Spring CSNS Meeting May 1-2, 2009

1. The CSNS met on May 1-2, 2009 in San Diego California prior to the AANS annual meeting. Attendance: 43 delegates from state societies, 23 delegates appointed by the AANS and CNS, 12 resident delegates and 11 guests.
2. New officers were elected at the Friday afternoon plenary session. They include Dr. William Bingaman as Chair, Dr. Deborah Benzil as Vice Chair, Dr. Alan Scarrow as Treasurer, Dr. Mark Linskey as Recording Secretary, and Dr. Ann Stroink as Corresponding Secretary. They will serve two year terms. The Quadrant Chairs remain Dr. Mick Perez-Cruet for Northwest Quadrant, Dr. John Davis for Southeast Quadrant, Dr. Ross Jenkins for Northeast Quadrant, and Dr. Adair Prall for Southwest Quadrant.
3. Resolution Summary: The plenary session considered 8 resolutions on Friday and then debated them on Saturday. The final actions included the following: Resolution 1 asked that the AANS and CNS work through the Joint Guidelines committee and Joint sections on trauma and spine to prioritize the spinal cord injury guideline update as well as put forth an interim update on the use of methylprednisolone for acute spinal cord injury. Resolution 2 tasked the CSNS medical practice committee chaired by Dr. Josh Rosenow to develop a white paper and report back to the CSNS body on peer-to-peer utilization review and the need for specialty specific review with accountability. Resolution 3asked the CSNS reimbursement committee to develop a list of resources to determine what is an acceptable method to determine usual and customary fees for neurosurgery. They are to collaborate with NERVES for this. Additionally it asks that the AANS/CNS work with the Washington Committee to support patient access for neurosurgical care by preserving fair compensation for care provided out-of-network. Resolution 4 was rejected. Resolution 5 asked the CSNS to investigate the role of simulators in neurosurgical residency training. This was assigned to the Young Physicians Committee under Dr. Darlene Lobel. Resolution 6 calls for the development of a password protected CSNS "toolbox" on the CSNS website (CSNSonline.org) where relevant socioeconomic tools can be kept. This will be developed by the CSNS website committee under the direction of Dr. Joseph Cheng. Resolution 7 will create an educational module summarizing AANS/CNS guidelines regarding conflict of interest and physician relationships with industry. It also calls for the AANS/CNS to support acceptable federal legislation providing transparency in the relationship between physicians and industry. Finally, resolution 8 was referred back to the CSNS executive committee which has asked the CSNS medical practice committee to study the principle of a national medical device registry.
4. Plenary Session Summary: Reports were heard from the officers and committee chairpersons. Rules and regulation changes regarding the CSNS mission and vision statements were voted in. Dr. Gary Bloomgarden was thanked for his service and received a commemorative plaque for his two years of chairmanship. Reports and updates were heard from the AMA (Dr. Peter Carmel) and the ACS (Dr. Shelly Timmons). Informational reports were given by Dr. Ann Stroink on Occupational Hazards, by Dr. Gary Simonds on Spinal surgery Code of ethics, and Dr. Zusman on the Socioeconomics of Neurosurgical Research. The Friday plenary session concluded with a detailed comprehensive report on the CSNS organizational structure. This report included a history of CSNS committee structure and recommendations for revision of same. It is currently open for comment and will be available on the password protected portion of the CSNS website (CSNSonline.org). Saturday.s highlights included the Washington Committee reports by Dr. Harbaugh, Katie Orrico, Dr. John Wilson, and Dr. Resnick. Much activity now is revolving around anticipation of federal legislation for healthcare reform. This includes anticipation of a revision of the current formula to calculate Medicare physician payment. Organized neurosurgery is working hard to oppose a budget neutral shift of funds towards primary care and away from specialty care. It was pointed out that a new initiative called .Operation Patient Access. has begun to communicate a number of important issues for our patients. The website is http://operationpatientaccess.facs.org. Dr. John Wilson has pointed out that CPT coding for ACDF will be reviewed and final recommendations made in the fall, 2009. It was the expectation that the arthrodesis code will be bundled with the discectomy code and that a decline in work RVU value will occur. Dr. Resnick provided a brief summary of Pay for performance and the ongoing expansion of the Physician Quality Reporting Initiative. For more detailed information, please contact Katie Orrico in our Washington DC office. We also heard presentations from Dr. James Bean (AANS President) and Dr. David Adelson (CNS President). Following this, the first class of Resident Socioeconomic Fellows was graduated; receiving their certificates from Dr. Gary Bloomgarden. Next, the CSNS Lifetime Achievement Award was given to Dr. Robert Florin in commemoration of his lifetime of work on the behalf of organized neurosurgery in the area of neurosurgical coding and reimbursement. Finally Dr. Bloomgarden was again thanked and congratulated on two years of outstanding service.
5. The CSNS meeting concluded with the afternoon Executive Committee session. Dr. Bingaman reemphasized the importance of becoming the leader in neurosurgical socioeconomics. Goals and plans to improve the CSNS relationship with neurosurgeons at the state level (including state societies) as well as the AANS and CNS were discussed. Quadrant and Committee work was reviewed and new appointments were announced. The next formal meeting of the CSNS Executive Committee will be in Boston on August 29, 2009 prior to the World Federation meeting.