Capitol Hill Report: How Many Times Will This Happen?

June 8, 2010

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By Mike Amery, Legislative Counsel, Federal Affairs, (202) 349-4299, mamery@aan.com

Congress comes back this week with the Senate needing to pass Extenders legislation to prevent a 21 percent cut to Medicare physician payment rates. The Centers for Medicare and Medicaid Services (CMS) has again delayed processing of Medicare claims for 10 business days to prevent the cut which, in reality, went into effect June 1. This is the third time this year that Congress has stepped in and provided a very brief fix and it doesn't look like there is any hope for a permanent fix this year. Before leaving for the Memorial Day recess the House of Representatives passed a 19-month fix that would stave off cuts until the end of 2011. It includes a 2.2 percent across the board increase for the rest of 2010 and 1 percent increase for 2011. This is hardly what the physician community was looking for.

One thing that has always been certain is that nobody in Congress is actually looking to implement this. Members on both sides of the aisle say that they want a permanent fix. The current cost of $250 billion over 10 years is just too much for Congress to absorb. The position of members of Congress on this is clearly the result of the collective voice of the physician community and letting them understand how much of an access to care problem this would be for Medicare beneficiaries. The physician community must keep pressuring Congress for a permanent fix because others are now questioning whether Congress should step in. A prime example is the editorial by Steven Pearlstein of the Washington Post last week, which essentially says that physicians simply make too much money. Of course Pearlstein makes no distinction between physician specialties like orthopedic surgeons and neurologists in arguing that physicians "pay themselves generous salaries."

Please join your colleagues in keeping up the pressure by sending messages to your members of Congress that we need a permanent fix, as temporary patches are unacceptable. We know you've done it many times before, but Congress needs to keep hearing the message until they get it done.

The MS Caucus Helping Out

A number of congressional caucuses on Capitol Hill bring members of Congress with similar interests together to support particular industries or causes. One of these is the MS Caucus, which is co-chaired by Reps. Russ Carnahan (D-MO) and Michael Burgess, MD (R-TX). Participation in these caucuses allows organizations like ours to identify members who might be sympathetic to the needs of patients with neurological disease. It isn't a mistake that you heard the names Carnahan and Burgess in past Capitol Hill Reports. We have worked hard to develop relationships with these two members of Congress and it has paid off. It was Carnahan who sent a letter to MedPAC asking about the omission of neurology from their health care recommendations. Burgess was the only member of the Republicans side to vote for the permanent SGR repeal in the House and was one of the Academy's keynote speakers at the 2010 Neurology on the Hill Congressional Breakfast last March.

I spoke with both Carnahan and Burgess last week about the omission of neurology and both are eager to help. The next step is to have Carnahan, Burgess and hopefully several others draft a letter that will go to House leadership asking for resolution in upcoming corrections bills. I will let you know if we are able to move forward with this letter.

A New Office

With Congress out of town last week I took the opportunity to move my office. I opened the DC office for the Academy of Neurology five years ago, subletting space in the law firm of Powers, Pyles, Sutter and Verville, a firm associated with the Academy for many years. With the increasing need of our lobbying and regulatory efforts as well as the expansion of our political action committee, BrainPAC, it became apparent that it would be beneficial to move the Academy's office to a larger location closer to Capitol Hill.

The new Academy office is on 2nd St., NE, one block east of Union Station and one block north of the Hart Senate Office Building.

This new office gives the Academy opportunities to expand our Washington, DC presence and will offer Academy members and staff a place to stop by for a rest or a computer connection. The conference room will be available for Washington, DC meetings and may be used for BrainPAC hosted fundraisers for congressional candidates.

There'll be more coming out in AANews in the near future, but rest assured the Academy is well positioned for a significant presence in Washington, DC for many years to come.