reflex loss1 (areflexia) Sensation loss1 (sensory neuropathy) Tiredness4 (fatigue) falls imbalance re ex loss tiredness sensation loss falls imbalance re ex loss tiredness sensation loss falls imbalance re ex loss tiredness sensation loss falls imbalance re ex loss tiredness sensation loss falls imbalance re ex loss tiredness sensation Because FA is a severe disease that relentlessly progresses to loss of ambulation and independence in nearly all patients, identifying these early signs is crucial.3 References: 1. Fogel BL, Perlman S. Clinical features and molecular genetics of autosomal recessive cerebellar ataxias. Lancet Neurol. 2007;6(3):245-257. 2. Indelicato E, Nachbauer W, Eigentler A, et al. Onset features and time to diagnosis in Friedreich’s Ataxia. Orphanet J Rare Dis 2020;15(1):198 3. Parkinson MH, Boesch S, Nachbauer W, Mariotti C, Giunti P. Clinical features of Friedreich’s ataxia: classical and atypical phenotypes. J Neurochem. 2013;126(suppl 1):103-117. 4. National Institute of Neurological Disorders and Stroke. Friedreich Ataxia Fact Sheet. Updated November 15, 2021. Accessed March 16, 2022. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Friedreichs-Ataxia-Fact-Sheet. FA LossCT:of balance is one of the early signs of Friedreich’s Ataxia (FA), but it may not be this obvious.1
September12HighlightsAdvocacy Pushes for Extension of Telehealth Flexibilities Past Pandemic
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Ever since the COVID-19 pandemic forced neurology practices around the country to dramatically reshape their delivery of care for the vulnerable populations they treat, telehealth has become an essential method of delivering care for most neurologists.
Email: Michael.Obrien @ wolterskluwer.com
News Briefs AAN in the News
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The Mission of the AAN is to promote the highest quality patient-centered neurologic care and enhance member career satisfaction. Vision of the AAN is to be indispensable to our members. Academy of Neurology 201 Chicago Phone:Minneapolis,AvenueMN55415(800)879-1960 (toll free) (612) 928-6000 (international)
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AANnews · September 2022
The
14 Residents: Apply for Neurology Today Editorial Board Position Neurology Today ®, the official news source of the AAN, seeks applications for a two-year resident position on the editorial board.
2022 has been a good year for Sarah Hon, DO, FAAN. In May, she graduated with honors in the Executive MBA program at Rockhurst University, and in June started a new position as vice president of neurosciences at The University of Kansas Health System.
APPLY NOW ZecavatiHon
16 2022 Marks Year of Successes for Women Leading in Neurology Program Graduate
Email: memberservices@ aan.com Website: AAN.com For advertising rates, contact: Michael J. O’Brien Account/RelationshipII Manager Wolters Kluwer Phone: (978) 578-4514
AAN Chief Executive Officer: Mary E. Post, MBA, CAE Editor-in-Chief: Melissa W. Ko, MD, MBA, CPE, FAAN Managing Editor: Angela M. Babb, MS, CAE, APR Editor: Tim Streeter
A Neurology ® study suggesting that acupuncture may reduce chronic tensiontype headaches was picked up by The Washington Post and CNN, along with more than 200 broadcast mentions on CBS, ABC, and FOX affiliates. A study that found a link between hypothyroidism and an increased risk of dementia was mentioned by The Independent, HealthDay, and Daily Mail. Another study that found shingles is not associated with an increased risk of dementia was covered by Yahoo!, The Telegraph, and Best Life.
AANnews® is published monthly by the American Academy of Neurology for its 38,000 members worldwide. Access this magazine and other AAN publications online at AAN.com.
INAANTHENEWS
Over the course of my tenure as a writer for Neurology Today ®, I have had the privilege of interviewing countless international members. Their knowledge and experience has helped me appreciate diverse health systems and has guided me to concepts which would be applied to my work as a member, and later chair, of the Medical Economics and Management Committee. I sometimes met those colleagues in times of crises, like after an earthquake which left Pakistan devastated, and an economic collapse that caused Greek neurologists to struggle with procuring basic services and medications for their patients. Their dedication to patients under duress was steadfast and inspired me in my practice here. I was repeatedly struck by how our common bond in neurology made our differences in backgrounds seem small and our connection immediate and strong.
From left to right: William M. Carroll, MBBS, MD, FRACP; Raad A. Shakir, MD, FRCP, FAAN; Orly Avitzur, MD, MBA, FAAN; Vladimir Hachinski, MD, DSc, FAAN; and Wolfgang Grisold, MD, FAAN.
4 A ANnews • September 2022
Nearly one in four American Academy of Neurology members now resides outside the United States. In the past two years alone, I have spoken to members in Canada, India, Mexico, Brazil, the United Kingdom, Spain, Italy, Saudi Arabia, Venezuela, Nigeria, and many other countries, to ask how COVID-19 has affected their patients and to hear about their challenges as neurologists. Several expressed interest, and ultimately joined our committees, despite time zone differences that have made participation arduous, and daily work demands made even more taxing by extra burdens created by the pandemic.
During that trip, I also met with Prof. Paul Boon, the newly elected president of the EAN, and engaged in a productive discussion about how our two organizations can work together on subjects of shared interest. We currently offer a joint membership with the EAN which we hope can be enhanced by cross-attendance at our annual meetings. I look forward to future such collaborations to benefit both our associations’ members.
PRESIDENT'S The Wide World of Neurology
Along with the time and effort involved in building and maintaining these vibrant relationships, our Academy delivers crucial financial assistance and badly needed resources. For several years, the AAN has provided financial support for trainees participating in the Regional Training Course presented by the EAN and African Academy of Neurology (AFAN) and held annually in conjunction with the AFAN Congress. The AAN pays for the travel expenses for an AAN faculty representative to teach at the course and attend the congress.Wealso give International Scholarship Awards to dozens of bright, young medical students from around the world so they can attend our Annual Meetings. This eye-opening experience puts them in proximity of many of our homecanandprovidesneurologistsleadingandknowledgepassiontheybringbackandshare.
