State “Surprise Bill” Laws or the Federal No Surprises Act—Which Law Applies When?

By Thomas LaGreca, Esq., Callagy Law

In September, NERVES Board of Directors approved updated bylaws. The updates to the bylaws will allow for board discretion to permit inactive members to continue to hold society positions for the benefit of the society.  Additionally, it will allow for Regional Directors to keep their position for their reminder of their term if they move to a different region during their term.

If you have questions or concerns about the current bylaws or have a governance question, please email us at [email protected].

I would like to start off by saying that being the NERVES Liaison to the Congress of State Neurosurgical Societies (CSNS) has been one of the most rewarding experiences of my time in NERVES. I have had the opportunity to interact with both professionals and physicians from across the practice spectrum. For those who don’t know much or anything about the CSNS it is the grassroots socio-economic organization that sits between the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgery (CNS). It is made up of various appointees and volunteers from all practice venues and state and regional neurosurgery societies. It has a Chair, currently Dr. Joseph S. Cheng, that serves a two-year term as well as various other officers. There are also several committees that have a Chair like the Practice Committee and the Medico-Legal Committee, among others. It also offers great exposure for residents. The CSNS take around 12 Socio -Economic Resident Fellows each year that get to learn many aspects of practice that they get little or no exposure to during their six to seven years of training in an academic program. The CSNS meets in-person at both annual meetings of its parent organizations and all neurosurgeons are welcome to attend and vote on the various resolutions that are put forward during the meeting. The CSNS also meets in the Summer and Winter either in-person or through a video to keep things moving forward between the annual meetings.

At the CNS meeting in San Francisco in October, several resolutions were put forward for consideration, of which only a few were adopted and are moving forward. Some of the following resolutions will be moving forward during the next year: 

Committee Members: Carrie Bennett, Antoine Curtis, Galyn Damiani, Kelly Hornbacher, M.J. Orellano (chair), Alex Palleschi, Jim Shea, Stacey Snodgrass, Kathy Tobin (past chair), Mark Vorherr, Melissa Klingberg (NERVES). 

The Education Committee is responsible for creating educational opportunities for NERVES members throughout the year. The committee has a great balance of private practice, hospital-based practices, and academic practice to represent our membership on our committee.

Curi was proud to be a platinum-level sponsor of the 2022 NERVES Conference in Philadelphia. It was wonderful to see NERVES members and to share how Curi’s advisory, capital, and insurance offerings are delivering valued advice that’s time-tested and trusted for practices and practice leaders across the country.  

We look forward to keeping in touch with the neurosurgery groups that make up the NERVES membership and are excited to partner with many of you to understand how we can continue to support you and your practices in medicine, business, and life.

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Name, Title, Employer: Cynthia Voorhees MSN, RNFA, ACNP-BC. CFO of TNSPINE PLLC.

How long have you been a NERVES member: I am new. Not even a year and I have enjoyed it very much.  

Hello NERVES Members,

Starting your recruitment on the right foot is only half of the recruitment equation. Once you’ve identified your top candidates, these four tips will help you to have your new hire signing on the dotted line!

Author, Nicola Hawkinson with SpineSearch

Our recent article "WHAT MAKES A CENTER OF EXCELLENCE..., EXCELLENT?" certainly caught the attention of many readers, and your questions have been well…, “excellent.”

Dear NERVES Members:

I am so pleased to report that our first Building the Best: The Future of Spine Care & the Development of Centers of Excellence conference on September 22-23 in Chicago was phenomenal! Everyone who attended learned detailed nuts and bolts information about spine center and ERAS planning, operations, multidisciplinary team approaches, marketing, cost measurement, insurer perspectives, and the future of spine care. We all returned to our workplaces with a tremendous amount of new information and ideas that will improve spine care for patients across the country.  Hats off to the NERVES members who planned this event and the exhibitors and speakers who supported it. It was a true success story!

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The membership committee has expanded the committee by six members. We are working on a plan to improve the retention and engagement of the members by the following : 

• Survey to establish the reasons for members leaving. Already sent to those who left. Pending results.
• We are developing a standard practice to ensure engagement from the regional directors and members within the next 30 days.  

