Capitol Hill Report: Congress Adjourns-Leaves Everything on the Table

September 21, 2012


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

As expected, the 112th Congress adjourned two weeks early, leaving several key issues unresolved, except for a six–month continuing resolution that ensures the government will remain open until March, 2013, after the presidential inauguration and the start of the 113th Congress.

This leaves several expiring tax provisions and huge mandatory spending cuts (called sequestration) on the books and scheduled to go into effect in 2013 unless Congress acts in a lame duck session following the November election.

What Is at Risk for Neurology?
The cost of a one–year fix to the Sustainable Growth Rate (SGR) formula that calls for Medicare physician cuts of almost 30 percent is $11 billion. With a looming cut of almost 30 percent, physicians will have to exert pressure on their members of Congress to make sure the SGR is taken care of before cuts are implemented and access to care is compromised.   

But SGR isn’t the only risk to neurology. In addition, several other provisions scheduled to go into effect at the end of the year would also dramatically affect neurology, including:

  • Eight–percent reduction in funding the NIH, called for by sequestration
  • Two–percent cut in physical reimbursement, called for by sequestration

AAN Active on Sequester and SGR
The AAN’s Washington office has been active on both of these issues, educating lawmakers about the impact of these cuts and encouraging them to act as soon as possible rather than waiting until what is sure to be a Christmas Eve deal. We sent out an action alert last week asking all US AAN members to send a message to Congress detailing concerns about the sequester. If you haven’t sent a message yet, please help us keep the pressure on by doing so now.

We also have been communicating directly with some of the key decision makers. Rep. Dave Camp (R–MI), chair of the House Ways & Means Committee, told me that he would be working for a two–year SGR fix with the intention of giving physicians an adequate window for finding a permanent solution that everyone agrees is necessary. In a conversation I had with Sen. Orrin Hatch (UT), top Republican on the Senate Finance Committee, he agreed with Rep. Camp that a two–year fix is preferable, but wasn’t sure that the Senate would be able to come to an agreement.

My DC colleague, Derek Brandt, talked with Energy & Commerce Committee member Rep. Kathy Castor (D–FL), who indicated that she would be pushing for improvements to primary care payments in an SGR fix and would be supporting the language the AAN worked so hard to get in the Medicare Physician Payment Innovation Act, HR 5707, sponsored by Reps. Allyson Schwartz (D–PA) and Joe Heck, DO (R–NV).

I talked with Rep. Heck, who said that he doubted that there will be substantive physician payment reform included as part of the year end SGR fix, but he will be ready if the opportunity presents itself. For more information on HR 5707 and our efforts, please take a look at this May Capitol Hill Report.

We aren’t getting our hopes up too high as neither side is even close to an agreement on an SGR fix, but we will keep advocating for a long term solution that includes recognition of neurology.

Headache Funding Progress
The AAN has been working for several years with AAN members Robert E. Shapiro, MD, PhD, of Vermont and Teshamae Monteith, MD of Florida, and many others to pursue funding for headache research.

Persistence has paid off as the Senate Appropriations Committee chaired by Sen. Daniel Inouye (D–HI) reported out of committee the FY 2013 Defense Appropriations bill on August 2, 2012. Within the report, chronic migraines and post traumatic headaches were identified for funding under the Congressionally Directed Medical Research Program. The AAN has requested this designation for several years.

The full Senate did not take up the bill prior to adjourning as the continuing resolution was enacted, but progress is made in small steps and if/when the Congress returns to regular order under the appropriations process, headache will be a part of the discussions. (No doubt in more than one way!)

Congratulations are in order to all of those who have made funding for headache an advocacy priority.

Fall Conference Advocacy CME
For the first time, the AAN will offer a free CME course on advocacy at the Fall Conference in Las Vegas. The course, “Physician–led Advocacy: Creating Change,” will be directed by AAN Government Relations Committee Chair Elaine C. Jones, MD, FAAN, of Rhode Island. The program is Saturday, October 27, from 1:00 p.m. to 5:00 p.m. and offers 3.5 hours of CME.