AAGP eNews
Jul. 16, 2013

AAGP 2014 Annual Meeting news
Mark your calendar for the AAGP 2014 Annual Meeting, March 14-17, in Orlando, Florida! Next year's conference promises a variety of educational sessions, popular pre-conference workshops, a robust exhibit hall, and several networking receptions. AAGP committee members recently reviewed 70 session proposals and saw a breadth of relevant topics. The final selection of sessions will occur later this summer, and the Advance Program will be out in October.

Proposals for new research posters and posters from early investigators are now being accepted. To submit, visit www.AAGPmeeting.org. New researcher posters are due Oct. 1. Early Investigator posters are due Oct. 15.

The meeting hotel, the Renaissance Orlando at SeaWorld, is now taking hotel reservations for the meeting. Learn more at www.AAGPonline.org/hotel.More

Call for Nominations: AAGP Member-in-Training Board Member
The AAGP Member-in-Training Nominations Committee is seeking qualified candidates to run for the MIT Board Member position for 2013/2014. All current Members-in-Training of AAGP are eligible to run. (A member-in-training is defined as a physician who is enrolled in an accredited residency in psychiatry or is enrolled in a fellowship in geriatric psychiatry that is affiliated with an accredited residency program). The MIT Board Member term of service is one year (Oct. 1, 2013 to Sept. 30, 2014). Members interested in being considered for this position are encouraged to submit a completed application to the MIT Nominations Committee. Learn more and download an application: www.AAGPonline.org/MIT. Applications are due Aug. 16.More

AAGP member news: Wallack publishes book on Alzheimer's
AAGP student member Max Wallack, along with Carolyn Given, recently published a book on Alzheimer's disease for children. The book, titled "Why Did Grandma Put Her Underwear in the Refrigerator?: An Explanation of Alzheimer's Disease for Children," is written from the point-of-view of a seven-year-old who explains what life is like living with a grandmother with Alzheimer's disease. Wallack's book is available through Amazon.com.More

Earn CME with AAGP 2013 Annual Meeting recordings
Access a wealth of educational sessions on late-life mental health with recordings of AAGP 2013 Annual Meeting sessions and earn up to 46 hours of CME. Hear audio of the sessions, access handouts, and take online CME tests. See the list of sessions, learn more and purchase online: click here.More

CMS issues proposed policy and payment changes to the 2014 Medicare Physician Fee Schedule
On July 8, the Centers for Medicare and Medicaid Services issued a proposed rule that would update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule on or after Jan. 1, 2014. The proposed rule continues to take steps to expand access to primary care services by proposing to provide payment for complex chronic care coordination services, beginning in 2015. The proposal would provide coverage for non-face-to-face complex chronic care services for Medicare beneficiaries who have multiple chronic conditions.

CMS projects a steep across-the-board reduction in Medicare payment rates, based on the Sustainable Growth Rate formula that was adopted under the Balanced Budget Act of 1997. If it goes into effect, Medicare payment rates are currently projected to be reduced by 24.4 percent for services in 2014. The final projection, based on more recent data, will be made available in the final rule when it is published in November. The proposed rule does not include any provisions on the physician fee schedule update, as these calculations are determined under the SGR formula, and that cannot be changed by CMS. In prior years, Congress has taken action to avert a reduction in physician fee schedule rates before they went into effect. The administration supports legislation to permanently address the flaws in the SGR, and committees in both the House of Representatives and the Senate are currently working on a permanent "fix". At this time, it is anticipated that the House Energy and Commerce Committee will approve a bill later this month that will then go to the entire House for consideration following the August recess. The other House committee working on this issue, the Ways and Means Committee, is expected to approve its version of Medicare physician payment reforms this fall. Senate committee action has not yet been announced, although the Finance Committee is currently working on the issue.

In the proposed rule, as part of its "misvalued services initiative," CMS is proposing to adjust payment rates for over 200 codes where Medicare pays more for services furnished in an office than in an outpatient hospital department or an Ambulatory Surgical Center since the resource costs required to furnish a service are generally expected to be higher in a hospital or ASC. CMS is proposing to limit the Medicare Physician Fee Schedule payment in that situation to the total payment that Medicare would make to the practitioner and the facility when the service is furnished in a hospital outpatient department or ASC. In addition, for 2014, CMS is proposing potentially misvalued codes that were identified with the assistance of the Contractor Medical Directors based on their personal experience in paying for Medicare services.

The proposed rule would also make refinements to the Physician Quality Reporting System program, the Medicare Shared Savings Program, and the Medicare EHR Incentive Program. In addition, the proposed rule would continue to implement the physician value-based payment modifier (Value Modifier) which would adjust payments to individual physicians or groups of physicians based on the quality of care furnished to Medicare beneficiaries compared to costs. For 2016 physician payment rates, the proposed rule would apply the Value Modifier to all groups of physicians with ten or more eligible professionals. For groups of 10 or more that do not participate in PQRS, CMS is proposing to apply a 2.0 percent payment reduction under the Value Modifier. The proposed rule can be viewed at: https://federalregister.gov/public-inspection. CMS is accepting comments on the proposed rule until early September. In the coming weeks, AAGP will review the proposed rule to identify issues that should be addressed.More

CMS releases proposed decision for PET amyloid-beta (Aβ) imaging in dementia and neurodegenerative disease

On July 3, the Centers for Medicare & Medicaid Services released a memo proposing a rule that positron emission tomography amyloid-beta (Aβ) imaging not be covered for Medicare beneficiaries with dementia or neurodegenerative disease in most cases. CMS proposes that the evidence is insufficient to conclude that the use of PET amyloid-beta (Aβ) imaging improves health outcomes for Medicare beneficiaries with dementia or neurodegenerative disease, and thus PET Aβ imaging is not reasonable and necessary under the Social Security Act.