It has long been the tradition of the AAN to build relationships with our counterparts in neurology in other parts of the world. We have had a close association with the World Federation of Neurology (WFN) and have enjoyed participating in World Brain Day and other WFN international activities. Recently, I traveled to the European Academy of Neurology (EAN) meeting in Austria where AAN CEO Mary Post, MBA, CAE, and I met with leaders from several countries and discussed brain health and other topics of mutual concern. It was our good fortune that Vienna is home to the president of the WFN, Prof. Wolfgang Grisold, a gracious host—and 2004 graduate of the AAN’s Palatucci Advocacy Leadership Forum—who introduced us to Viennese culture and sites and to his family and colleagues.
Later this year, I plan on speaking at the 18th Asian Oceanian Congress of Neurology and 29th Annual Conference of the Indian Academy of Neurology in New Delhi. India comprises the second largest number of international members at the AAN. I hope to meet delegates of their subsections during the conference and learn more about global neurology. Our two organizations have been meeting annually for many years and enjoy exchanging ideas regularly.
COLUMN
I have consistently learned from those interactions but never was it so urgently needed as in March of 2020, when neurologists in Australia, Spain, and France provided us with early insights on the presentation and treatment of COVID-19 patients who were tragically filling their intensive care units. Since that time, the pandemic has served to emphasize that many public health issues are interwoven and that we benefit most from working together.
Avitzur
With Prof. Paul Boon, the newly elected president of the EAN.
The Academy, along with its publisher, Wolters Kluwer, provides access to Continuum® as an enduring reference and source of education to neurology professionals in 49 World Bank classified low- and low-middle-income countries in collaboration with the WFN as its distribution partner. Continuum has paid subscribers in 92 countries. Our flagship science journal Neurology ® receives 65 percent of its manuscript submissions from outside the US. The journal also publishes Argentinian and Japanese editions edited locally by Ricardo Reisin, MD, and Nobutaka Hattori, MD, PhD, respectively. Our popular Brain & Life® en Espanol web page can be accessed by Spanish-speaking people anywhere, while the quarterly Spanish-language print edition is also shared by US neurologists with patients and their caregivers. But no matter what language you speak or where you call home, our focus as neurologists is on the health and safety of our patients. This September 17 marks World Patient Safety Day in which the World Health Organization is calling for global solidarity and concerted action by all countries and international partners to improve patient safety; this year’s focus is on medication. As I wrote in the May President’s column, Ukraine is experiencing a severe shortage in neurologic drugs and several of our members are engaging in efforts to send antiseizure medications and other supplies there. Since then, I have heard from more of you—with and without ties to the region—who are raising funds to send more packages. I know how much that means to our members who live in Ukraine who continue to care for patients with neurologic conditions.
CESC: 22 Fall Conference Advanced Registration Ad—Half Page Horizontal> AN Placed in AANnews 8.25 x 5.25 +0.125 bleed, 4C October 28–30 A premier conference with top experts on the hottest topics in neurology, real-world issues in practice management, and innovative science―plus valuable CME. Additional in-person-only APP and Sports Concussion Pre-conferences on October 27. Bundle either with your Fall Conference registration for discounted rate. AAN.com/Fall Register by September 29 for Advance Registration and Hotel Savings Join us at Caesars Palace in Las Vegas
One such AAN member from Kyiv, whom I met at the EAN meeting where she had been invited to present a paper, remarked on how quiet and peaceful the streets of Vienna were and how surreal it was to experience such calm after over 125 days of war and violence. She also shared how she takes one day at a time, and no longer focuses on an uncertain future. Her duty, she says, is to serve a hospital with few remaining neurologists. Perspectives from international members like her are often similarly grounding and help me acknowledge what is important to an organization like ours: providing quality care to people with neurologic conditions and respecting each other as members of a large, diversely wonderful world with a singular love of neurology. Orly Avitzur, MD, MBA, FAAN President, AAN oavitzur@aan.com @OrlyA on Twitter
Time requirements for the revised codes are not listed as a range, rather, a specific number of minutes “must be met or exceeded” if billing based on time
Addition of “1 acute, uncomplicated illness or injury requiring hospital inpatient or observation level of care” as a criterion for low complexity in the “Number and Complexity of Problems Addressed” column of the table
The June and August editions of AANnews® feature additional creative solutions. Be sure to connect with the AAN on social media at #AAN and @AANMember as we feature new solutions throughout the year.
Deletion of hospital observation care codes and the inclusion of observation services in the initial and subsequent hospital care codes
PRACTICE Prepare Now for January 2023 E/M Revisions
Visit AAN.com/em to access the MDM table and to review the entire AMA CPT E/M Code and Guidelines Changes. Check back often for additional resources including registration in late fall for a free member webinar in December that will cover changes to the 2023 Medicare Physician Fee Schedule.
6 A ANnews • September 2022
Specialized Staff Augment Neurology Care Teams
Deletion of level 1 consultation codes (99241 and 99251)
AAN business administrators agreed their top three care-team specialized staff were neuropsychologists, clinical psychologists, and social workers. Some of the benefits of adding them to the team include: Delivering support to patients by providing testing, guidance, and resources Shifting counselingpatienttothis group allows physicians to practice at the top of their license and increases availability to other patients Expanded care coordination Improved organizational efficiency Holistic treatment plans You can read more at the Managing Staffing Challenges web page at AAN.com/practice/staffing-challenges, including other helpful specialties and important things to consider when adding members to the team. If you’re not already participating in the Business Administration Section Community on SynapseSM, visit synapse.AAN.com to learn more and join in the conversations with your colleagues.
The next iteration of updates to the evaluation and management (E/M) code set and guidelines is scheduled for implementation January 1, 2023. The key to avoiding a disruption in claims processing at that time is to begin learning now!
