Capitol Hill Report: Have You Spoken Out Yet?

November 22, 2010


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

SGR Update—Let Congress Know You Are Angry!

Have you sent your message to your House members of Congress demanding that they fix the SGR? If not, do it now!

On Thursday, November 18, the Senate passed a bill by unanimous consent to delay a scheduled 23-percent cut in Medicare physician payments until January 1, 2011.

Pushing the cuts back one month is estimated to cost $1 billion, which will be offset through cuts to Medicare reimbursements for certain outpatient therapy services. The measure now proceeds to the House, where members will likely approve the bill following the Thanksgiving recess. (Note: You still need to send your House member a message if you haven’t already!)

The Academy has signed on to a letter asking for a 13-month delay, which would give the physician community time work with the new Congress on a permanent solution. The Obama administration came out in favor of a 13-month fix that is supported by the AMA and the AAN. For a full 13 months, the price tag is an estimated $17 billion—all of which would have to be offset.

A 30-day, short-term fix is just a bridge through the end of the year when another cut is scheduled. It is sill very important that Congress act after Thanksgiving on a more permanent solution because Congress will be in such disarray with the new members of the 112th taking office in early January, just as the cut goes into effect. We will need to keep the pressure on Congress in December as well as January.

In an interesting development, incoming Senate Finance Committee Ranking Member Orrin Hatch (R-UT) made comments that the AMA's support for the health reform law may be hurting efforts to fix the SGR in the Senate. Politico reported that Hatch said, "The AMA has really irritated an awful lot of people the way they've handled this…and they've irritated me. I've always been fair to them. I've always tried to help them. But they became very partisan and I think there's a little bit of that here now."

Republicans Start Their House Party

AAN Legislative Counsel Mike Amery and Majority Leader Eric Cantor (R-VA)

The House also returned to Washington last week with a full plate of issues to resolve but spent most of the week preparing for the 112th Congress which starts in January.

Both parties held leadership elections, freshman went through orientation, and there was even the office lottery where members of Congress pick their office space based solely on seniority. Unlucky freshman get stuck up the 7th floor of the Longworth Building while senior members move to larger Rayburn Building offices with spectacular views of the Capitol. Sometimes it takes decades for these office to open up, but this year there were several with the defeats of members with more than 20 years of service in Congress.

I attended several events throughout the week celebrating this and that. An event honoring the Democratic leadership drew a couple hundred, but only outgoing Speaker/incoming Minority Leader Nancy Pelosi (D-CA) showed up.

This was in contrast to the 80th birthday party for Congressman Sam Johnson (R-TX) that was attended by Republican leadership and a number of members including the entire Texas Republican delegation. I spoke briefly with incoming Speaker John Boehner (R-OH) and took a quick BlackBerry photo with incoming Majority Leader Eric Cantor (R-VA).

This was followed by an event honoring the entire incoming freshman Republican class of 80+ where almost all of them attended. I got a chance to introduce neurology to many of them, but there is a lot of work to do to help educate these new members!

Health Reform Implementation Continues

CMS launched the Centers for Medicare and Medicaid Innovation (CMI) last week. The CMI will consider strategies for payment and care delivery that CMS hopes will lead to better quality care. The center plans to consider strategies for "bundling" payments for multiple procedures and creating a "health home."
Learn more about the CMI.

AAN Prepares for the 112th Congress

The AAN is developing issues for the Academy’s Government Relations Committee to consider as federal priorities for 2011. Do you have an issue that you think we should focus on? The best ideas are neurology specific—those things that will only be brought to the attention of Congress if neurologists bring it up. In 2007, a member of the Academy contacted me with an idea to create Epilepsy Centers of Excellence at the VA. Congress passed the legislation we drafted in 2008 and the centers are up and running serving veterans today. If you have an idea or see a need, let me know at

Of course, we also want your help in DC! Apply by December 5 to represent your state and district at Neurology on the Hill in late February. More information can be found here.