Capitol Hill Report: $6 Million Win, NCS/EMG Update, VP Biden Mentions AAN

January 21, 2013


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

AAN Wins Funding for Epilepsy Centers of Excellence

In an exciting victory for AAN advocacy, the Department of Veteran’s Affairs has agreed to continue funding of the Epilepsy Centers of Excellence (ECoE) for FY 2014 for $6 million.

When the ECoE were created by Congress in 2008 the legislation contained a “sunset” provision that would end authorization of the centers after five years unless Congress acted or the VA continued funding.

In October of last year, we received signals that the ECoE may not be funded, even though data clearly show the centers are improving care for veterans while also saving the VA money since patients no longer have to be referred to outside specialists.

We took our concern to the original author of the legislation, Rep. Ed Perlmutter (D-CO), to ask him to lead a letter to the VA requesting that the ECoE be fully funded. The AAN was joined in this effort by the Epilepsy Foundation of America (EFA). Both the AAN and EFA activated a grassroots lobbying campaign that resulted in 43 members of Congress signing Rep. Perlmutter’s letter.

The AAN is pleased that the VA indicated that the ECoE would be included in their FY 2014 budget. In a city dominated by dysfunction, the ECoE are at least one success story of how things can get done in Washington. We thank all AAN members who took the time to send a message to Congress that led to this success.

NCS/EMG Update

For the last two months, much of the Capitol Hill Report has been devoted to AAN efforts to curb the dramatic cuts to nerve conduction and EMG studies proposed by CMS on November 1, 2012. If you do these studies you no doubt know that the cut went into effect on January 1.

Your AAN leadership, including President Bruce Sigsbee, MD, FAAN; Elaine C. Jones, MD, FAAN; and AMA RUC Committee member Marc Raphaelson, MD, worked tirelessly along with AAN staff to try to overturn this uninformed, arbitrary decision.

We have received a number of complaints from AAN members asking why we “allowed this to happen” or “why didn’t you do anything to stop this?” Regular readers of Capitol Hill Report know that we did everything we could before the cut went into effect, so I have a favor to ask. If you encounter AAN members with similar complaints, please let them know that our response to this situation was a swift, vigorous defense of physicians who conduct these studies and the patients who rely on them. 

CMS is an unelected, unaccountable government agency that ignored the recommendation of the RUC and acted (unfairly but legally) outside the normal process of government, which typically offers advance notice and an opportunity to comment, especially on reductions as significant as those affecting nerve conduction and EMG studies.

In the short time we were given, the AAN:

  • Created a coalition of interested patient and provider groups
  • Generated a letter from the US House objecting to the change that was signed by more than 40 members of Congress (at the height of the fiscal cliff crisis)
  • Generated a similar bipartisan letter from the US Senate
  • Met twice with CMS, including a high-level meeting attended by the AAN president, AAN's Government Relations chair, and the AAN’s RUC representative
  • Prompted 1,368 letters from AAN members to members of Congress
  • Encouraged more than 150 personal letters from AAN members to CMS
  • Generated upwards of 5,000 congressional contacts, including coalition member contacts

We also learned that neurology is not the only physician specialty to have fallen victim to this process recently. Several groups, including cardiology and ophthalmology, have experienced similar situations. That is little consolation but at least we know we aren’t being targeted.

Going forward, CMS has asked for information on patient access to care problems caused by this cut. When treatment is adversely impacted arise, as it surely will be, the AAN will be asking you to share your stories. The cuts have gone into effect, but the end of this story has yet to be written.

AAN Mentioned by Vice President Biden

The AAN was mentioned by Vice President Joe Biden in this CNN news clip regarding medical organizations his task force met with on gun control. He calls the AAN a “leading organization,” along with the American Academy of Pediatrics and others. AAN President Bruce Sigsbee, MD, FAAN, represented the AAN at the meeting in Washington, DC.

I talked with Dr. Sigsbee after the meeting and he said that although there was no consensus on how to reduce gun violence, it was clear that everyone has an interest on improving mental health services. Sigsbee also said it served as a great opportunity to increase communication between the AAN and the administration on this and other issues.