July 30, 2013
This is another in a series of occasional ASHA Chief Executive Officer Updates. These Updates are intended to provide ASHA members with a more in-depth view of various National Office units, their key member services and initiatives, and the names and roles of ASHA staff. Information about staff changes and ASHA National Office recognitions/awards is also included.
Many thanks to those of you who provided feedback regarding the previous Updates or made suggestions for future CEO Updates.
ASHA's Public Policy Agenda
Every year the Government Relations and Public Policy Board (GRPPB) solicits members for input to help develop the Association's annual public policy agenda (PPA). The PPA serves as a guide to define how the Association allocates its resources for advocacy initiatives. Currently, the GRPPB is in the process of analyzing the member feedback gathered this year to develop the 2014 Public Policy Agenda (PPA). I'll probably report on the 2014 PPA in a future Update, but I thought it would be of great interest to members if I used this opportunity to summarize some of the key activities and accomplishments over the past year that helped move ASHA's 2013 Public Policy Agenda forward. Here are some highlights of two areas of ASHA's focus at the federal level: Medicare reimbursement and school-based service delivery. (The full report on ASHA's advocacy efforts, Agenda in Action 2012-2013 [PDF], is available online.)
Medicare Reimbursement and Coverage Policies
ASHA works with Congress, the Centers for Medicare and Medicaid Services (CMS), and the Medicare Payment Advisory Commission (MedPAC), an advisory body to Congress on Medicare cost issues, to represent the concerns of the professions of audiology and speech-language pathology related to reimbursement and coverage policies. Here's a snapshot of some of the recent advocacy activities related to this issue.
Medicare Therapy Caps
On January 1, 2013, Congress passed a law that would extend the therapy caps through the end of 2013. In this law, critical access hospitals were included in the tally of the therapy caps and the multiple procedure payment reduction (MPPR) on outpatient therapy services was increased to 50%.
Medicare Physician Fee Schedule
ASHA collaborated with other organizations to prevent cuts in the Medicare Physician Fee Schedule in order to ensure fair reimbursement for services provided by audiologists and speech-language pathologists. These collective efforts prevented a drastic 26.5% reduction from 2012 levels that would have adversely affected all payments under the fee schedule.
ASHA's Health Care Economics Committee (HCEC) plays an active role in the development, revision, and revaluation of Current Procedural Terminology (CPT) codes.
- For audiology, ASHA participated in the development, valuation, and passage of new intraoperative neurophysiology monitoring codes that were published in the 2013 CPT Handbook and the 2013 Medicare Physician Fee Schedule.
- For speech-language pathology, the HCEC submitted proposals for four new evaluation codes. The new codes are related to voice, fluency, speech sound production, and language evaluation. They will replace the current code for evaluation for speech, language, voice, communication, and/or auditory processing (CPT 92506). The new codes will be effective January 1, 2014, and published in the Medicare fee schedule final rule in November 2013.
Additionally, the HCEC collaborated with other audiology organizations to submit a proposal for new Health Care Common Procedure Coding System (HCPCS) Level II codes to expand the current assistive listening device code set (V5268-V5274) to include personal FM/DM auditory devices. As a result, 10 new codes and 1 revised code are listed in the 2013 HCPCS Level II Handbook.
ASHA's National Outcomes Measurement System (NOMS) and Support of Alternative Payment Models
The Middle Class Tax Relief and Job Creation Act of 2012 required CMS to develop a claims-based outcomes reporting system for all Medicare Part B therapy services.
- ASHA successfully advocated for the inclusion of seven of the ASHA NOMS Functional Communication Measures (FCMs) as part of the functional outcomes reporting system.
- Recognition of NOMS by CMS provides speech-language pathologists with a tool that easily crosswalks to the CMS HCPCS G-codes and meets the requirements for documenting an outcomes measurement tool in the medical record.
- NOMS has been recognized by MedPAC and included in its June 2006 report to Congress as a viable outcomes measurement system for addressing speech-language pathology care.
Medicare Physician Quality Reporting System
Medicare Part B Physician Quality Reporting System (PQRS) is a mandated program where health care providers, including audiologists and speech-language pathologists in private practice, report measures to CMS that represent the quality of services they provide.
