Capitol Hill Report: What the AAN Is Doing For You

December 8, 2009


By Mike Amery, Legislative Counsel, Federal Affairs, (202) 349-4299,

The mission of the Academy is to be "indispensable to its members." One way the Academy fulfills this mission is by representing of neurology in the halls of Congress. Capitol Hill Report presents regular updates on legislative action and how the AAN ensures that the voice of neurology is heard on Capitol Hill. The Academy's legislative counsel in Washington, DC, Mike Amery, offers weekly updates on advocacy for neurology and neurologic concerns.

The US Senate started debate on health care reform late last week, and continued in a rare Saturday–Sunday session. Senate Majority Leader Harry Reid (D-NV) has said that the Senate will remain in session next weekend as well, with the goal of completing a health reform bill prior to the holiday break.

I had the pleasure of spending last Wednesday afternoon on the Hill with AAN President-elect Bruce Sigsbee, MD, FAAN, of Maine. If you have read previous installments of Capitol Hill Report, you know that one of the Academy's top priorities is to make neurology eligible to receive bonuses under the primary care incentive section of the congressional health care reform bills. Sigsbee and I were on the Hill recruiting cosponsors for an amendment by Sen. Amy Klobuchar (D-MN), which will do just that. We met with Sen. Klobuchar and her staff to discuss amendment strategy, followed by meetings with staff from Senators Debbie Stabenow (D-MI), Olympia Snowe (R-ME), and Susan Collins (R-ME). Later that evening, we attended a dinner in support of Sen. Collins, where Sigsbee asked her to support the Klobuchar amendment. We have high hopes for Sen. Collins cosponsoring the amendment, making it a bipartisan effort. Klobuchar introduced the amendment on Monday with Collins and Sen. Sherrod Brown (D-OH) as original cosponsors.

The Academy is asking all members to contact their senators to ask them to cosponsor the amendment and contact the Senate Finance Committee to express the importance of this amendment.  If you haven’t already sent a message to your senators, please take two minutes to log in to Vocus and contact your representatives in the Senate.

On the larger question of reform, the contentious issues are similar to those that the US House encountered: a public option insurance plan and the issue of abortion funding. Senate Democrats have 60 votes with the two independent members of the Senate caucusing with the Democrats—exactly the number they need in order to pass any legislation. So, assuming there are no Republican votes for the health care bill, Democrats need to keep all 60 on board. This week Senators Joseph Lieberman (I-CT) and Blanche Lincoln (D-AR) reiterated earlier statements in opposition of the public option, while senators Bernard Sanders (I-VT), and Roland Burris (D-IL) stated that they will oppose any bill that does not contain a strong public option. Senator Ben Nelson (D-NE) announced that he would introduce an amendment that would mirror the abortion language restricting federal funding contained in the House bill, authored by Rep. Bart Stupak (D-MI). If the amendment fails (which is likely), it remains unclear whether Senator Nelson will vote for final passage, absent an acceptable compromise.

Both of these issues cast uncertainty on the bill's final form and when it will pass.

Practice Expense Update

The Academy has joined a coalition of 19 medical and health care organizations to push for implementation of the Practice Expense portion of the 2010 Medicare Physician Fee Schedule. This update benefits neurology by about four percent over the next few years, but there are a few specialties arguing for a moratorium because they are unhappy with the results. I have been working with representatives from the American Academy of Ophthalmology, American College of Surgeons, and several others to meet with as many US Senate offices as possible to make senators aware of the significant opposition there is to any delay. We could use your help on this issue: contact your members of Congress with a quick email. This debate is also being played out in the newspapers of Capitol Hill (see an ad running in DC papers).

Elimination of Consult Codes

Along with other cognitive specialties, the Academy is working on an amendment to the health system reform proposals that would stop or at least delay the January 1, 2010, elimination of consult codes. offers a great deal of information on the consult code elimination, including an impact calculator. We could also use your support on this issue: send a message to your members of Congress.

Finally, for those unable to participate in last week's teleconference on health reform, an audio file is now available online.