Capitol Hill Report: Advocates Score Points at Neurology on the Hill

May 6, 2013

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

"A big success" was the feeling of AAN member advocates who came to the AAN's 11th Neurology on the Hill on April 22 and 23. More than 250 House and Senate offices were visited by 138 neurologists from 42 states who carried the message that patient access to neurology is in crisis.

Government Relations Committee (GRC) Chair Elaine C. Jones, MD, FAAN, led the event, which focused on the need for a permanent elimination of the flawed Sustainable Growth Rate (SGR) formula and the need to include cognitive physicians in efforts to improve problems with patient access to care.

Specifically, the AAN asked for cosponsors for the Enhanced Access to Medicare Services Act (S. 755) by Senators Amy Klobuchar (D–MN) and Susan Collins (R–ME). This piece of legislation would add neurologists and others to the Medicaid Bump portion of the Affordable Care Act (ACA). This provision currently pays Medicaid providers Medicare rates for evaluation and management services but excludes neurology and other specialists not boarded by the American Board of Internal Medicine.

You can help our effort! Look for an AAN Action Alert on Tuesday, May 7, that asks you to contact your members of Congress to support S. 755 and the House companion bill by Reps. Steve Stivers (R–OH) and James Moran (D–VA) that will be introduced this week.

AAN Past President to Consult with DC Advocacy Team

Past President Bruce Sigsbee, MD, FAAN, was one of the first Academy members I met when I joined the AAN staff in 2000. It was clear to me right away that as a member of the GRC that he was a leader for the AAN on federal advocacy.

Throughout the last 13 years I have had the privilege of working with many neurologists who are committed to using the political process for the good of neurology and patients, but few have had the commitment of Dr. Sigsbee. As well as serving on the GRC, he served as the first chair of the BrainPAC Executive Committee, setting the PAC off in the right direction and then was on to the AAN Board of Directors before becoming president.

He always has been at the table helping determine the direction of the AAN on the health policy positions. So it is fitting that as he concluded his term as president at the recent Annual Meeting in San Diego, the AAN Board asked him to assist the advocacy team as a consultant.

As you saw in the last Capitol Hill Report, we just moved to a larger office space near Capitol Hill which makes the timing perfect for an expansion. Dr. Sigsbee will spend 40 percent of his time with AAN, split between his home in Maine and the AAN's DC office. We are pleased that he has joined us.

Dr. Sigsbee in Washington

New BrainPAC Chair Named

I also am looking forward to working with Lily Jung Henson, MD, MMM, FAAN, who has been named by President Timothy A. Pedley, MD, FAAN, as the chair of the AAN's BrainPAC Executive Committee.

The eleven–member BrainPAC committee oversees fundraising and political contributions for the Academy's federal political action committee. In the 2012 election cycle, the committee directed more than $500,000 in AAN member contributions to congressional candidates of both parties.

I also have enjoyed working with outgoing chair Anna Hohler, MD, FAAN, who has served with great passion. Under Dr. Hohler's leadership BrainPAC contributors and dollars more than doubled.


Regulatory Corner

By Daneen Grooms, MHSA, AAN Manager of Regulatory Affairs

Primary Care Specific E/M Codes Miss the Mark

The Medicare system does not need separate, more highly valued E/M codes for primary care physicians. Instead, as we contended in our letter to the Centers for Medicare & Medicaid Services (CMS) last week, higher level E/M codes are necessary to reflect complex cognitive services, such as those provided by neurologists. We sent that message to CMS last week in a letter explaining why the American Academy of Family Physicians' request for separate primary care E/M is misguided. We are hopeful that CMS will not act on the AAFP request, but we'll keep closely monitoring the payment rules.

AAN Engages in Dialogue with CMS on Future of Health Care

Last week, AAN leadership met with Mandy Cohen, MD, CMS senior advisor to the administrator, to discuss the role of neurology in the changing health care landscape. We mentioned that for 2013, the Physician Quality Reporting System includes dementia, stroke, Parkinson's disease, and epilepsy measures that our members can report and that we encourage neurology participation in the program through our collaboration with CE City. We also stated that AAN is looking for innovative ways to allow neurologists to adapt to the changing health care environment through value–based payment models, i.e., the role of neurologists in accountable care organizations and patient–centered medical homes. CMS and the AAN are committed to developing a positive relationship through ongoing dialogue, communication, and frank discussions, and AAN looks forward to working with CMS in the future.

Be Prepared: Manufacturers of Drugs, Devices Will Report Payments Given to Physicians

We recently mentioned that starting August 1, the Physician Payment Sunshine Act (Sunshine Act) requires pharmaceutical companies and device manufacturers to report to CMS payments and gifts greater than $10 given to physicians for 2013. In addition to our website, the American Medical Association's Sunshine Act web page provides a detailed overview of the regulation's key provisions, important dates and has a FAQ list.


Advocacy Notes

By Tim Miller, Senior Program Manager, Communications & State Advocacy

  • The AAN has endorsed the Making Investments Now for Dementia (MIND) Act for Alzheimer's Research Bonds (H.R. 1619). Reintroduced by Rep. Michael Burgess, MD (R–TX), the MIND Act, through the investment in bonds, would allow all proceeds to be directed to the National Institutes of Health solely for Alzheimer's research.
  • Georgia, Montana, and Tennessee now have new laws pertaining to youth sports concussion. . This brings the total number of states having implemented new laws to 47, with South Carolina and West Virginia having legislation pending . Mississippi is the lone state yet to take action.
  • Former AAN Medical Economics and Management chair untangles a "Tangled Mystery." An excellent article was published recently in Pittsburgh Magazine involving former chair, Neil Busis, MD, FAAN, and one of his patients.