Capitol Hill Report: AAN Presses Deficit Committee to Avoid Reimbursement Cuts

November 3, 2011


By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506-7468,

AAN Congressional Affairs Representative Derek Brandt or I have met personally with half of the Joint Select Committee on Deficit Reduction members and have been in contact with the staff of all of the others. I'm skeptical that the Deficit Committee is going to come up with detailed Medicare cuts that would negatively impact physicians more than the alternative, which is a two percent across-the-board cut to physician payments. Deficit Committee members have told us that they need to come up with a plan in early November in order to get a cost analysis by the nonpartisan Congressional Budget Office prior to the November 23 deadline for presenting a plan to Congress.

We are taking every opportunity to educate the Deficit Committee members on the need to ensure that patients have adequate access to cognitive care providers. But it's difficult for us—or anyone else, for that matter—to know if the committee is sympathetic to our position. I met last week with House Minority Whip Rep. Steny Hoyer (D-MD) and discussed his thoughts on how physicians might be impacted by the Deficit Committee. Surprisingly, even congressional leadership doesn't have all the details of the behind-the-scenes discussions taking place within the Deficit Committee. Although I'm sure he does have some ideas, the reality is that Deficit Committee members are keeping their efforts under wraps.

AAN Stays on Message with Congress

Since early October, Derek and I have made contact with more than 125 members of Congress or their staff regarding MedPAC's recommendation to spare "primary care" but cut all physician specialties almost 18 percent over the next three years. We have been meeting members in their offices and at fundraisers. These contacts have included several senators and a diverse group of House members like the Republican physicians from Georgia—Reps. Gingrey, Price, and Broun—to Democrats such as House Ways and Means Health Subcommittee member Rep. Mike Thompson (CA) and Energy and Commerce members Reps. Mike Ross (AR) and Jim Matheson (UT). Fortunately, we haven't found a single member of Congress on either side of the aisle who thinks the MedPAC recommendation actually will be approved by the Congress. But the recommendation has given the Academy an excellent opportunity to join with our Cognitive Specialty Coalition partners to describe to Congress how separating primary care from all other specialties makes no sense.

AAN members also have been engaged by responding to our action alert in big numbers. Almost 1,000 AAN members have sent nearly 3,000 messages to Congress detailing the disaster that would occur to access to care if Congress instituted draconian cuts in Medicare payments to physicians. Have you sent your message yet? If not, please send your message in three easy clicks today.

Congressman Joe Heck Addresses AAN BrainPAC Reception

Attendees at the AAN Fall Conference in Las Vegas were treated to an address by US Rep. Joe Heck, DO (R-NV) at a reception sponsored by the AAN's political action committee, BrainPAC. Heck, an emergency physician, was elected to Congress in 2010 with the support of BrainPAC. Heck talked and took questions about the current congressional environment and the concern about the physician payments being threatened, not only by the Deficit Committee but also the looming Sustainable Growth Rate (SGR) cut of almost 30 percent facing physicians on January 1, 2012. Heck is very supportive of our efforts to recognize cognitive care and is now citing the promotion of primary care at the expense of cognitive care as an example of a key problem in the current health care debate.

CMS Appoints AAN Member Marianna V. Spanaki-Veralas to Federal Panel

The AAN successfully nominated Marianna V. Spanaki-Veralas, MD, PhD, MBA, for a position on the Centers for Medicare and Medicaid Services (CMS) Ambulatory Payment Classification (APC) Advisory Panel.

The appointment is for a four-year term through January 31, 2016. The panel reviews the APC groups and their associated weights, and advises the secretary of the Department of Health and Human Services and the CMS administrator concerning the clinical integrity of the groups and their weights. The advice provided by the panel is considered as CMS prepares its annual updates of the hospital outpatient prospective payment system.

Spanaki-Veralas currently serves on the Academy's Medical Economics and Management Committee (MEM) and is the AAN's advisor to the American Medical Association's Relative Value Committee (RUC), the group that assigns relative values to Current Procedural Terminology (CPT®) codes.

The AAN congratulates Spanaki-Verlas, who also received the support of several members of the Michigan congressional delegation, including both Sens. Carl Levin (D) and Debbie Stabenow (D).