Revision of “Decision regarding hospitalization” to include “Decision regarding hospitalization or escalation of hospital-level care” as an example of high risk in the “Risk of Complications and/or Morbidity” column of the table
Updates to Medical Decision Making (MDM) table:
The AAN continues to reach out to neurology business administrators from across the country to learn what unique solutions they are finding to manage the ongoing staffing crisis sparked by COVID-19. Creating a care team that includes specialized staff can deliver an excellent patient experience and optimize the efficiency of your practice. Recently, the Academy asked, “What are some benefits of other specialized staff?”
This phase includes updates to inpatient and observation care, consultations, emergency department, nursing facility and home and residence service, and prolonged services codes. To align with current guidelines for office and outpatient visits, starting in January the history and physical exam will no longer be used to determine the visit level for the updated services, rather the code selection will be based on time or medical decision-making (MDM). The exception is emergency department visits, which do not have a time component. While there are many nuances to the changes, key considerations include:
AAN Quality Achievement Award Recipients Selected
“Neurologists who participate in the Axon Registry have made a particular commitment to high-quality care for their patients, and it’s a pleasure to recognize their performance with this award. While we acknowledge there are many quality improvement initiatives happening across our specialty, this program is a specific benefit of participation in the Axon Registry,” said Lyell K. Jones, Jr., MD, FAAN, chair of the Quality Committee. This is an optional award that practices may choose to pursue if they are participating in the Axon Registry and would like to be recognized for their efforts. Practices are recognized and can promote their status to patients and other stakeholders. Recipients receive complimentary plaques to display at their facility. To join the Axon Registry, visit AAN.com/axon
Platinum: Average performance rate of 95 percent or greater
The new AAN Quality Achievement Award acknowledges AAN members and practices who have invested time and resources into improving neurologic care for their patients. This is an annual recognition exclusive to Axon Registry ® participants. Recipients of the award can be viewed at AAN.com/practice/axon-registry-participants
Axon Registry Transitions EHRs to Verana Health
Silver: Average performance rate between 75 percent and 84.9 percent
A ANnews • September 2022 7
Bronze: Average performance rate up to 75 percent
In early 2021, the Axon Registry® began a new relationship with its technical partner Verana Health. Over the past year, the AAN has worked with Verana Health to get practices fully transitioned over to Verana Health. As of September 2022, several electronic health records (EHRs) have begun transitioning. In the first half of 2022, the Axon Registry provided dashboards for practices with the following EHRs: Cerner, eClinicalWorks, eMDs-Solution Series, EPIC, and Webchart. In quarter three, the registry will be providing dashboards for Athenahealth, and eMDs-Lytec MD, eMDs-Medical Clinical, and eMDs-Practice Partner. To assist current Axon Registry participants in transitioning to Verana Health, the AAN is offering IT grants in 2022. Practices can receive up to $20,000 in funding from the AAN to help with integration costs. To receive funds, practices will need to sign the business agreement and new vendor form that the AAN provides. For the 2022 MIPS submission period, some practices will be submitting through Verana Health, and others will still be using FIGmd. Verana Health has reached out by email to all our practices to let them know which technical partner will be assisting them for the remainder of 2022. If a practice needs to confirm which technical vendor will help them submit for MIPS, it can contact the Axon Registry staff to answer any questions. As more dashboards become available, Verana Health and Axon Registry staff will contact practices and review the data available. For data mapping and refinements, staff will meet with practices to ensure the practice’s dashboard is accurate and up to date. For any questions about the Axon Registry’s partnership with Verana Health or their practice’s status, please contact registry @ aan.com Jones
Gold: Average performance rate between 85 percent and 94.9 percent
Using the data from the previous year’s dates of service, average practice-level performance for the top six measures was calculated. These averages were used to determine the practice tier.
Chapter 2 includes tips for negotiating contracts with payers and useful information needed before your negotiations begin.
The new series is available at AAN.com/education/onlinelearning-programs
Got practice@aan.comday.inGetquestions?managementpracticeanswersonebusinessJustask.
The brief videos offer tips and insights that members can use to build better relationships with payers and confidently interact with them, particularly with regard to skillfully negotiating contracts.
Chapter 3 presents tips, tools, and tricks for small/solo practices to overcome challenges in their contract negotiations and make the process easier.
Prior authorization (PA) has been an ongoing area of concern for the entire medical community with members of the AAN specifically citing alleviating administrative burden and step therapy protocols as a priority issue. On August 3, the AAN hosted an “Ask Me Anything About PA” session with an expert panel who shared their tips and insights into PA. AAN members Kavita Nair, PhD; Tyler Allison, MD; and Donald Shook, Jr., MBA, answered questions about the advocacy work the AAN is doing on the hill and shared practical tips for members to ease the process. Members can access a recording of the webinar on the AAN Online Learning Center at learning.AAN.com
PRACTICE New Practice Video Series Can Help Improve Relationships with Payers
Explore New Prior Authorization Resources
The AAN has launched “Navigating Relationships with Your Payers,” a new three-part series of five-minute videos focused on establishing and maintaining relationships with payers.
Helping our members navigate the landscape of PA and providing related resources continues to be a priority for the AAN. The AAN has launched a new PA resource page with legislative updates, PA checklists, and new disease/therapyspecific PA forms for Botox and Calcitonin Gene-related Peptide (CGRP). Additional disease-specific forms will launch as the year continues. Check the AAN.com/practice often for updates. If you would like to share your PA experiences with our staff to inform the Academy’s work, please submit them at practice @ aan.com
Practice Email Ad—Half Page Horizontal> AN Placed in AANnews 8.25 x 5.25 +0.125 bleed, 4C“When“HowI…?”is the deadfor...?” “Is there a code shouldfor…?”“Canthepayer…?”“WhatformI…?”“Whocantellme…?”“What is the best…?” “How do I…?” “When is the deadline for...?” “Is “What“How“Whendeadlinethereacodefor…?”“Canthepayer…?”“WhatformshouldI…?”“Whocantellme…?”“Whatisthebest…?”“HowdoI…?”“Whenfor...?”“Isthereacodefor…?”“Canthepayer…?”“WhatshouldI…?”“Whocantellme…?”“Whatisthebest…?”“Howdoisthedeadlinefor...?”“Isthereacodefor…?”“Canthepayer…?”“WhatformshouldI…?”“Whocantellme…?”“Whatisthebest…?”doI…?”“Whenisthedeadlinefor...?”“Isthereacodefor…?”“Canthepayer…?”“WhatformshouldI…?”“Whocantellme…?”isthebest…?”“HowdoI…?”“Whenisthedeadlinefor...?”thereacodefor…?”“Canthepayer…?”“WhatformshouldI…?”“Whotellme…?”“Whatisthebest…?”“HowdoI…?”“Whenisthefor...?”“Isthereacodefor…?”“Canthepayer…?”“WhatformshouldI…?”“Whocantellme…?”“Whatisthebest…?”“HowI…?”“Whenisthedeadlinefor...?”“Isthereafor…?”“Canthepayer…?”“WhatformshouldI…?”“Whocantellme…?”“Whatbest…?”“HowdoI…?”“Whenisthedeadlinefor...?”
