Capitol Hill Report: AAN Advocacy—The Road to Success

January 6, 2014

By Rod Larson, Chief Health Policy Officer, (612) 928-6093

AAN Advocacy Has Come a Long Way
In 2003, we had no full-time presence in Washington, DC; just a few AAN members heading up to Capitol Hill; an online advocacy program accessed by a few hundred members; and no political action committee.

Today, we have a full-time Washington staff of three, with Academy members in and out of the DC office regularly, including AAN Past-President Bruce Sigsbee, MD, FAAN, who has been consulting on advocacy issues on a part-time basis for the past year. The DC efforts are also supported by several advocacy staff in the Minneapolis office developing policy, tracking legislation on the state and federal level, training AAN members to be skilled advocates, and building a grassroots system for members to engage in the process. Advocacy also includes close scrutiny of new regulations and expressing our concerns, attention to neurologic CPT codes that are appropriate and reimbursed, and interaction with CMS and private payers to address payment and coverage issues.

In 2013, more than 150 AAN members attended Neurology on the Hill (NOH), approximately 2,300 members sent 11,000 emails to Congress, and eight members of Congress even made in-person visits to neurology practices back in their home districts to learn more about how neurologists diagnose and treat patients. 

We track every personal AAN interaction with a member of Congress or their staff. In 2013, we had 1,138 in-person encounters, whether they are from Neurology on the Hill, meetings with AAN staff in congressional offices, attending fundraisers with support from BrainPAC, or countless other interactions. 

BrainPAC raised $304,000 from 1,301 Academy members, both record highs. The AAN also distributed more than $300,000 to 117 candidates running for Congress, also a record high.

The AAN has come a long way with an advocacy program designed to increase the influence and profile of America's neurologists, the patients they treat, and the research they do. From all of us at the Academy in both Washington and Minneapolis, we thank you for your participation in what is truly a team effort. In the meantime, be on the lookout for a special section in the March edition of AANnews summarizing our 2013 direct efforts in greater detail.

Legislative Update
by Mike Amery, Esq., Legislative Counsel, (202) 506-7468

Epilepsy Centers of Excellence Funding Increase
One of the first true successes of the AAN advocacy program was convincing Congress to create Epilepsy Centers of Excellence (ECoE) at the Department of Veterans Affairs (VA). Legislation was introduced on our behalf by Sen. Patty Murray (D-WA) and Rep. Ed Perlmutter (D-CO) in 2007 and passed in 2008 with an annual appropriation of $6 million. The VA created 16 ECoEs that are organized under four regions with a spoke system of satellite facilities that vastly expand epilepsy services to America's veterans. 

Today, data show that the centers are saving the VA money compared to what it was spending on outside services prior to the creation of the ECoEs. In addition, the access and quality of care veterans with epilepsy receive has improved with the VA now a national leader in providing epilepsy care through telemedicine. Significant safety initiatives are being instituted, as well.

Part of the legislation created an outside national board to review the accomplishments and provide direction to the ECoEs. I was fortunate to be appointed to this board and learned at our December meeting that with these amazing accomplishments and a clear need to continue support of the excellent work being done, the VA has increased funding for the ECoEs to $8 million per year beginning in 2014.

This increased funding will allow the ECoE to support a national administrative infrastructure and fund the database and information systems. This will allow the collaboration, outreach, and referral plans to all VA sites so that the mission of aiding all veterans with epilepsy, regardless of their geographic location, can be met.

The AAN thanks Congress and congratulates the VA on the exemplary work it has done to provide expert care to veterans and to have developed the only national care system for epilepsy. 

Regulatory Corner
by Daneen Grooms, MHSA, Regulatory Affairs Manager

The VA Expands Disability Benefits for Patients with TBI
There's more good news regarding AAN's regulatory advocacy efforts. The VA released its final rule Secondary Service Connection for Diagnosable Illnesses Associated with Traumatic Brain Injury (TBI) last month and incorporated the AAN's recommendation to change the definition of dementia to include frontotemporal dementia and dementia with Lewy bodies in addition to presenile dementia of the Alzheimer type.

The VA revised this regulation because it wanted to expand the list of illnesses that are considered to be a result of service connected TBI—meaning that the illness arose in service or was aggravated by said service. As of January 16, veterans with moderate or severe TBI who also have parkinsonism, unprovoked seizures (epilepsy), dementia, depression, or diseases of hormone deficiency resulting from hypothalamo-pituitary changes may be eligible to receive additional disability pay. The AAN applauds the VA's commitment to protecting veterans' access to health care and will continue to work with the VA on these issues.

Learn About Medicare's Payment Changes for 2014
Last month, the AAN hosted a webinar discussing the major payment and policy changes impacting neurologists in the 2014 Medicare Physician Fee Schedule final rule. The webinar, led by William S. Henderson, FACMPE, and Gregory Barkley, MD, is free to all AAN members. You can still listen to the webinar by registering for "Decoding the 2014 Physician Fee Schedule: Changes that Impact Neurology" on the AAN website.


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