Capitol Hill Report: AAN Advocacy Scores Victories with Medicare Final Rule

November 9, 2015

AAN Advocacy with CMS Wins ACP, More for Neurologists
By Daniel Spirn, Regulatory Counsel

On October 30, the Centers for Medicare & Medicaid Services (CMS) issued its final rule that impacts how neurologists are paid. The rule updates payment policies and rates for physicians paid under the Medicare Physician Fee Schedule (MPFS) in 2016. Over the past year, the AAN has worked hard to develop a more meaningful relationship with CMS, holding several meetings with agency officials and actively commenting on regulatory proposals like the MPFS. Developing a proactive regulatory advocacy program is important because our efforts help shape the regulations that impact neurology practices across the country.

This year's final rule is a great example of how these advocacy efforts pay off. Now, for the first time, Medicare will reimburse neurologists for the conversations on advance care planning (ACP) they hold with their patients regarding future care for a serious illness. The AAN and coalition stakeholders have advocated for this coverage and helped in defining and valuing these codes. We are especially pleased to see CMS accept our proposal to not impose any frequency limitations on the benefit.

The AAN also has been a leader in efforts to seek additional CMS research into evaluation and management (E/M) activities. We are encouraged by the agency's interest in ways to recognize the different resources in cognitive work involved in the delivery of broad-based, ongoing treatment. Although CMS did not finalize related policies in this rulemaking, the agency anticipates future proposals. This is similarly true for the agency's intention to accurately capture the work associated with surgical global service periods and pending implementation of the Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA.

As always, the AAN will continue to lead efforts that showcase the value of neurology. Our advocacy on behalf of the AAN's membership helped secure victories in this year's MPFS, but our work is far from over.

AAN Members Leverage BrainPAC to Connect with Congress
By Mike Amery, Esq., Senior Legislative Counsel, Federal Affairs

Every few months, AAN members join the Academy's lobbying team in Washington to help amplify our message on Capitol Hill by sharing their personal experiences practicing neurology. Recently, Steven Lewis, MD, FAAN, of Chicago and Chris Prusinski, DO, FAAN, of Melbourne, FL, visited DC to join Derek Brandt and me on visits to their congressional members. We also attended a number of fundraisers for members of Congress through the Academy's political action committee, BrainPAC.

A highlight of the trip was an event for Rep. Ed Perlmutter (D-CO). Perlmutter, the author of the AAN's legislation creating Epilepsy Centers of Excellence at the VA a few years ago, held a reception at a townhome near the House office buildings prior to evening votes. As members were called to the floor to vote, Perlmutter invited us to walk over to the Capitol where he escorted the three of us to the House gallery just as an amendment to a bill reauthorizing the Export-Import Bank was taking place.

Perlmutter stayed a few moments to point out some of the titans of the House, like Rep. Paul Ryan (R-WI) who would become speaker the next day, and Democratic Minority Leader Nancy Pelosi (D-CA), before he went down to the floor to cast his vote. “What a thrill,” said Dr. Lewis. “I knew we were going to get a chance to meet several lawmakers, but to actually see the House in action was really a highlight of my visit to Washington for the AAN.”

The next day began with fundraising breakfasts for Sen. Pat Toomey (R-PA), and Democratic Congressional Campaign Committee Chair Rep. Ben Ray Lujan (D-NM), followed by a full day on Capitol Hill visiting congressional offices. We have pictures of their visit to share with you.

During these meetings, Drs. Lewis and Prusinski educated lawmakers and their staff about what makes neurology unique and shared some of the highlights and challenges of practicing neurology. They also urged their legislators to support of the FAST Act (S. 1465/H.R. 2799), which would improve care for stroke patients by expanding access to neurologists via telemedicine. We believe this change will result in greater utilization of tPA, in turn reducing disability and generating a significant savings to the federal government.

“What an exceptional day on Capitol Hill,” said Dr. Prusinski. “The FAST Act is such a great piece of legislation that will benefit our patients and our practices and I really appreciated the opportunity to encourage my members of Congress to sign up as cosponsors.” The FAST Act now has 38 cosponsors (19 Republicans and 19 Democrats), including Rep. Perlmutter who signed on after meeting with Drs. Lewis and Prusinski. Please take a quick minute to urge YOUR lawmakers to support the FAST Act here.

Collaborating with Patient Advocacy Groups for Neurologic Disease Tracking
A few weeks ago, AAN President Terrence L. Cascino, MD, FAAN, led a congressional briefing on the Advancing Research for Neurological Diseases Act (S. 849, H.R. 292). This bill would allow the Centers for Disease Control and Prevention to better track prevalence and incidents of neurologic disease. Earlier this year, this legislation passed out of the House as a part of the 21st Century Cures Act, but the Senate must also weigh in on this idea for it to move forward.

We are urging key members of the Senate to cosponsor S. 849 and our results have been fruitful. Thirteen senators have cosponsored the bill so far with the addition of Sen. Jack Reed (D-RI) this week. Issues like this one are rewarding because they allow us to partner with neurology-based patient groups like Parkinson's Action Network and the National MS Society to unite patients and providers together under one unified advocacy effort.

We are hoping that the Senate includes S. 849 within their version of the 21st Century Cures Act, which we expect to see soon. If not, we will continue to advocate for the Advancing Research for Neurological Diseases Act as a standalone bill.


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