Chapter 1 is focused on building and navigating relationships with payers and advice for working with payers.
A full day of advanced practice provider education programming designed especially for care team members! The APP Pre-conference neurology fundamentals and clinical case studies on several topics such as dementia, epilepsy, movement disorders; a deeper dive on techniques and skills for lumbar punctures, deep brain stimulation, nerve blocks, and botulinum toxin use in treatment of migraine; as well Concussion
Neurology ® Podcast: 20 Minutes Pack a Punch! Subscribe and download the latest podcast at Neurology.org/podcast PODCAST A ANnews • September 2022 9 EVENTS Secure Early Registration Savings for Fall Conference by September 8 continued from cover The AAN Fall Conference will offer timely updates on the hottest topics in the world of neurology, practical issues in practice management, the most innovative science, long-awaited networking, and the chance to earn up to 51.5 valuable end-of-year CME credits. Highlights include: New programming based on updates and progress made in the field of neurology over the past six months The latest innovative science through the Neuroscience in the Clinic and Plenary Sessions Insights on practice management ranging from coding, building service lines, value-based care, and productivity to telemedicine and HR/staffing Leadership University with four sessions focused on professional development Interactive Experiential Learning Areas with one-on-one Curbside Consults where you can bring your most challenging cases for discussion with an expert or learn about neuro exam tips and tricks. Opportunities to learn about the latest industry innovations in the Exhibit Hall Join Us a Day Early for One of the In-person Pre-conferences! Attend either of these in-person-only pre-conferences on Thursday, October 27, as a stand-alone, or bundle with the full Fall Conference to save! Visit AAN.com/Fall to learn more and register by the September 8 early registration deadline. Advanced Practice Provider
includes
as special networking opportunities. Sports
A full day of sports concussion programming designed especially for residents, medical students, and general neurologists. The curriculum will focus on the physical exam, TBI, special populations, brain health, and updated concussion guidelines for the general neurologist.
Enfermedad de Alzheimer Un nuevo fármaco genera controversia y esperanza Nutrición Perder peso es bueno para la salud cerebrodelReír es importante El comediante George Lopez utiliza el humor para despertar conciencia en los latinos sobre la importancia de cuidar su salud. NEUROLOGÍA PARA LA VIDA DIARIA INVIERNO 2021 ManagementSeizure Advice from Those In the EpilepsyNeurologistsKnow:with Back to the Office A Healthy Transition From Remote to In-Person Work Brain Wonders Experts ConfabulationExplainthings.”incredibleshevisible,outwardlyalwaysthat’samomMyhasstrengthnotbuthasdone —LINDSAY VONN Podcast An entertaining weekly podcast with people whose lives are affected by brain conditions, celebrity advocates, and neurology experts. Free Magazine Articles on neurologic conditions and brain health not found anywhere else. Available in both English and Spanish. Orly Avitzur, MD, MBA, FAAN Editor-in-Chief, Brain & Life® Joseph I. Sirven, MD, FAAN Editor, Brain & Life® en Español Audrey R. Nath, MD, PhD Brain & Life podcast co-host Daniel José Correa, MD, MSc, FAAN Brain & Life podcast co-host We Aren’t Just a Magazine
Join the Brain& Life Community! Book Series Books for navigating life with brain Tenmajoravailabledisease,fromallbooksellers.titlesavailable. BrainandLife.org/Books BrainandLife.org Features Disorders A-Z, Healthy Living, Brain Science articles, and more. David C. Spencer, MD, FAAN Editor, Brain & Life® Books Magazine Anymore!
Access to audio-only telephone-based services is important for Medicare beneficiaries of limited means and is also vital for Medicare patients who live in communities that lack sufficient broadband cellular service and internet connectivity. As much as seven percent of the US population does not use the internet, including 25 percent of adults aged 65 or older, according to a Pew Research Center study.
Fortunately, in July the House passed by a wide bipartisan margin an extension of current telehealth flexibilities, which included audio-only coverage, through the end of 2024. The Senate has not yet taken up this bill. Neurology is one of the top specialties benefiting from telehealth flexibilities, with an increase from one percent of neurology providers delivering telemedicine in the pre-COVID period to a high of 56.3 percent of neurology providers delivering telemedicine from March through June 2020. While virtual visits in many areas dropped after their early peak, neurology remains one of the highest utilizers of telehealth of all physician specialties, with one study showing headache patients have a 99-percent level of satisfaction. Telehealth has also benefited children with neurologic disease, with 86 percent of patients/caregivers in a large pediatric neurology care network indicating interest in telemedicine for future care after the onset of the pandemic.
