Capitol Hill Report: President Sigsbee Goes to Washington

September 23, 2011

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By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506-7468, mamery@aan.com

AAN President Bruce Sigsbee, MD, FAAN, joined me the week of September 19 on a whirlwind tour of key congressional members and staff to discuss the Academy's views on physician reimbursement and cognitive care.

Dr. Sigsbee's trip to Washington was perfectly timed as the Joint Select Committee on Deficit Reduction has begun deliberations. Also, the congressional advisory committee MedPAC recently floated an idea to cut all specialists by nearly 18 percent (while freezing "primary care" providers) over the next three years in order to help fix the Sustainable Growth Rate problem. The Deficit Committee needs input from organizations like the Academy and Congress needs to know what we think about a MedPAC "solution" that picks winners and losers based on the shingle the physician holds outside their office rather than the care they provide to patients.

AAN President Dr. Sigsbee and Sen. Susan Collins (R-ME)

On the Senate side, Dr. Sigsbee and I met with Sen. Pat Toomey (R-PA), who is a member of the Deficit Reduction Committee, as well as Sens. Susan Collins (R-ME), Tom Udall (D-NM), Carl Levin (D-MI), and Olympia Snowe (R-ME). On the House side, we met with Rep. Dave Camp (R-MI), who is chair of the powerful Ways & Means Committee and also a member of the Deficit Committee.We also had discussions with Reps. Pete Sessions (R-TX), Henry Waxman (D-CA), Sander Levin (D-MI), Michael Michaud (D-ME), and Chellie Pingree (D-ME).

Dr. Sigsbee and I also met with the top health staff of Speaker John Boehner (R-OH), Majority Leader Eric Cantor (R-VA), the House Ways & Means and Energy & Commerce Committees, as well as the Senate Finance Committee. As those who study Congress know, it is often these staffers who write the legislation and most need to hear from groups like the Academy.

Our meetings went a long way toward moving the Congress in a direction that will recognize the work of neurologists and prevent future legislation like that suggested by MedPAC that would so negatively affect Academy members and patients with neurologic conditions. I agreed with Dr. Sigsbee when he commented that it appears top health staff seem more informed than in the past, especially on the issues important to neurology.

MedPAC Floats Brutal SGR Suggestion

As mentioned above, MedPAC made a suggestion last week that would devastate neurology and other cognitive specialties by lumping neurology in with all other specialties in cutting reimbursements by almost 18 percent over three years while freezing primary care.

In every meeting we had with both members and staff, Dr. Sigsbee vigorously objected to the MedPAC's recommendation and provided detailed statistics on how this would negatively impact neurology as a specialty. He also stressed that many Academy members rely heavily on E/M codes, just like primary care physicians.

Fortunately, the responses we received ranged from "that isn't getting much traction" to "that's insane!" It also elicited understanding of how neurology fits in the health care system in relation to primary care and procedural specialties.

However, although Dr. Sigsbee and I reached a lot of key decision makers, we still need all US AAN members to let Congress know that they need to permanently fix the SGR and that the MedPAC idea would be devastating. Recently, the Academy sent an action alert asking US members to contact their members of Congress. If you haven't sent your letters yet, please take a minute to do so today. The Academy also recently sent a letter to the Deficit Committee detailing these issues.

Congressional Caucus Invites AAN Member

Dr. Williams testifies on Capitol Hill

The Congressional Adult and Pediatric Hydrocephalus Caucus chaired by Reps. Leonard Lance (R-NJ) and Tim Walz (D-MN) hosted a briefing on pediatric hydrocephalus on Capitol Hill on September 23. Michael Williams, MD, FAAN, who serves as Medical Director of the Sandra and Malcolm Berman Brain & Spine Institute and Director of the Adult Hydrocephalus Center at Sinai Hospital of Baltimore was asked to provide the medical overview.

Dr. Williams, a former chair of the AAN's Ethics, Law and Humanities Committee, provided background on the nature of hydrocephalus, the population it affects, the available treatments, and the state of clinical and basic research. His testimony can be reviewed here.

Follow Neurology in Washington on Twitter!

Derek Brandt and I recently started posting regular updates on our congressional interactions including office visits and fundraisers with members of Congress. Stay informed by following us at @AANMember or by checking out #AANDC.