CSNS Attends to Business

The Council of State Neurosurgical Societies (CSNS) held its semiannual plenary session on April 26 in conjunction with the Annual Meeting of the American Association of Neurological Surgeons (AANS) in San Diego. During the plenary session, a new administration was voted into office. Officers include Frederick Boop, MD, chair; David Jimenez, MD, immediate past chair; Fernando Diaz, MD, vice-chair; Edie Zusman, MD, corresponding secretary; Thomas Rigsby, MD, recording secretary; and Gary Bloomgarten, MD, treasurer.

Eight resolutions were debated during the plenary session, but discussion centered on three: Resolution I and IV (combined), involving the resource-based relative value system, commonly known as RBRVS; Resolution V, regarding the neurosurgical continuing medical education (CME) requirements of the American Association of Neurological Surgeons (AANS); and Resolution VIII, involving CSNS representation to the American Board of Neurological Surgery (ABNS).

Resolution I, a combination of resolutions I and IV, called for the AANS and CNS leadership to oppose an RBRVS system for compensation for workers’ compensation patients. During debate, some mentioned difficulties in several states that had adopted a modified Medicare fee schedule for worker’s compensation, but others gave testimony that the worker’s compensation in their own state was working well and that a broad-based policy could lead to a change in reimbursement in states that currently are not experiencing difficulty. Given the complexities of the issue, the resolution was referred to committee for study, with a report requested at the next plenary session in October.

Resolution V concerned changes to the AANS requirements for neurosurgical CME. The AANS had announced last winter that for AANS Active and Active Provisional members seeking to earn the 60 neurosurgical CME credits required during every three-year cycle, credits earned only at programs sponsored or jointly sponsored by the AANS could be accepted. The reasoning behind the policy was stated, chiefly that there must be a mechanism available to verify the quality of neurosurgical CME and that for AANS-sponsored and jointly sponsored programs, such a mechanism already is in place. However, concern was expressed that the new policy could exclude credits earned at non-neurosurgical meetings such as the North American Spine Society and the American Epilepsy Society. The need for the resolution was questioned given that in March the AANS Executive Committee already had delayed any policy change at least until the start of the next CME cycle in January 2005. However, an amended Resolution V was passed.

Resolution VIII called for CSNS representation at the ABNS, which currently is developing its Maintenance of Certification (MOCTM) process. It was thought that CSNS representation at the ABNS would ensure that the MOC process would be scrutinized in terms of time away from practice and expense to the practicing neurosurgeon. An amended resolution passed, and since that time the ABNS has been contacted and has expressed interest in inviting CSNS members to serve as guest examiners for the board on a regular basis.

More Meeting Highlights
Neurosurgery Executive’s Resource Value and Educational Society, the NERVES group of practice managers, was formally recognized during the plenary session, and its leadership team, headed by Mark Mason, was introduced. NERVES conducted several sessions for practice managers in conjunction with the AANS Annual Meeting. The CSNS encourages neurosurgeons to foster this group by supporting the participation of their practice managers.

The Washington Committee of the AANS and the Congress of Neurological Surgeons (CNS) provided an overview of neurosurgery’s progress toward resolution of the professional liability insurance crisis. Neurosurgeons to Preserve Health Care Access (NPHCA) was introduced; this is the 501(c)(4) tax-exempt entity formed by the AANS and the CNS to allow the maximum flexibility for fully funding neurosurgery’s campaign for federal medical liability reform. The membership endorsed a proposal for neurosurgeons to contribute $1,000 each year for three years to NPHCA, adding to substantial funds that organized neurosurgery already committed to NPHCA.

The week at the AANS Annual Meeting closed with a platform session on Thursday for which David Jimenez, MD, and Stanley Fronczak, MD, put together a morning program featuring in-depth presentations on aspects of the professional liability insurance crisis. This session was well attended and feedback on the topic was outstanding.

Looking Ahead
The CSNS is in the process of organizing its third Neurosurgical Leadership Development Conference (NLDC) to be held in Washington, D.C., in July of 2004. Following the format of the first two successful and well-attended conferences, this NLDC will feature a series of lectures addressing current issues important to neurosurgeons, coupled with advice on how they can effectively lobby their representatives. To conclude the conference, attendees will meet with their representatives on Capitol Hill to discuss with them organized neurosurgery’s position on issues such as federal tort reform and patient access to healthcare. We hope that as the third leadership development conference approaches, you will consider taking the time to attend the conference and become politically involved.

Frederick Boop, MD, is chair of the Council of State Neurosurgical Societies.

For More Information

• CSNS Web Site
  https://www.aans.org/legislative/council/organizational.asp
• About Resource-Based Relative Value System (RBRVS)
  For an explanation of RBRVS, see the Coding Corner in the Fall 2001 issue of the Bulletin: “RBRVS-A Management Tool” by Gregory J. Przybylski, MD. https://www.neurosurgery.org/aans/bulletin/fall01/codingcorner.html
• AANS and Neurosurgical CME
  To review the current AANS requirements for neurosurgical CME, go to https://https://www.aans.org/membership/cme.asp. For current information about the AANS CME policy and the new opportunity to track CME credits online, turn to the Education column in this issue.
• ABNS and Maintenance of Certification (MOCTM)
  For background on the American Board of Neurological Surgery’s Maintenance of Certification requirements, as well as its relationship to the AANS CME policy, see the cover story of the Winter 2002 issue of the Bulletin, https://www.aans.org/library/Article.aspx?ArticleId=9978.
• Neurosurgeons to Preserve Health Care Access (NPHCA)
  See the 2003 Annual Meeting feature in this issue. Coming this fall:
  https://www.neuros2preservecare.org.