Capitol Hill Report: AAN Meets with CMS, Delivers Congressional Letter on NCS/EMG

December 21, 2012


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

Last week, AAN President Bruce Sigsbee, MD, FAAN, hand delivered a letter to officials at the Centers for Medicare & Medicaid Services. The letter was signed by 42 members of the US House asking CMS to consider the significant impact its cuts to electrodiagnostic tests will have on Medicare beneficiaries. Without giving any opportunity for notice and comment, CMS notified the AAN and others on November 1 that it would begin cutting payments for these tests by 50 percent starting January 1.

In order: AAN President Bruce Sigsbee, MD, FAAN, Elaine Jones, MD, FAAN, Jonathan Blum, Director, Center for Medicare at CMS, Marc Raphaelson, MD, FAAN

Dr. Sigsbee was joined by Marc Raphaelson, MD, FAAN, who represents the AAN on the AMA Relative Value Update Committee (RUC), which makes recommendations to CMS on code values, and by Elaine Jones, MD, FAAN, Chair of the AAN Government Affairs Committee. Representatives from AANEM, AAPM&R, and APTA also attended.

The meeting did not result in any agreement to roll back or delay the cuts. CMS heard our concern about patient access to care and asked the AAN to develop two or three data indicators based on claims data that could help CMS understand the secondary impact. If data show access is impacted, CMS may consider future adjustments.

The AAN Medical Economics and Management Committee will consider the request and we will meet again with CMS early next year.

Senate Also Chimes In

Dr. Sigsbee also delivered another letter authored by Sen. Amy Klobuchar (D-MN) and Sen. Lisa Murkowski (R-AK) that also asks CMS to consider the impact the NCS/EMG cuts are likely to have on patients.

Cannon House Office Building, 2nd floor, Dec. 21, 2012
Cannon House Office Building, 2nd floor, Dec. 21, 2012

Did Your Member Sign?

It took a great deal of effort to get the 42 congressional signers. In fact, it was quite difficult if you consider what is going on in the halls of Congress.

First, as everyone knows, Congress and the president are facing the “fiscal cliff,” which, without action, will create economic chaos for just about everyone—including physicians facing 28.5-percent reductions in Medicare payments due to the Sustainable Growth Rate cut and sequestration.

Second, Congress is a mess. Really.

If you have been to the House office buildings, you know the long marbled hallways with doors leading into individual congressional offices. Trying to get through today is like being in a maze. Office selection is based on seniority, so current members are moving to the nicer suites vacated by retiring senior members. Then, more than 93 new members are preparing to take the offices that remain. All of this makes for hallways full of computers, furniture, and file cabinets.

All of this makes it difficult to get the attention of members of Congress and their staffs. So, did your member sign the letter? If so, congratulations and thanks for your effort. Here is a list of the signers:

Rep. Roskam (R-IL) Rep. Altmire (D-PA)
Rep. Ruppersberger (D-MD) Rep. Woodall (R-GA)
Rep. Smith (R-TX) Rep. McCollum (D-MN)
Rep. Welch (D-VT) Rep. Grimm (R-NY)
Rep. Tonko (D-NY) Rep. Benishek (R-MI)
Rep. Burgess (R-TX) Rep. Gingrey (R-GA)
Rep. Pastor (D-AZ) Rep. Roe (R-TN)
Rep. Thornberry (R-TX) Rep. Hanna (R-NY)
Rep. Chabot (R-OH) Rep. Schock (R-IL)
Rep. Braley (D-IA) Rep. Palazzo (R-MS)
Rep. Matheson (D-UT) Rep. Hultgren (R-IL)
Rep. Moran (D-VA) Rep. Heck (R-NV)
Rep. Buchanan (R-FL) Rep. Paulsen (R-MN)
Rep. Bartlett (R-MD) Rep. Price (R-GA)
Rep. Young (R-IN) Rep. Blackburn (R-TN)
Rep. Marchant (R-TX) Rep. Tiberi (R-OH)
Rep. Griffin (R-AR) Rep. Jenkins (R-KS)
Rep. Runyon (R-NJ) Rep. Broun (R-GA)
Rep. Boustany (R-LA) Rep. Pascrell (D-NJ)
Rep. Nunnelee (R-MS) Rep. Sessions (R-TX)
Rep. Black (R-TN) Rep. Latham (R-IA)

Neurology Successes

So much of the news in Capitol Hill Report has been frustrating lately, so as you read this in the holiday season I want let you know about some successes by AAN members.

Safe Driving in Michigan

Gov. Rick Snyder of Michigan recently signed into law legislation allowing physicians to warn third parties regarding a patient’s mental and physical qualifications to operate a motor vehicle and providing the physician with legal immunity.

This legislation was the result of a several year effort by AAN member Marianna Spanaki, MD, PhD who developed the idea at part of her action plan at the AAN’s Palatucci Advocacy Leadership Forum.

Congratulations are in order for Dr. Spanaki, who led the effort lobbying and testifying in support of the legislation and was invited by Gov. Snyder to attend the signing ceremony.

Bringing Art to Life

In another success for a Palatucci Forum graduate, 2008 Palatucci Advocate of the Year Daniel Potts, MD, recently shared a short video made about his foundation’s “Bringing Art to Life” Program, an art therapy/life story preservation initiative in conjunction with the University of Alabama for persons with Alzheimer’s disease. It is very interesting and I hope you will take a look at the video.