February 22, 2016

Neurology on the Hill Issues Gain Steam in Congress

By Mike Amery, Esq., Senior Legislative Counsel, Federal Affairs

With the AAN's Neurology on the Hill just a week away, momentum on two issues affecting our members is growing at a perfect time.

The Furthering Access to Stroke Telemedicine Act (FAST Act), HR 2799 has reached 48 cosponsors with recent signers Reps. Devin Nunes (R-CA) and Kenny Marchant (R-TX) of the important House Ways & Means Committee, and Phil Roe, MD, (R-TN) an important member of the House Doctors Caucus.

The Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative was a huge success for the AAN last year, when our Neurology on the Hill advocates helped secure an increase of $85 million for the project. Just last week, the president's budget was released with a recommendation that Congress increase the funding by another $45 million to $195 million for FY 2017.

Next Monday, 190 AAN members will be joined by 30 advocates from the American Heart/Stroke Association to push for the FAST Act and the BRAIN Initiative. Our goal for NOH is to hit 100 cosponsors for the FAST Act and sign dozens of House and Senate members on to a letter supporting the BRAIN Initiative. We also plan to address the burden of CMS standards for Meaningful Use of electronic health records.

If you can't join your colleagues in person this year, we hope you will join us virtually. Look for an AAN Action Alert in your email so you can quickly and easily add your voice in support with your congressional offices. Let us know when you've sent your message with a Tweet including #NOH16 and include me @MikeAmeryDC. Then look for the next Capitol Hill Report for some preliminary results. 

AAN, Cognitive Groups Press CMS on Concerns Affecting Practice   

By Daniel Spirn, Regulatory Counsel

2016 is shaping up to be a busy year as CMS works to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This is reflected in the AAN's effort to address two recent CMS requests for feedback. The first request asked how CMS should define “care episode groups” under the new law. These groups are part of an effort to help CMS measure resource use more effectively. In our response, the AAN stressed that neurologists should be held accountable only for the services over which they have direct control.
CMS also posted a draft plan addressing its desire to develop quality measures that will be used to support the Merit-based Incentive Payment System (MIPS) and alternative payment models (APMs). We strongly recommended that CMS engage specialty societies as it determines measures for quality-related programs and called upon the agency to establish a specialty-specific advisory group. We have positioned the AAN to serve as a critical resource for CMS as it further defines quality measures for neurologists. 

In a few weeks, we expect a major proposed rule that will significantly outline the new MIPS program, which seeks to link fee-for-service payments to quality and value. The pending CMS proposal will also have an impact on the development of APMs. 

While MACRA is critically important to neurologists, staff at the AAN also continues its work on efforts to properly value E/M services. In late January, we partnered with a coalition representing a number of groups including rheumatology, gastroenterology, and endocrinology in a meeting with leadership at CMS. The AAN outlined flaws in the definitions and valuations of E/M as they fail to capture the complex work of cognitive services. We informed CMS about the immediate need to enhance payment for complex cognitive outpatient E/M services that will be accessible to all cognitive physicians. The meeting was productive and we expect it to be part of an ongoing dialogue with the agency on this important topic.