Capitol Hill Report: One Contact Can Make a Difference

May 12, 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 bi-weekly updates on advocacy for neurology and neurologic concerns.

One Contact Can Make a Difference

I spent the last Monday on Capitol Hill with AAN President-elect Bruce Sigsbee. One of the meetings we had was with Sen. Susan Collins (R-ME). Dr. Sigsbee specifically wanted to thank her for cosponsoring the Neurology Amendment offered by Sen. Amy Klobuchar during the health care debate in the Senate. As you may remember, Sen. Collins was the one Republican on the amendment making it bipartisan, quite a rarity during the debate.

During their discussion Sen. Collins reminded Dr. Sigsbee of a meeting they had in 2008. In March of that year, advocates from the Academy were on Capitol Hill during the annual Neurology on the Hill program.  One of the key issues was the Academy's effort to raise awareness of the problem of TBI impacting veterans returning from Afghanistan and Iraq.  Sen. Collins said that up until their meeting she had not been aware of the extent of the problem and Dr. Sigsbee's discussion led her to take a leading role in the Senate on the issue of TBI in Veterans. Sen. Collins become the lead Republican sponsor of the Heroes at Home Act which was authored by then Sen. Hillary Clinton (D-NY) with the help of the Academy.

The point of this is to show that you never know when your contacts with a member of Congress or even their staff can have long-lasting benefits for your profession and your patients. There is no question that the services that veterans with TBI are receiving today are improved. There is still much more work to be done but just one contact can make a difference.

Physician Reimbursement Update

The House will begin fresh discussions this week on the issue of Medicare physician reimbursements to delay a scheduled 21-percent cut to the Sustainable Growth Rate (SGR) formula on May 31. A House-passed bill that would repeal the existing payment formula and boost payment rates has been held up in the Senate because of concerns over cost. However, House and Senate Democratic leaders may work for a longer-term fix, which would delay the cuts for five years. New Congressional Budget Office (CBO) estimates the cost of a five-year fix at $88.5 billion and a permanent repeal of the existing formula at $275 billion over 10 years.   It just so happens that under the February pay/go law, Congress exempted exactly $88.5 billion to prevent the cuts! Interesting how those numbers are the same…

Although Dr. Sigsbee was in congressional offices mainly talking about neurology's omission from the misnamed primary care incentive, he was able to express the Academy's concern about the SGR cuts to key staff people in the Senate Finance Committee, House Ways and Means Committee, as well as the House Energy and Commerce Committee. The Academy believes that the time for a permanent fix is now and at continued temporary delays will only exasperate the enormous financial problem that the SGR has become.  The reality is, if Congress passes a five-year temporary fix, at the end of five years the total cost for a permanent fix may well be north of half a trillion dollars.

Headache on the Hill Sees Results

For the last several years Academy member Robert Shapiro, MD of Vermont has led a group of neurologists and activists interested in headache to Capitol Hill for a Headache on the Hill lobby day.  Each year they have pointed out that research dollars going towards headache does not equal the societal costs of headache.  The AAN has been supportive of Dr. Shapiro's efforts and this year they have paid off. Dr. Shapiro and his group secured an agreement from Sen. Patrick Leahy (D-VT) to send a letter to NIH Director Frances Collins asking that more funds be directed towards headache research. The letter was signed by 19 other members of Congress and can be viewed here. (link to attached PDF)  Dr. Shapiro thanked supporters by saying, "Thank you for your personal efforts that made the attached letter a reality. It is a landmark congressional recognition of Americans suffering with these disorders. I’m sure that you share my hope that it will result in material increases in NIH funding for headache disorders research programs."

There are a lot of big issues out there and you never know when that one contact you make makes the difference.