“The AAN has been at the forefront in advocacy on this issue,” said Zecavati. “We had a big win last year when we championed the funding of $65 billion for improving internet access as part of the Infrastructure Investment and Jobs Act. We have had big wins in continuing to persuade the administration to extend the ongoing Public Health Emergency declaration, which is essential for telehealth flexibilities in Medicare. We now need the Senate to join the House in advancing this critical legislation to continue flexibilities through at least 2024, giving us adequate time to enact permanent reforms.” Zecavati
The AAN has been lobbying Congress to extend these telehealth flexibilities beyond the public health emergency, and this was one of the top three issues discussed by members with their senators and representatives during Neurology on the Hill in May 2022. To help solve this problem, the AAN has asked members of Congress to advance legislation to maintain access to care via telehealth for people with neurologic conditions for at least two years following the public health emergency. Nassim Zecavati, MD, FAAN, a member of the AAN’s Telehealth Subcommittee, helped Neurology on the Hill participants understand the scope of the Zecavatibill.said that a permanent expansion of telehealth coverage is projected to cost roughly $25 billion over 10 years, making a permanent expansion more challenging due to the cost. “The key questions posed by the Congressional Budget Office are: Does the use of telehealth supplement or replace existing care? Does pay parity provide too much incentive? Does fraud and abuse occur and how often? We need more data to help us answer these questions.”
The ability for neurologic patients to access telehealth services will be severely threatened when the public health emergency and 151-day-extension recently enacted by Congress ends. The Senate must act to preserve the progress that has been made by extending telehealth flexibilities through the end of 2024 to provide additional time to further gather data, study this issue, and enact permanent reforms.
ADVOCACY Advocacy Pushes for Extension of Telehealth Flexibilities Past Pandemic
Ever since the COVID-19 pandemic forced neurology practices around the country to dramatically reshape their delivery of care for the vulnerable populations they treat, telehealth has become an essential method of delivering care for most neurologists. This has only been possible due to the policy flexibilities enacted by Congress, along with the broad interpretation of these provisions by the Centers for Medicare & Medicaid Services.
Outlined below are several key developments, including progress on two Neurology on the Hill 2022 priorities—prior authorization reform and telehealth.
The Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040) passed the House on July 27 by a vote of 416–12. This legislation mirrors our Neurology on the Hill 2022 telehealth ask, ensuring that Medicare beneficiaries continue to have access to telehealth in Medicare by extending key flexibilities that were enacted during the public health emergency until at least December 31, 2024. Act now and tell your senators to support the extension of these flexibilities by passing H.R. 4040 through the Senate!
On July 29, the AAN led a letter to the House and Senate Judiciary Committees urging them to take swift action on the Conrad State 30 and Physician Access Reauthorization Act (H.R. 3541/S. 1810) before the end of the 117th Congress. This letter was joined by 62 other organizations representing a broad range of constituencies, including patients, physicians, hospitals, and immigration organizations.
Congress was busy as both chambers aimed to wrap up their legislative sessions prior to leaving for the August recess.
Neurology on the Hill 2022’s #FixPriorAuth ask, the Improving Senior’s Timely Access to Care Act (H.R. 8487), finally received a hearing in the House Ways & Means Committee and was reported out favorably with overwhelming bipartisan support. This legislation, which would reform the use of prior authorization requirements in Medicare Advantage plans, has been a focus of AAN advocacy efforts for several years. The next step for this bill is consideration by the full House of Representatives.
The Senate released its draft FY23 Appropriations packages on July 28. Congressional leaders have not agreed to a topline number, although Senate Appropriations Chair Patrick Leahy (D-VT) has expressed his desire to finish the process by the end of this Congress. The bills include $2.768 billion for NINDS, an increase of $150 million from FY22. Within NIH, the BRAIN Initiative is funded at $700 million, $80 million more than was appropriated in the House version of the bill. All four Neurology Centers of Excellence (Epilepsy, Headache, MS, Parkinson’s) are mentioned in the bill, with the Parkinson’s Center being appropriated $12 million, a 50-percent increase from FY22. The committee also recognizes the importance of increased investments for the expansion of MS Centers. Now that both chambers have released draft language, negotiations are able to begin. It is still unlikely an agreement will occur before government funding runs out, creating the need for a continuing resolution come October 1.
The Medical Marijuana and Cannabidiol Research Expansion Act (H.R. 8454) passed the House and was received in the Senate. This bill creates a registration process for researchers and manufacturers of medicinal marijuana and cannabidiol (CBD). It specifically allows physicians to discuss both the potential harms and benefits of medicinal cannabis with patients and requires relevant federal agencies to report findings on the therapeutic potential for conditions as well as its impact on developing adolescent brains and ability to operate motor vehicles. The AAN has repeatedly provided support for research in this area, discussed in our position statement.
A ANnews • September 2022 13 Capitol Hill Report
The AAN urged Congress to stave off an 8.55-percent Medicare physician payment cut that is scheduled to go into effect at the end of 2022, and to also provide an inflationary update based on the Medicare Economic Index to combat rising practice costs.
Capitol Hill Report presents regular updates on legislative and regulatory actions and how the Academy ensures that the voice of neurology is heard on Capitol Hill. It is emailed to US members twice monthly and is posted at AAN.com/view/HillReport are
The Centers for Medicare & Medicaid Services recently announced an indefinite delay in implementation of the Appropriate Use Criteria (AUC) program. As such, there is currently no timeline for when the AUC program will transition from the education and testing phase into the payment penalty phase This delay is in alignment with the AAN’s ongoing advocacy on this topic, which has urged CMS and Congress to reconsider the utility of this program, given the burdens it is likely to place on providers.
Democrats released and passed through the Senate the Inflation Reduction Act, a package that proposes significant health care, climate, and tax policies via the reconciliation process that only requires a simple majority of votes. The AAN has been supportive of provisions in the package that would lower the cost of prescription medications, cap outof-pocket drug costs for Medicare recipients, and extend Affordable Care Act insurance subsidies for three years. The House passed the bill and sent it to the president for his signature.
some recent highlights. Latest Advocacy News
. Below
EDUCATION Residents: Apply for Neurology Today Editorial Board Position
Applications for subspecialty fellowship programs seeking United Council for Neurologic Subspecialties (UCNS) accreditation have new deadlines: January 31, 2023, for spring 2023 review, or July 31, 2023, for fall 2023 review.
The responsibilities of the neurology resident are to attend bimonthly editorial board meetings and optional in-person planning meetings, provide feedback and story ideas, and suggest content relevant to trainees.
