Capitol Hill Report: House Passes Final Bill

March 22, 2010


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.

A Final Health Bill

A final health reform bill finally passed the US House on Sunday, March 21. It was accompanied by another bill passed by the House and sent to the Senate that will correct a number of problems with the final bill. Both measures passed with no Republican support. Unfortunately, neither of these bills included neurology in the primary care incentive section of the bill or a permanent fix for the sustainable growth rate (SGR) formula that threatens physician reimbursement under Medicare each year. Because of this, the American Academy of Neurology did not take a position on the legislation. President Obama is expected to sign this legislation sometime this week. Continue to watch for more details.

Neurology on the Hill

The Academy worked for several months to include neurology in the bill and will continue to work on technical corrections legislation or other efforts designed to improve the new $940 billion health plan. The first step in that effort occurred March 8–9 at the Academy's eighth annual Neurology on the Hill. More than 100 Academy members came to Washington, DC, to discuss this issue with their members of Congress. One of the highlights included a meeting of Academy President-elect Bruce Sigsbee, MD, Government Relations Committee Co-chair Elaine Jones, MD, the AAN CEO Catherine M. Rydell, AAN Chief Health Policy Officer Rod Larson, and myself, with House Majority Leader Steny Hoyer (D-MD). Hoyer and his chief of staff agreed that the exclusion of neurology from the incentive was a problem, and that we would have to work out the details after passage of health care reform. They assured the group that there would be numerous efforts to improve the legislation, and we hope to have the Majority Leader as a supporter of our efforts.

Another highlight was the congressional breakfast. Attendees heard from three key members of Congress. First was Congressman Michael Burgess, MD (R-TX), the only Republican to support HR 3961, which would have provided a permanent repeal of the SGR. Burgess was followed by Sen. Amy Klobuchar (D-MN), who is the author of the Neurology Amendment that will make neurologist eligible for the primary care incentive. The morning concluded with a talk by Sen. Michael Enzi (R-WY), the ranking member of the Senate Health, Education, Labor and Pensions (HELP) committee and one of the Republican senators who negotiated the health care reform bill throughout 2009.

Physician Reimbursement (SGR)

Each of the speakers agreed on the need for a permanent repeal of the SGR. Unfortunately, Congress continues to push back by passing temporary fixes that do not permanently eliminate the cuts and provide little, if any, increases in reimbursement. The latest action is a seven-month extension that will delay the cuts until November 2010. During Neurology on the Hill the Academy urged members of Congress to finally eliminate this problem, rather than passing these temporary fixes. Unfortunately, Congress has been unable to come to an agreement that will finally ensure a proper reimbursement system for America's physicians.