By Mike Amery, Legislative Counsel, Federal Affairs, (202) 506-7468, firstname.lastname@example.org
A record-breaking 129 Academy members participated in the ninth annual Neurology on the Hill (NOH) last week.
Advocates from 43 states addressed critical issues with over 200 members of Congress including the need for a permanent repeal of the SGR, the omission of neurology from the primary care incentive, funding for pediatric specialists, and requests for cosponsors of HR 610, the Making Investments Now for Dementia (MIND) Act, which is an innovative Alzheimer's research funding bill sponsored by Michael Burgess, MD (R-TX).
On Monday, AAN member advocates met one another, trained on advocacy techniques, and reviewed the leading issues.
Tuesday was the big day on the Hill, starting with a congressional breakfast in the House of Representatives Rayburn Office Building. Congressman Russ Carnahan (D-MO) launched the program by encouraging participants to tell their stories and educate Congress about the need for access to care for neurology patients. Carnahan is co-chair of the Congressional MS Caucus and has been a key supporter of adding neurology to primary care incentive programs.
House Majority Leader Eric Cantor (R-VA) then gave an update of House Republican's plans on medical liability reform and an SGR fix. He also expressed his appreciation for neurology as his father deals with Shy-Drager Syndrome. Cantor said his father's primary care provider is his neurologist.
From there it was off to the congressional offices. The event was a big success in raising the profile and influence of neurology in Congress with visits to more than 220 congressional offices and personal visits with almost 100 members of Congress.
NOH advocates came to DC at an interesting time. Since neither the current nor last Congress has been able to pass a FY2011 appropriation bill, a government shutdown loomed if Congress couldn't agree on a temporary funding bill.
In his comments to neurologists at Neurology on the Hill, Majority Leader Cantor expressed confidence that the House and Senate would pass a short-term extension of a bill called a "continuing resolution" which is currently funding government at FY2010 levels.
Last week, the House and Senate finally passed a two-week extension that cut $4 billion in spending, but sets up another looming shutdown. House Republicans would be fine with a series of two week extensions as the cuts would equal $60 billion by the end of the year.
Senate Democrats conceded the House Republicans had won the first round of the budget battle, but vowed that will change. The next round of negotiations must be settled before March 18.
One of the key messages that the AAN is developing for Congress and the administration is the need for recognition for cognitive specialties who spend most of their time evaluating and managing their patients as opposed to performing procedures. With the elimination of consult codes by CMS for 2010, several other specialties have found themselves in the same position as the Academy, which has resulted in the formation of a coalition.
The Cognitive Specialty Coalition (CSC) consists of representatives of infectious disease, rheumatology, neuro-ophthalmology, and endocrinology. Recently, AAN Chief Health Policy Officer Rod Larson and I accompanied Marc Raphaelson, MD, FAAN, of Virginia to a meeting with the Medicare Payment Advisory Committee (MedPAC). MedPAC is a very influential congressional advisory committee. You may recall from previous Capitol Hill Reports that MedPAC was responsible for the recommendation to Congress for the primary care incentive that eventually passed in the health reform bill.
Although there were several specialty physicians present, MedPAC staff was clearly interested in the opinions of Raphaelson, who serves as the AAN's representative on the American Medical Association's Relative Value Update Committee (RUC). Raphaelson eloquently described how the elimination of the consult codes resulted in primary care physicians receiving greater payment for less time-consuming, less intensive, and less complicated patients than cognitive specialists.
The goal of the meeting was to increase the awareness of the need for recognition of cognitive specialists by MedPAC in hopes of their recommendation to Congress of a reinstatement of the consult codes or some other effort to improve the practice climate for cognitive specialties like neurology. Of course, we won't be just relying on MedPAC; the CSC has also started meeting with key congressional offices to state our case.
The Academy has nominated President Elect Bruce Sigsbee, MD, FAAN, for a seat on MedPAC.
Sigsbee has received letters of recommendation from Sen. Susan Collins (R-ME), Rep. Chellie Pingree (D-ME), Rep. Michael Michaud (D-ME), as well as several patient groups including the National MS Society, the Alzheimer's Foundation of America, and the Parkinson's Action Network. Nominations close March 7, 2011. I'll let you know how it goes.