“The Neurology Today resident editorial board member will be well positioned to ensure that the interests and needs of trainees are well represented in the publication,” said Neurology Today Editor-inChief Joseph E. Safdieh, MD, FAAN. To apply, candidates should submit a letter of interest, CV, and letter of recommendation from their program director or department chair. For more information or to apply, contact Andrea Weiss at aweiss @ aan.com by October 30. Applicants will be notified of selection by November 30, 2022.
The UCNS now accredits programs in nine subspecialties. Accreditation is a measure of training program excellence and UCNS-accredited programs demonstrate that they meet the standards of graduate medical education excellence set by both the UCNS and the subspecialty experts of each of the UCNS-recognized subspecialties. The peer-reviewed accreditation process is overseen by the Accreditation Council, a standing committee reporting to the UCNS Board of Directors. Visit UCNS.org/Accreditation to learn more and to apply using the new accreditation application. For questions about submitting a new application or accessing your existing account, contact Amanda Carpenter at acarpenter @ ucns.org
Neurology Today ®, the official news source of the AAN, seeks applications for a two-year resident position on the editorial board. Applications are sought from rising PGY-3 (adult) or PGY-4 (child; child neurology year 2) residents. The two-year term will be January 2023 through December 2024.
APPLY NOW
Apply for Accreditation of Subspecialty Fellowship Programs— New Deadlines
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The award features a $1,000 prize and complimentary registration to the 2023 Annual Meeting, where the award will be featured and the recipient will make a 30-minute presentation highlighting work being done.
AAN.com/practice/staffing-challenges New AAN Award Recognizes Academic Neurology EDI Effort
Visit AAN.com/Awards to learn more and apply.
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Staffing shortages exhausting your team?
MEMBERSHIP
Inclusion is the reason the AAN was founded. To be an organization that is the home for all neurologists. It is what makes us stronger. To support our goal of being a fully inclusive, deliberately diverse, and anti-racist organization and our core values of Inclusion, Diversity, Equity, Anti-racism, and Social Justice (IDEAS), we are excited to share progress and updates with you.
The new IDEAS Changemaker Award is for an AAN member who has made a meaningful contribution within their academic institution by increasing equity, diversity, and inclusion (EDI) efforts within the neurology department. Applications are being accepted through October 31, 2022.
Along with being an active AAN member, applicants must be an actively certified neurologist working at an academic institution and residing in the United States. Application requirements include a letter of recommendation, curriculum vitae, and a description on how you have increased EDI efforts in the academic department (500 words or less).
The AAN has resources for staffing, recruiting, and optimizing staff to help alleviate pressure on your team.
With the encouragement of Smikle, Hon ultimately decided to pursue more study in the form of entering the Executive MBA program at Rockhurst. “This definitely shows the power of the WLN program,” she beamed.
16 A ANnews • September 2022 MEMBERSHIP 2022 Marks Year of Successes for
The AAN Women Leading in Neurology Program is an empowering and inspirational leadership program designed to help mid-career participants tackle gender disparities head-on, create a peer network with other women AAN members, and advance to the top levels of leadership in their fields and within the Academy. Learn more at AAN.com/WLN Neurology
Program was supported in part by: AbbVie Alexion, AstraZeneca Rare Disease Amgen argenx Eisai, Inc. Lundbeck Merz Therapeutics Biosciences,Neurocrine Inc. UCB Hon AAN LEADERSHIP DEVELOPMENT
Take the Next Step in Your Career Development Don’t miss your once-in-a-lifetime opportunity to participate in Women Leading in Neurology and Transforming Leaders programs. Applications are due October 19. Past participants of the AAN Leadership Development Programs have found them to be an essential supplement to their careers, the neurology profession, and patient care. Learn more about the programs and eligibility requirements at AAN.com/Lead The 2022 AAN Women Leading in
Women Leading in Neurology Program Graduate
It's been a good year for Sarah Hon, DO, FAAN. In May, she graduated with honors in the Executive MBA program at Rockhurst University, and in June started a new position as vice president of neurosciences at The University of Kansas Health System.
Hon attributes both successes directly to her experience with the AAN’s Women Leading in Neurology (WLN) Program. Achieving her MBA “was a great experience and came straight from the AAN WLN program,” explained Hon. “During my time in the program, I was exposed to articles and books about leadership and business. As I reflected on what I was reading and had the opportunity for discussion with my colleagues and my program coach, Joanne Smikle, PhD, I concluded that I wanted to learn even more.”
Hon also credits the WLN for her recent career move to The University of Kansas Health System. “The program helped me identify my most valuable strengths as well as name and embrace my key values, incorporating these as core components into my leadership style,” she said. The WLN program also helped Hon recognize and address disparities in the workplace—particularly those related to being female. “My mentor, Sarah Benish, MD, FAAN, provided valuable guidance as I considered my career options and ultimately in the process of negotiating my current position. The program’s powerful triad of an outstanding professional coach, thoughtful pairing of each participant with an experienced mentor, and relationships developed among the cohort was invaluable.”
Prepared 2012 Recipient’s Successful Career, Critical Discoveries
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AMERICAN BRAIN FOUNDATION Schindler
Once again, Brain & Life® and Neurology Today ® won Awards of Excellence in the annual APEX editorial competition. The competition draws more than 200 entrants and is judged by editorial and communications professionals. Brain & Life won in the Feature Writing category for the article Mace’s Race, which was published in the February/ March 2021 issue. The article profiles an endurance athlete who has been diagnosed with Alzheimer’s disease and who participated in an endurance athletic event called the Eco Challenge with his son. Read more about his extraordinary journey at https://bit.ly/3oiOelR Neurology Today won in the category of Magazines, Journals & Tabloids—Magazine Series for its articles on disparities in clinical research and efforts to address the issue. Examples of these articles can be read at https://bit.ly/3zk4bP9, https://bit.ly/3RQgxFX, and https://bit.ly/3cBdwcA The Macys forded streams and biked mountain trails during the World’s Toughest Race: Eco-Challenge Fiji.
