May AANnews: Practice Q&A

Peers Provide Expert Answers to Practice Questions

The practice@aan.com email inbox is an efficient way to reach staff and member expertise on practice related topics such as payers, MIPS/MACRA, coding, and practice management. Staff experts respond within one business day and can seek the real-world expertise of the Practice Support Network, a group of 30 practicing neurologists and graduates of the AAN Practice Leadership Program, or the Business Support Network, a group of six business administrators in various practice settings. Below are some common questions that have come into the inbox recently.

PRACTICE MANAGEMENT

Q: I am interested in starting telehealth services at my practice. What should I know about malpractice insurance and billing and reimbursement?

A: The AAN has many resources to help you navigate the changing telehealth environment. With regards to malpractice insurance, most of our Practice Support Network found that their current carriers added telehealth coverage to their existing policies at the start of the pandemic. They recommended connecting with your current provider to see if that is still the case, if there are any additional fees associated with the coverage, and how the carrier handles out-ofstate coverage if applicable. One member recommended confirming with your carrier that they are bonded in the state in which you are practicing telehealth.

For Medicare, many telehealth billing flexibilities are renewed every three months as the public health emergency (PHE) is renewed. These flexibilities include lifting geographic restrictions and paying the same as an in-person visit. The AAN is aware that without legislative action, critical flexibilities will expire when the PHE is terminated, making it difficult for practices to continue to treat patients via this valuable modality. The AAN is strongly advocating that some of these flexibilities continue beyond the PHE expiration to ensure there is no disruption in patient care and to be able to collect more data to add to the telehealth evidence-base. You can stay up to date on telehealth regulations and AAN’s advocacy efforts at AAN.com/Telehealth.

PAYMENT POLICY

Q. My practice is considering stopping our commercial payer contracts. Will my practice be reimbursed in-network under a grace period of 90 days after our termination with the payer?

A. If there is any grace period for in-network coverage after the termination of a contract with a commercial payer, it is dependent on the contract specific to the payer. It is recommended to review the termination section of the contract to confirm the terms for that specific payer. It is also important to review your state laws regarding patient notification of your practice no longer accepting their health plan to avoid any issues with patient abandonment.

QUALITY PAYMENT PROGRAM

Q: CMS makes changes to measures I can report in the Merit-based Incentive Payment System (MIPS) each year. How can I make sure I have the most updated information for 2022 Quality component reporting?

A: Each year, the AAN develops updated resources related to the Quality Payment Program (QPP) and MIPS, including identifying measures and activities that are most relevant to neurologists that year. The AAN’s Quality Payment Program webpage just refreshed its resource on how to “Navigate the Quality Component of MIPS” which includes 2022 neurology measures available in MIPS, including measures in the Axon Registry®. For the Improvement Activities component, the AAN continues to offer the resource on “Improvement Activities for Neurologists to Consider” that can help practices determine what practice improvement activities neurologists can select or may already be participating in and can attest for credit in MIPS. Members can find these resources at AAN.com/qpp. Additionally, the Centers for Medicare & Medicaid Services (CMS) has a tool to search and navigate quality measures by specialty at qpp.cms.gov. •