Capitol Hill Report: Congressional Concussion Discussion

June 5, 2011

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By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506-7468, mamery@aan.com

AAN Input on Congressional Concussion Discussion

I had spent a day last week on Capitol Hill with the chair of the AAN Sports Section, Jeffrey S. Kutcher, MD. Dr. Kutcher is an expert on concussion and is the team physician for the University of Michigan. We went to provide education about the efforts neurologists are making to protect youth athletes from concussion and offer the services of Dr. Kutcher and the Academy as Congress considers issues regarding concussion.

We met with Congressman Todd Platts (R-PA), who is co-chair of the Congressional Traumatic Brain Injury Caucus, and then with the staff of Congressman Bill Pascrell (D-NJ), who is the caucus chair. From there it was on to Michigan members.

There is one big benefit from Dr. Kutcher's Michigan roots. After the last election that state became much more important in the US House. Congressman Dave Camp (R-MI) became chairman of the Ways and Means Committee, while Congressman Fred Upton (R-MI) became chairman of the Energy and Commerce Committee. Both of these committees have significant jurisdiction over health care issues and we made certain to meet with both their staffs who are the gatekeepers for most health care issues. Visits like these that can significantly boost the Academy's profile with Congress and can lead to helpful decisions on a variety of issues important to neurologists.

Lastly, we met with the staff of Sen. Tom Udall (D-NM), who has introduced the Children's Sports Athletic Equipment Safety Act (S. 601), which would crack down on athletic equipment companies that make bogus safety claims about their equipment such as football helmets. Dr. Kutcher and other AAN members participated in reviewing Sen. Udall's bill before it was introduced. We believe that concussion will be an area of congressional discussion in which the Academy could have a profound impact.

Headache Advocates Take to the Hill

I think that most AAN members are now familiar with the Academy's Neurology on the Hill program in which more than 100 neurologists head to Capitol Hill to advocate for neurology. But did you know that a group of headache advocates led by an AAN member also have a Hill day?

Last week, 70 physicians, researchers, and patient advocates descended on Capitol Hill as a part of the fourth annual Headache on the Hill lobbying day, run by AAN member Robert Shapiro, MD, PhD, of Vermont. Attendees came from 37 states and visited more than 160 congressional offices with the goal of educating members of Congress and their staff about the dramatic costs of headache in the US and the lack of NIH funding in this area, which is estimated at $15 million annually. Attendees called for a congressional hearing to be hosted in either the House or Senate to spotlight this issue. They also highlighted the ongoing struggle in headache medicine to develop innovative drug therapies and proposed fully funding the Cures Acceleration Network (CAN), which was approved in the health care reform law last year.

The final "ask" of this event was to request Senate support of Sen. Klobuchar's (D-MN) bill S. 597, which would add neurology to the list of physicians eligible for the primary care incentive in health care reform law. The National MS Society also took this issue to the Hill during their lobby day in March. Gaining support for this legislation remains a top priority for the Academy.

IPAB

Have you heard about the IPAB? IPAB stands for Independent Payment Advisory Board. The Board was established under the Patient Protection and Affordable Care Act (ACA). Beginning in 2012, the President would appoint 15 "health experts," who, after confirmation by the Senate, would be tasked with making recommendations to Congress to reduce Medicare expenditure growth. The key is that recommendations must cause spending to go down and would go into effect unless Congress overturns them, much like the base closure commission worked to shutter military bases.

President Obama recently proposed to strengthen the powers of the panel, but this is drawing opposition from members of Congress on both sides of the aisle, many of whom want to repeal the provision completely. Some Republicans contend that IPAB is a group of bureaucrats authorized to ration health care, while some Democrats insist that it will remove significant decision-making powers from Congress.

The issue has drawn strong opposition from physician groups and the congressional Doctors Caucus, which sent a letter opposing IPAB to the president on June 1. Sen. John Cornyn (R-TX) and Rep. Phil Roe, MD (R-TN) have authored legislation S. 668 and HR 425 to repeal the IPAB and have gotten 28 cosponsors in the Senate and 122 cosponsors in the House.

In a somewhat funny look at the issue, the Washington publication Politico asked if being a board member of the IPAB could be "the worst a job in Washington." Serving requires a six-year commitment and complete severing of ties to the health care industry to avoid conflict-of-interest. This could mean a serious downturn to an academic or professional health care career, especially when your job is to cut health care spending. Keep and eye out for this issue, there is surely more to come.