CMS does state that there is sufficient evidence that the use of PET Aβ imaging could be promising in two scenarios: to exclude Alzheimer's disease in narrowly defined and clinically difficult differential diagnoses, such as AD versus frontotemporal dementia; and to enrich clinical trials seeking better treatments or prevention strategies for AD, by allowing for selection of patients on the basis of biological as well as clinical and epidemiological factors. CMS proposes to cover one PET Aβ scan per patient through coverage with evidence development, in clinical studies that meet certain criteria. Clinical study objectives must be to (1) develop better treatments or prevention strategies for AD, or, as a strategy to identify subpopulations at risk for developing AD, or (2) resolve clinically difficult differential diagnoses (e.g., frontotemporal dementia (FTD) versus AD) where the use of PET Aβ imaging appears to improve health outcomes. More

Physician Compare website redesigned to aid consumers

On June 26, the Centers for Medicare and Medicaid Services announced that Physician Compare, a website that allows consumers to search and compare information about hundreds of thousands of physicians and other health care providers, has been redesigned to make the site easier to use and provide new information for consumers, including an improved search function.

The Physician Compare website is being improved based on user and partner feedback and includes new information on physicians, such as:

Physician Compare is also now connected to a consistently updated database so that consumers can find the most accurate and up-to-date information available. In 2014, quality data will be added, and this will help users choose a medical professional based on performance ratings.

"Nearly a million physicians and other health care professionals serve the Medicare population," said CMS Administrator Marilyn Tavenner. "This vastly improved website will provide new information in an improved, easy-to-use format." See the Physician Compare website here: www.medicare.gov/physiciancompare. More

New report: Future long-term care needs and costs

The Congressional Budget Office has released a new study examining the long-term care needs of the next generation and the cost for providing long-term services and supports. In order to explore the impact of the growing elderly population on long-term care expenditures, the CBO has developed three scenarios that examine the factors impacting those costs. More

AAGP member news: Wallack publishes book on Alzheimer's
AAGP student member Max Wallack, along with Carolyn Given, recently published a book on Alzheimer's disease for children. Wallack's book is available through Amazon.com.More

Commonly prescribed drugs may influence the onset and progression of Alzheimer's disease
Multiple drug classes commonly prescribed for common medical conditions are capable of influencing the onset and progression of Alzheimer's disease, according to researchers at The Mount Sinai Medical Center. The findings are published online in the journal PLoS One.More

UC Davis researchers: A second amyloid may play a role in Alzheimer's disease
A protein secreted with insulin travels through the bloodstream and accumulates in the brains of individuals with type 2 diabetes and dementia, in the same manner as the amyloid beta Aβ plaques that are associated with Alzheimer's disease, a study by researchers with the University of California, Davis Alzheimer's Disease Center has found.More

Neurological changes in older adults may shift center of peripersonal space
Age-related neurological changes appear to shift perception of peripersonal space from hand-centered to body-centered locations, affecting how older adults perform many common movements, according to new data.More

Sedative use drops at nursing homes
The Boston Globe
A pilot program to reduce the use of antipsychotic drugs in 11 Massachusetts nursing homes lowered rates by 21 percent in the first year, according to data provided to The Boston Globe by the state's nursing home trade association.More

Brain region implicated in emotional disturbance in dementia patients
Science Daily
A study by researchers at Neuroscience Research Australia is the first to demonstrate that patients with frontotemporal dementia lose the emotional content/color of their memories. These findings explain why FTD patients may not vividly remember an emotionally charged event like a wedding or funeral.More

Alzheimer's disease and cancer: Each may lower risk of the other
LiveScience via Huffington Post
Alzheimer's disease and cancer are both diseases of aging, but interestingly, having one of these conditions lowers the risk of developing the other, a new study from Italy suggests. In the study, people with Alzheimer's disease were 43 percent less likely to develop cancer, and people with cancer were 35 percent less likely to develop Alzheimer's disease, compared with the general population.More

Brew on this: Latest research on coffee's connection to Alzheimer's
By Denise A. Valenti
As I stared into my morning cup of black coffee, trying to percolate into alertness, I received an email from a colleague alerting me to a recently published article about acetylcholinesterase inhibition. Some of the most commonly prescribed medications for Alzheimer's disease act upon the cholinergic system, inhibiting acetylcholinesterase.More

'Dementia village' inspires new care
'Dementia Village' — as it has become known — is a place where residents can live a seemingly normal life, but in reality are being watched all the time. Caretakers staff the restaurant, grocery store, hair salon and theater — although the residents don't always realize they are carers — and are also watching in the residents' living quarters. Residents are allowed to roam freely around the courtyard-like grounds with its landscaped trees, fountains and benches — but they can't leave the premises.More