The American Brain Foundation’s Next Generation Research Grants fund and support a broad range of innovative research by the best and brightest early-career clinician-scientists, encouraging passion for research and laying the groundwork for future success. It is the Foundation’s belief that funding research across a broad spectrum of the brain is the key to finding better treatments, prevention, and cures for brain diseases and disorders. No one exemplifies the mission of the Next Generation Research Grants more than Suzanne Schindler, MD, PhD. She received her award in 2012 and is now an assistant professor of neurology at Washington University School of Medicine in St. Louis. "I am grateful to the American Brain Foundation for providing funding that enabled me to start my independent research career,” said Schindler, whose research focus on Alzheimer’s and dementia. Since then, she has been involved in clinical trials for Alzheimer’s disease, including the first prevention drug trial for Alzheimer’s, and received a K23 career development award from the National Institute on Aging to study fluid biomarkers of Alzheimer’s disease. Schindler’s research career has primarily focused on validating blood tests for Alzheimer's disease—including in diverse groups—as well as trying to better predict when individuals with early brain changes from Alzheimer's disease will develop dementia. Most recently, Schindler and her colleagues published a study titled “Effect of Race on Prediction of Brain Amyloidosis by Plasma Aβ42/Aβ40, Phosphorylated Tau, and Neurofilament Light” in the April 21, 2022, issue of the Neurology ® journal. The study evaluates the accuracy of blood tests for Alzheimer’s disease among Black and White individuals. As principal author, Schindler identified inconsistencies in three of the four leading tests that may contribute to the misdiagnosis of Alzheimer’s for people of color, underscoring the critical need for diversity in clinical trials to ensure these important tests provide accurate results. You can read the study at neurology.org/content/99/3/e245
Brain & Life and Neurology Today Take Key Publishing Prizes
The Foundation’s Next Generation Research Grants are offered in collaboration with the American Academy of Neurology. To date, the grants have provided millions of dollars to fund the innovative research of early-career investigators, with over 86 percent of past recipients having gone on to secure funding from the NIH and other national entities. Learn more and meet the current class of researchers at AmericanBrainFoundation.org/ngrg
Research Grant Funded by the American Brain Foundation
YOU’RE AMERICANINVITED!BRAIN FOUNDATION EVENTS OUR 2022 FALL EVENTS The American Brain Foundation is proud to offer a wide range of virtual events featuring neurology experts covering a broad spectrum of brain diseases and disorders. These free webinars are open to everyone.
Learn more about these opportunities
Monday, November 14 — 8:00 p.m. ET
“Navigating Migraine: Treatment and Research” with David Dodick, MD, FAAN and Faisal Amin, MD, PhD at: www.AmericanBrainFoundation.org/Events
Monday, October 10 — 8:00 p.m. ET
“Managing Parkinson’s Disease and Multiple Sclerosis” with Lisa Shulman, MD, FAAN and Ellen Mowry, MD, FAAN
Tuesday, September 13 — 8:00 p.m. ET
“Meet the Researchers” featuring our 2022 grant recipients
APP Neurology Opportunity—Texas Coast! Relocation Assistance Available!—SOC Telemed—Corpus Christi, Texas We are looking for dedicated APP's to provide in-person Neurology services at CHRISTUS SPOHN Shoreline and South, located in the great coastal city of Corpus Christi! Our APP's will be working alongside our Tele-Neurologists to include the boots on the ground team. Below are additional details about the position, but if you're interested in learning more we'd love to speak with you! -Location: Corpus Christi, TX (fantastic coastal community) -Schedule: 7on 7off rotation -Hours 7a-7p (no nights) -Setting: Inpatient Neuro Hospitalist setting (inpatient/hospital experience preferred); working alongside tele-Neurologists during the day throughout the hospital floor -Neurology training and education offered if needed -Full benefits available -Relocation assistance available -Competitive compensation package. Reach out to Garrett Youngblood at gyoungblood@soctelemed.com for more information.
The Robert Larner, M.D. College of Medicine at the University of Vermont (UVM) and the University of Vermont Medical Center (UVMMC) seek to recruit a physician to join our established program in General/Comprehensive Neurology.
Reading Hospital/Tower Health seeks a Neurologist with Fellowship Training in Neuro-Immunology—Tower Health–West Reading, Pennsylvania Reading Hospital/Tower Health is seeking a Neurologist with fellowship training in Neuro-Immunology. The new Neurologist will be joining our growing Neuroscience Center, a multisubspecialty clinical service line including 20+ Neurologists, APPs and 5 Neurosurgeons. The critical community need for a Multiple Sclerosis specialist will ensure a full patient panel. The new physician will be joining a very collaborative Neurology team to include Neurology Residents from our newly approved
Careers.AAN.com
ACGME program. Reading Hospital is a 714-bed hospital, the flagship, Magnet Recognized, acute care hospital of Tower Health located in West Reading, Pennsylvania. Reading Hospital is home to many top-tier specialty care centers, including Reading HealthPlex, McGlinn Cancer Institute, Miller Regional Heart Center, Emergency Department, Level I Trauma Center and Beginnings Maternity Center, which houses the region's only Level III Neonatal Intensive Care Unit (NICU). With more than 1,000 physicians and providers across 49 locations, Reading Hospital has been recognized for its quality outcomes and clinical expertise across services lines. It is listed as one of America's 100 Best Hospitals for five consecutive years, America's 50 Best Hospitals for 2022 and received a 5-Star Rating from CMS two years in a row.
The AAN offers a complete package of print, online, and in-person recruitment advertising opportunities. Visit careers.AAN.com for all AAN options, rates, Adand deadlines.copyforthe November 2022 print edition of AANnews must be submitted by October 1, 2022. The same deadline applies to changes/cancellations. The American Academy of Neurology reserves the right to decline, withdraw, or edit advertisements at its discretion. Every care is taken to avoid mistakes, but the responsibility for clerical or printer errors does not exceed the cost of the ad. Visit the AAN’s Neurology Career Center to view hundreds of additional jobs and sign up for customized, confidential notifications when positions of interest are added.
