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Capitol Hill Report:Congress Hears About Concussion, MACRA, FAST Act

March 21, 2016

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

Neurologists Testify at House Concussion Roundtable
The Energy & Commerce Committee (E&C) in the House of Representatives is led by Chair Fred Upton (R-MI) and Ranking Member Frank Pallone (D-NJ). It has the largest subject matter jurisdiction of any House committee but maintains a continued focus on health care policy, as it has since the late 18th century. 

Last week, the E&C Committee kicked off a broad review of concussion with a roundtable discussion led by Oversight & Investigations Subcommittee Chairman Tim Murphy (R-PA). "Today, we begin a new chapter in the national dialogue on concussions,” stated Murphy. “We are not here to re-litigate past actions, point fingers, or cast blame. We are here to take a step back, to gain some perspective and to begin a conversation focused on solutions, not on problems.”

During the hearing, Rep. Jan Schakowsky (D-IL) pointedly asked Jeff Miller, executive vice president of health and safety policy for the National Football League (NFL), if football leads to chronic traumatic encephalopathy (CTE). For the first time, the NFL agreed that it does. This made big news nationally.

Less reported were the comments of several other participants, including two AAN members who were invited to participate in this first hearing, Walter J. Koroshetz, MD, FAAN, director of the NINDS at NIH, and Brian W. Hainline, MD, FAAN, chief medical officer for the National Collegiate Athletic Association (NCAA), and clinical professor of neurology at Indiana University School of Medicine and New York University School of Medicine.

Chairman Murphy began his questions by asking Dr. Koroshetz about misconceptions about concussion and Dr. Koroshetz responded that concussion is on the spectrum of TBI and that, contrary to past thoughts, it is mostly agreed that we can see changes in the brain due to concussion. “We now see a symphony orchestra of cellular changes that occur in a concussive event.” Koroshetz also commented that we are constantly learning more and that resources such as the American Academy of Neurology's Concussion Guidelines are now routinely used by coaches to help athletes.

Much of the hearing focused on problems of concussion, but Dr. Hainline expressed optimism in describing all of the different organizations that have come together, including the American Academy of Neurology, to improve research and development of concussion diagnoses and management protocols focusing on “absolute recovery.” Dr. Hainline will be a key note speaker at the AAN Sports Concussion Conference taking place July 8 to 10 in Chicago. 

Ranking Member Pallone has asked for at least four more E&C Committee hearings on concussion and we expect that AAN members will continue to be prominent as this issue has risen to the top of concerns among parents of athletes―and now the US Congress.

Lobbying House Leadership on MACRA, FAST Act
Another House committee that examines health care policy, the Ways & Means (W&M) Committee, exercises jurisdiction over US revenue and revenue-related aspects of the Social Security system, Medicare, and social services programs. And the W&M Committee also has an important component, the Health Subcommittee.

Last week, I sat down for lunch with the new chair of the Health Subcommittee, Rep. Patrick Tiberi (R-OH), along with several other physician groups, to discuss his plans for the subcommittee in 2016 and beyond. We thanked him for the 2015 repeal of the SGR, but shared our concern over how the Center for Medicare & Medicaid Services (CMS) is implementing the new physician reimbursement system that Medicare will require in the coming years due to the Medicare Access and CHIP Reauthorization Act, also called MACRA.

We also talked about some more nuanced issues including the FAST Act (HR 2799) by Rep. Morgan Griffith (R-VA). This legislation will greatly improve stroke patients' access to neurologists and should save more than $1 billion over ten years.

The FAST Act was a key issue for 185 neurologists and nearly three dozen patient advocates who participated in Neurology on the Hill on March 1.  Since then, 12 members of the House have cosponsored the FAST Act, bringing the total number to 64. A big thanks to the following members of Congress for signing on and to the AAN advocates who brought this important issue to their attention:

  • Rep. Tim Ryan (D-OH)
  • Rep. Jared Polis (D-CO)
  • Rep. Joe Heck (R-NV)
  • Rep. Susan Davis (D-CA)
  • Rep. John Duncan (R-TN)
  • Rep. John Shimkus (R-IL)
  • Rep. Brad Ashford (D-NE)
  • Rep. Lois Capps (D-CA)
  • Rep. Kevin Cramer (R-ND)
  • Rep. Ann Kirkpatrick (D-AZ)
  • Rep. John Larson (D-CT)
  • Rep. Diane Black (R-TN)   

Register Now for CMS Open Payments System
By Daniel Spirn, Regulatory Counsel

CMS announced that its Open Payments system is ready for physician and teaching hospital registration. While registering in the Open Payments system is not a requirement for physicians or teaching hospitals, it is required in order to be able to review and dispute records attributed to them. This period begins in April and will last for 45 days.

According to CMS, the initial registration is a two-step process and takes approximately 30 minutes. First, register in the CMS Enterprise Identity Management System (EIDM), and then register in the Open Payments System, which is accessible via the EIDM. Those who registered last year are not required to register again this year. However, accounts are deactivated if it has been over 180 days since the last login to the EIDM. Contact theCMS Help Desk to reactivate an account in this circumstance.

Physicians or teaching hospitals interested in registering should have a National Provider Identifier (NPI) number, Drug Enforcement Agency (DEA) number, and state license number (SLN) available.

The CMS Help Desk can be reached at openpayments@cms.hhs.gov or (855) 326-8366, Monday through Friday from 8:30 a.m. to 7:30 p.m. ET.

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