Capitol Hill Report: Academy Examines ACOs, Requests Your Help

April 26, 2011


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

Congress heads back to work next week after a two-week recess for Easter. During the recess I attended the AAN's Annual Meeting in Honolulu, where I spent most of my time discussing politics and policy with Academy members. It was good to see so many of you who passed along your appreciation of the Capitol Hill Report and offered suggestions for improving our efforts. Throughout the week, BrainPAC raised $65,000 from 254 Academy members.

Respond to AAN Action Alert Emails

With Congress out of session, I'll take this opportunity to stress the importance of using the AAN's online advocacy tools and encourage you to participate in our efforts. When Congress returns, we expect several key issues to come to the forefront that will require all US AAN members to contact their members of Congress. Fixing the flawed SGR formula, medical liability reform, and Senate Bill 597—which adds neurology to the primary care incentive of the health reform law—are just a few of the issues we expect will need coordinated advocacy efforts. You can help by responding to "Action Alerts" sent by the Academy to your email inbox. With just three mouse clicks you can send a letter to your members of Congress. These mail campaigns truly make a difference when congressional offices assess what interests their constituents, so please take the time to respond to all AAN Action Alerts.

With that, I would like to again introduce you to the Academy's new Regulatory Affairs Manager based here in DC, Mark Pascu who will discuss an important regulatory issue that moved forward recently.

AAN Action on ACOs

In the April 7 issue of the Federal Register, the Centers for Medicare & Medicaid Services (CMS) issued proposed rules to create a voluntary accountable care organization (ACO) program that would allow entities to share in the savings—and pay for any losses—they create for Medicare as long as certain quality thresholds are met. The goals of ACOs are to improve patient care and reduce health care costs. It is hoped that these goals will be met by increasing care coordination. The AAN will comment on CMS's proposal by their June 6 deadline and continue to educate its members about this important new payment model, scheduled to launch on January 1, 2012, and the role neurologists will play in ACOs. Dr. Terri Postma, a neurologist and the lead CMS staff person on the proposed ACO rule, will be meeting with AAN leaders to answer questions about the regulations. Postma served on the staff of the US Senate Finance Committee as the AAN's Viste Neurology Public Policy Fellow in 2008-2009.

Physicians should pay attention to the proposed rule and to future development of ACOs because the buzz from several Washington insiders is that the Obama administration needs ACOs to succeed. The reasoning is that President Obama's legacy and the success or failure of the Patient Protection and Affordable Care Act could depend on how ACOs fare.

Once a Senator, Always a Senator

Tim Hutchinson is a former US senator from Arkansas. Today he is a lobbyist and one of his clients is the American College of Rheumatology (ACR) which, along with the AAN, is a part of the cognitive coalition arguing for a restoration of the consult codes that CMS eliminated beginning in 2010. On one of the first hot days of the year in Washington, coalition representatives including Sen. Hutchinson joined Derek Brandt and me for several meetings with Hill staff. We are searching for a sponsor for legislation to restore the codes and met with several congressional offices including Sen. Mike Crapo (R-ID) as well as Reps. Brett Guthrie (R-KY), Erik Paulsen (R-MN), and majority staff of the House Ways & Means Committee. The hot day taught us that some of the perks of being a senator never go away. Although much of the Capitol complex is restricted by security, as a former senator, Hutchinson kindly asked us to join him as we moved from the House side to the Senate side through the air-conditioned tunnels under the Capitol rather than out in the hot sun. We thanked him and learned that once you are a senator, you are always a senator.