We are looking for permission from the board to develop the following: 

Unfortunately, I was unable to attend the Winter CSNS EC Meeting in Washington, DC due to a prior commitment, but was able to attend the CSNS Meeting in Philadelphia during both the NERVES Annual Educational Meeting and the AANS Annual Meeting. This was the first in-person plenary meeting since the onset of COVID. There were many topics discussed as resolutions and I will highlight some of the ones that should be of interest to our group.

• Cost Awareness Amongst Neurosurgeon Faculty and Residents: A Need for Health Care Sustainability Education
• Case Minimum and Credentialing Requirements
• Creating Sustainable Reimbursement for the Physician Workforce of the Future (Medicare)
• Evaluating Medical Error Reporting Practices in Neurological Intensive Care Units (Emergency Resolution pertaining to the criminal conviction of a neurosurgical ICU nurse)

I was also asked to sit on a lunch panel at the CSNS luncheon that was focused on philanthropy, how to pursue it and what areas within a practice that it can help, like bridge research funding, helping backstop certain clinical programs that lack reimbursement but are critical to high functioning centers and teams.

Hello NERVES Members,

Committee Members: Carrie Bennett, Antoine Curtis, Galyn Damiani, Kelly Hornbacher, M.J. Orellano (chair), Alex Palleschi, Jim Shea, Stacey Snodgrass, Kathy Tobin (past chair), Mark Vorherr, Melissa Klingberg (NERVES). 

The Education Committee is responsible for creating educational opportunities for NERVES members throughout the year. We are pleased to welcome two new committee members this quarter: Carrie Bennett from the Neurological and Spine Institute of Savannah and Mark Vorherr from Mayfield Clinic.  We have a great balance of private practice, hospital-based practice and academic practice to represent our membership on our committee.

HUB was proud to be a platinum level sponsor of the 2022 NERVES Conference in Philadelphia. It was a great opportunity to meet with NERVES members from throughout the country and to update attendees on the many resources offered by HUB.

The conference was well supported with excellent networking events. NERVES volunteer leadership along with Melissa Klingberg went above and beyond to make sure we were taken care of.

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Please join NERVES in congratulating our member, Diana M. Hansen for 50 years with her practice! 

From Diana: On March 6, 1972 (when I was 5 years old!  Not really, of course, but it is usually good for a laugh!) I started working with two neurosurgeons: Dr. David Hubbell and Dr. Harley Deere. They had just left another neurosurgery group to go out on their own. They needed someone to file charts, copy charts (copy machines needed liquid toner at that time), and other general clean up office duties so that is how it all began. I was in high school at the time and the office manager worked around my school schedule allowing me full time work during school holidays, Saturdays, and summertime. That arrangement continued through college. I got my teaching credential which remains current to this day, but there were no teaching jobs in California, so they offered me a fulltime position with benefits as secretary to Dr. Harley Deere. That was in 1977. In 1981 I was offered the office management position and have been working in that capacity since. Several doctors have come and gone, but I am still here!

Rosa Schiro, CFO IGEA Brain, Spine, & Orthopedics 

How long you've been in the role and what past jobs/experiences led up to this role:
I accidentally ended up in medical. I had been a SAHM running my husband’s business and raising my children for the last 20 years when I decided to dip my toe back into the career pool.  I was working part time at an accounting firm across the street from my sons’ school and wanted to start looking for a full-time position because my boys would be starting high school soon and I wanted to stay busy.  When I was initially offered the position of accounting manager at IGEA I was reluctant because I knew nothing about medical but as I someone close to me said “1+1 will always equal 2” so I took the plunge.  Within a year I was promoted to Controller and last year I was also put in charge of overseeing our billing and promoted to CFO.

Dear NERVES Members:

I’m sending greetings from Birmingham, Alabama to all of you across the U.S.  I hope you are enjoying the summer and getting outdoors, but I also know that many of you are facing scorching deep-south temperatures -- no matter where you live!  The heat this summer is in stark contrast to the cold temps and wind we experienced at our April Annual Meeting in Philadelphia on the rooftop bar that night, right?  The heat from the fire pits and the great personal and professional connections we made that night kept the networking and fun going all the way past closing. I met so many of you at the April meeting, and I’m extraordinarily thankful for that opportunity!