AANnews® Classified Advertising
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The successful applicant will be involved in a primarily clinical care role at University of Vermont Health Network—Central Vermont Medical Center (CMVC) in Berlin, Vermont. This position offers the unique opportunity to work in a community setting while still being involved with an academic center. Located in the heart of the Green Mountain state, CVMC has a reputation for clinical excellence with a staff deeply rooted in our community. The general neurology practice sees a wide variety of neurologic conditions, including epilepsy/ seizure disorders, stroke, chronic headaches/ migraines, multiple sclerosis, Parkinson’s and Alzheimer disease, as well as movement and neuromuscular disorders. The ideal candidate will be skilled in reading EEGs and/or conducting/ interpreting EMGs. This is a full-time, 12 month, salaried position with attending staff privileges at CVMC. All applicants must be American Board of Psychiatry and Neurology board eligible/certified. Fellowship training in a clinical neurology discipline is desired, however not a requirement. Our goal is to continue the high level of clinical care and education currently provided as we develop our clinically integrated network. The Central Vermont Medical Center site is evolving as a graduate medical education site and opportunities for teaching will be supported. UVM is especially interested in candidates who can contribute to the diversity and excellence of the academic community through their research, teaching, and/or service. Applicants are requested to include in their cover letter information about how they will further this goal. UVM and UVM Medical Center are Equal Opportunity/ Affirmative Action Employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other category legally protected by federal or state law. The University encourages applications from all individuals who will contribute to the diversity and excellence of the institution. The application receipt and review process will begin immediately and continue until the position is filled. Interested individuals should apply online for position #45098 at www.uvmjobs.com. For more information, contact Sarah Child at Sarah.Child@CVMC.org or phone (802) 225-1739. For more information regarding the Department of Neurological Sciences, please see our website at http://www.uvm.edu/ medicine/neuro/
Neurologist—Assistant/Associate Professor UVM Health Network—Central Vermont Medical Center–Vermont, Four Seasons of Outdoor Activities at Your Doorstep!
For more information, visit towerhealth.org. Tower Health & Drexel University College of Medicine have partnered to open a brand new medical school 1/2 miles from the Reading Hospital campus. The medical school opened in July 2021; when fully operational, the medical school will enroll 200 medical students. Reading Hospital Awards and Recognition: America's 50 Best Hospitals Award™ (2022), America's 100 Best Hospitals Award™ (2017-2021), America's 100 Best Hospitals for Stroke Care™ (2013-2021), Top 10% in the Nation for Neurosciences (2015-2021), Top 10% in the Nation for Treatment of Stroke (2007-2021), Five-Star Recipient for Treatment of Stroke (2006-2021), One of 10 Best Value Hospitals in Pennsylvania, Top 1 percent of U.S. hospitals for clinical outcomes. Job Summary: The Neuro-Immunologist will be joining an experienced Neurology Team with layered support including Neuro-Radiologists, 3T MRI capabilities, an on-site Infusion Center, a free-standing Rehabilitation Hospital with advanced modalities for treatment of patients with physical disabilities, Neuropsychology, Advanced Practitioners and Residents. The Neurology Service is wide ranging with highly collaborative, multiple subspecialty support, a multidisciplinary stroke team, state-of-art technology, Neuro ICU, advanced endovascular treatment program, and experienced support staff. Benefits & Perks: Competitive Compensation Plan with a superb benefits package, CME Allowance, Retirement programs, Loan Forgiveness Assistance Program, Malpractice Insurance with Tail Coverage, Relocation Assistance, Spousal/ Domestic Partner Job Search Support, H1B Visas and Green Card Sponsorship (we cannot currently support J1 Visa Waivers). Living in Berks County—From Reading Fellows (Video) Reading Hospital is located in West Reading, part of Berks County, Pennsylvania. This is an area that offers many wonderful places to live and raise a family. Berks County is 1 hour northwest of Philadelphia and within driving distance of other major metropolitan areas like Baltimore and New York City, offering an easy chance to get away for some big city excitement. Contact Name: Ken Nichols Contact Email: Kenneth.nichols@towerhealth.org Contact Phone: (484) 628-6581 Req 2022-41873 Requirements: MD or DO candidates must be licensed/eligible to practice medicine in Pennsylvania Board Certified in Neurology and BC/BE in Multiple Sclerosis Neurology.
Sent to your email address the second and fourth Wednesday of each month, AANe-news™ delivers the latest top headlines and resources from the Academy so you can quickly scan and connect directly with the information you need to know. Another members-only solution from your AAN. AANe-news. Because Your Time Is Valuable. DATES & DEADLINES SEPTEMBER 2022 SUN MON TUE WED THU FRI SAT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 SEPTEMBER 1 Deadline: Research Applications AAN.com/ResearchProgram SEPTEMBER 7 Applications Open: Transforming Leaders and Women Leading in Neurology Programs AAN.com/Lead SEPTEMBER 8 Early Registration Deadline: AAN Fall Conference AAN.com/Fall SEPTEMBER 29 Advance Registration and Hotel Deadline: AAN Fall Conference AAN.com/Fall OCTOBER 2022 SUN MON TUE WED THU FRI SAT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 30 24 25 26 27 28 29 OCTOBER 11 Submission Deadline: 2023 Annual Meeting Abstracts AAN.com/AMAbstracts OCTOBER 13 Registration Opens: RITE® (Residency In-service Training Exam) AAN.com/RITE OCTOBER 19 Application Deadline: Transforming Leaders and Women Leading in Neurology Programs AAN.com/Lead OCTOBER 26–27 Virtual Career Fair Careers.aan.com OCTOBER 27 AAN Fall Pre-conferences: APP and Sports Concussion AAN.com/Fall OCTOBER 28–30 AAN Fall Conference AAN.com/Fall NOVEMBER 2022 SUN MON TUE WED THU FRI SAT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 NOVEMBER 2 Application Deadline: AAN Awards AAN.com/Awards 30 31
