California association of neurological surgeons

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Advocating for the practice of neurosurgery in California to benefit our patients and profession

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A Message From
CANS President

January 31, 2021

The standpoint of good news, on March 25 the US Senate voted to delay Medicare payment cuts for the rest of 2021. This was a big win for hospitals and providers as these cuts were originally scheduled to start April 1, 2021, in the absence of Congressional action. These cuts would have been a significant “hit”, for neurosurgeons, other physicians and healthcare providers as well as hospitals. This moratorium provides an important “stay of execution” for us, but it remains to be seen if they will yet be implemented come fiscal year 2022. At least it gives our Washington Office and other allied healthcare lobbyists critically needed additional time in order to try and influence eliminating the cuts all together.

From the standpoint of uncertainty and concern, on March 18 the US Senate confirmed former California (CA) Attorney General Xavier Becerra as President Joe Biden’s Secretary of Health and Human Services (HHS). Xavier Becerra is not a physician nor a PhD in Public Health or Healthcare Policy. He does not even have a masters degree in public health, healthcare policy or health administration. He is, in fact, a lawyer and a career politician, with no medical experience or training whatsoever. He has certainly never managed a medical bureaucracy. Furthermore, as CA Attorney General, he was a strong proponent of a single party payer system in the U.S., coming out strongly and publicly in support of Bernie Sanders’ “Medicare for All” plan during the presidential primary. He also has a history of targeting faith-based third-party payers in CA with legal actions for their objections to covering certain provisions enfolded in Obamacare. It remains to be seen how surgeons, and especially subspecialty surgeons like us, will fair under this sort of leadership at HHS over the next four years. It was also somewhat troubling and disconcerting to see that his appointment was actively supported by the American Medical Association (AMA).

On March 11, the Mayor of Anaheim, CA along with business and union officials renewed the push on the CA Governor’s Office to reopen the Anaheim Convention Center and to release information on when CA hotels can resume indoor meetings. On the same day a spokeswoman for the Governor’s Office stated – “As you know, we have yet to provide guidance for larger social events, due to the increased risk of indoor disease transmission at large gatherings where it can be harder to enforce consistent masking, particularly during meals, and physical distancing,” …”That said, conditions are improving, as we learn more about COVID-19 and how it spreads, more people are vaccinated, Californians continue to adhere to safety protocols, and business continue to take substantial measures to keep their employees, customers, and guests safe,” the statement added. “As such, we expect to release new guidance for events such as conventions in the coming weeks.” https://spectrumnews1.com/ca/la-west/business/2021/03/11/california-to-release-guidance-for-hotel-meetings–events-and-conventions–in-coming-weeks- However, as of March 29, 2021, we are still waiting for the Governor’s Office to release their Meeting and Convention Re-Opening Guidelines https://covid19.ca.gov/industry-guidance/ . These guidelines will have a very important impact on how the California Association of Neurological Surgeons (CANS) approaches potential venues for potentially negotiating an in-person CANS annual session, tentatively planned for Saturday – Sunday January 15-16, 2022, and as a result the CANS 2022 Annual Meeting Committee has held back soliciting bids so far this year.

As of the writing of this message, all professional medical meetings for April and May have either been cancelled, re-scheduled for later dates, or are proceeding “virtually”. From a neurosurgery standpoint, the American Association of Neurological Surgeons (AANS) has moved their 2021 meeting to a “Covid-open” state – Orlando, FL August 21-25, while the Congress of Neurological Surgeons (CNS) and the Society of Neurological Surgeons (SNS) are meeting in another “Covid-open” state – Austin, TX, October 16-20 and October, 14-16 (rescheduled from May 2021), respectively.

In the State of CA, the website for the University of CA (UC) San Francisco (UCSF) 2021 Spine Symposium June 4-5 is still accepting registration for an in-person meeting https://spinesymposium.ucsf.edu/ . However, as of the end of February 2021, the Chancellor at UC Irvine (UCI) has cancelled the in person UCI “Spine by the Sea” symposium in June as well as the Fall UCI Multidisciplinary, in-person, Neuroscience Symposium”. Both UCI events are now being re-engineered as “virtual events”.