- ASHA worked diligently with CMS officials to ensure that PQRS appropriately represented the professions through clinically relevant measures for audiologists and speech-language pathologists to report.
- In 2012, several audiology-related measures were recommended for deletion based on low reporting rates and questionable applicability for the PQRS program; however, ASHA, along with other members of the Audiology Quality Consortium (AQC), were able to ensure that two audiology measures were retained for reporting.
Medicare Beneficiary Audiology Benefit
Most recently-after more than 3 years of effort and input from thousands of audiologists, volunteer leaders, members of Congress, and policy experts-H.R. 2330, the Medicare Audiology Services Enhancement Act of 2013, was introduce in Congress by Representative Gus Bilirakis, a member of the House Energy and Commerce Committee. Under the terms of this bill, Medicare beneficiaries would be covered for diagnostic and treatment services performed by audiologists. This bill is an important step in making sure that audiologists are recognized in the evolving health care and payment reform discussions and that Medicare patients receive the full range of professional services provided by audiologists.
School-Based Service Delivery
Federal issues related to the provision of school-based services also rank high on ASHA's public policy agenda. ASHA's federal advocacy team engages with members of Congress and the U.S. Department of Education (ED) and other agencies and stakeholders on these issues.
In response to member concerns, ASHA established a team to develop paperwork reduction strategies for school-based providers. To better understand the problem, ASHA conducted focus-group sessions and a 1-day facilitated meeting with multiple stakeholders at the 2012 Schools Conference. ASHA will continue to work with stakeholders throughout 2013 to develop legislative and regulatory strategies to address paperwork management challenges.
Efforts to Address Classroom Acoustics
ASHA submitted a code amendment to the International Code Council's (ICC) A117.1 building code, which would add a national classroom acoustics standard to the building code. The amended building code pertains to access for persons with disabilities. The ASHA amendment was considered and passed by a voice vote of ICC's A117.1 code committee at its January 2013 meeting. Pursuant to ICC's procedures, additional paper balloting needs to be taken on this code change before it can become permanent; ASHA staff will continue to work toward that end in 2013.
Other School Regulatory Issues
ASHA continues to work closely with ED on various regulatory issues, including meeting with ED staff and providing feedback on proposed rules and other proposals. ASHA developed and submitted comments on ED's Draft Strategic Plan for fiscal years 2011-2014. ASHA's advocacy efforts resulted in changes to two areas of the ED strategic plan, in the areas of elementary and secondary education: inclusion of specialized instructional support personnel and inclusion of gender identity and sexual orientation.
ASHA Agenda in Action 2012-2013
If you are interested in learning more about ASHA's advocacy efforts at both the federal and state level, I would encourage you to download ASHA's annual advocacy report Agenda in Action 2012-2013 [PDF]. In it you will find a wealth of information about ASHA's advocacy efforts in 2012 and 2013 and links to much more information about critical issues impacting the professions. And, consider reviewing some of the interesting and informative videos. One of my favorites features ASHA's Vice President for Government Relations and Public Policy Theresa Rogers, who explains her views about the importance of member advocacy.
For timely updates on ASHA's advocacy efforts, consider following ASHA Advocacy on Facebook, Twitter, Pinterest, and YouTube.
National Office Staff Updates
The following individuals are new to the ASHA staff since April 11, 2013:
- Aidan Callery, Marketing Manager
- Renault "Randy" King, Manager, Purchasing & Inventory
- Michele Moy, Online and Print Art Director, The ASHA Leader
- Francine Pierson, Public Relations Manger
The following individuals have left ASHA to pursue other opportunities:
- Gwen Bellamy, Director, Purchasing & Inventory
- Danielle Huber, Associate Director, CE Registry Operations
- Yingtao Zhu, Staff Accountant
National Office and ASHA Awards
- The online ASHA 2012 Convention program and The ASHA Leader redesign campaign both won silver Excel Awards from the Association Media & Publishing. In 2013, close to 1,000 entries were submitted, representing 83 nonprofit organizations and associations.
The Next CEO Update
2014 Public Policy Agenda