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F R O M T H E H I L L
HHS Opens IT Office
Notice of the establishment
of the Office of
Health Information
Technology, a new branch
of the U.S. Department
of Health and Human
Services, was officially
given in the Federal
Register on Dec. 27.
The office’s administrator
sits on the Health
Resources and Services
Administration’s Health
Care Quality Council.
Creation of the new
office is the latest
evidence of the Bush
administration’s strong
support for nationwide
adoption of health information
technology, an
integral component of
so-called pay-forperformance
programs.
3 Don’t Claim Unpaid Services for Indigents as Charitable Deductions As a new year begins, taxes are on
the minds of many. The AANS Board of Directors recently asked AANS legal counsel for an opinion on
whether doctors can claim a charitable deduction for the value of uncompensated services performed
for Medicaid patients or otherwise indigent individuals. “The answer is no, primarily because Congress
specifically excluded individuals from the list of charitable organizations set forth in the Internal
Revenue Code,” said Russell M. Pelton, JD. “To receive a charitable deduction for services provided to
individuals would require an amendment to the Internal Revenue Code by Congress, an event that is
unlikely to occur in the foreseeable future.” The two main reasons why the value of services performed
for Medicaid patients are not deductible are that Medicaid patients do not constitute a charitable organization
within the meaning of section 170(c) of the tax code and that deductions are not allowed for
the performance of services on behalf of a charitable organization. According to Pelton, a substantial
number of court decisions hold that services do not constitute property for charitable deduction purposes.
The full text of the opinion, “Charitable Deduction Issues,” is available at www.AANS.org.
3 CMS Pledges Rapid Implementation of New Reimbursement Rates Although Congress adjourned in
December without finalizing budget legislation that would have prevented a 4.4 percent cut to physician
reimbursement from taking effect Jan. 1, the Centers for Medicare and Medicaid Services advised
Congress of its readiness to quickly implement the legislation once it is passed. In a letter to Rep. Bill
Thomas, Herb Kuhn, director of the Center for Medicare Management, said the CMS would instruct
Medicare contractors to begin paying claims at the revised update of 0.0 percent within two business
days of the legislation’s passage. Contractors also would be instructed to automatically reprocess claims
received between Jan. 1 and passage of legislation, relieving physicians of the resubmission process. The
reprocessed claims would be paid in a lump sum to providers by July 1. The CMS also plans to offer
physicians a second enrollment period of 45 days following enactment of the budget legislation.
Complete text of the letter is available at www.aans.org/ltr_to_leadership01_06.pdf.
3 AANS/CNS Prevent a 3 Percent Reimbursement Cut, Proclaim Victory for Neurosurgeons On Nov. 2 the
Centers for Medicare and Medicaid Services announced that it would withdraw its proposal of last
August to change the practice expense calculation under the Medicare fee schedule, thus preventing a
nearly 3 percent cut in neurosurgeons’ Medicare reimbursement. The AANS and CNS, along with
numerous other specialty societies, had objected to the proposed changes. The CMS also adopted two
additional policy changes that will result in increased Medicare reimbursement for neurosurgeons. First,
the agency made minor modifications to its formula for calculating malpractice expenses. Second, the
CMS is applying a multiple procedure payment reduction for diagnostic imaging (similar to the multiple
surgery payment reduction policy). Together, these changes result in a modest 0.5 percent increase in
reimbursement for neurosurgeons. Regulation CMS-1502-FC can be found at www.cms.gov.
Frequent updates to
legislative news are
available in the
Legislative Activities
area of www.AANS.org.
3 Medical Liability Reform Initiative Progresses In November Doctors for Medical Liability Reform
released a new animated e-mail message calling for reform. The e-mail message from A. John Popp, MD,
president of the AANS/CNS advocacy organization Neurosurgeons to Preserve Health Care Access,
encourages recipients to extend the medical liability reform message by forwarding the e-mail to as
many people as possible. The e-mail initiative is one facet of the nationwide grassroots education and
advocacy campaign, Protect Patients Now. More information about the DMLR campaign is available at
www.protectpatientsnow.org. A listing of donors in 2005 to the NPHCA, an organization that funds the
DMLR Protect Patients Now campaign, is available in this issue’s Washington Update, page 42.
Volume 14, Number 4 • AANS Bulletin 7