Even if Governor Newsom’s office comes forward with formal Meeting and Convention Re-Opening Guidelines, this will not necessarily address the separate issue of relevant, applicable, institutional pandemic-related travel restrictions. For example, the UC currently has a formal travel restriction in place only allowing approval and/or re-imbursement for essential travel for all faculty, residents and fellows. There has been no indication from the UC Office of the President (UCOP) so far, as to if, and/or when, this travel restriction will be lifted. The University of CA includes neurosurgery faculty at six CA medical schools as well as residents and fellows at 5 of the 11 current M.D. (n=9) and D.O. (n=2) neurosurgery training programs in the state. The UC “essential travel” definition specifically excludes travel to professional meetings, even if this is for continuing medical education (CME) purposes, and even if the employee in question is presenting at the meeting. It affects out-of-state meeting travel to meetings like the AANS, CNS and SNS as well as meetings within the state of CA. To attend these meetings as things currently stand, UC faculty, residents and fellows would have to take personal vacation days and fund all expenses on “their own dime”, as well as keep their travel plans confidential with respect to the UC. As a result, things currently remain “murky” for trying to predict the feasibility of having our in-person CANS Annual tentatively planned for Saturday – Sunday January 15-16, 2022, though we remain hopeful. Please stay tuned…

While the AANS has moved their meeting from April to August 2021, the Council of State Neurosurgical Societies (CSNS) is still moving forward with their Spring CSNS meeting as a virtual meeting April 23-24, 2021. For this meeting, the CANS Board has unanimously (without any abstaining vote) endorsed submission of a resolution from CANS entitled: “Improving diversity, equity and inclusion within the Congress of Neurological Surgeons (CNS) leadership”. We look forward to vigorous discussion of this resolution and the important issues it addresses at the upcoming CSNS meeting. The CANS Board will be meeting either Saturday April 10 or Saturday April 17 to formally review all upcoming CSNS resolutions in preparation for CSNS Reference Committee testimony from our CANS CSNS Delegates April 23. As of March 29, 29021, the CSNS has yet to post the final list of, and description for all the resolutions accepted to be considered at their upcoming meeting. Our CANS Newsletter Editor, Dr Randy Smith will no doubt present all CSNS resolutions, CANS’ position on each of them, as well as their eventual outcome in the April CANS newsletter.

I would like to once again remind all CANS members of their 2021 Annual Dues commitment. Many of us use the CANS Annual Session registration opportunity as the time where we pay our outstanding CANS dues to allow us to register. This year we did not be have a 2021 formal CANS Annual Session, and as a result, many members missed this opportunity this year. We derive a significant income for our operational budget from our Annual Session which did not occur. Thus, this year it is extremely critical that every member take the time to follow this hyperlink to our CANS website and pay our CANS annual dues https://cans1.org/membership-renew/ I would ask every CANS member to please do this right now as you are reading this in order to help our organization remain fiscally healthy going forward. This is extremely important, and your participation and support of our organization is greatly appreciated!

I continue to hope that all of our members continue to remain healthy and safe during this trying time with Covid-19. CANS has yet to hear of any member who has been sick with Covid-19, but we very much want to know and keep track of any such event(s) to measure and document the direct personal impact of the pandemic among individual California Neurosurgeons. Anyone who knows of a CANS member, or any California neurosurgeon, for that matter, who has been sick with Covid-19, please contact our executive secretary Emily Schile with the particulars at emily@cans1.org .
Please stay safe everyone. Please support CANS and the CMA, they are fighting for you. All the best! 

Mark Linskey, MD

CANS President

Thank you for joining us!

CANS
Special Session

COVID-19 California Neurosurgery Practice Impact

Virtual Meeting

Sunday

January 17, 2021

12 PM to 5:30 PM

Be the Change

Our work

Since 1973, CANS has advocated for neurosurgeons and our patients in all practice settings in California on a state and national level. 

Engagement

We directly engage with state and national political leaders via CSNS, AANS/CNS Washington Committee, and Neurosurgery PAC.

Advocacy

We survey neurosurgery ER coverage data in California to ensure fair reimbursement and continue work to defend MICRA.

Representation

We send delegates to the California Medical Association. We participate in reimbursement advisory committees for both Medicare and private payors.

Help CANS continue to advocate for you and your patients