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Capitol Hill Report: AAN Fighting for Regulatory Relief, Brain Research Funding

April 10, 2017

By Daniel Spirn, Regulatory Counsel

AAN Continues its Regulatory Advocacy for Relief from Burdensome Hurdles on Neurology Practices
A major priority of the AAN is to reduce the regulatory hassles faced by neurologists as they work to provide high-quality care for their patients. With these efforts in mind, we recently joined the American Medical Association and state medical societies from across the United States to call upon the federal government to reduce the burden and penalties associated with electronic health records, the Physician Quality Reporting System, and the Value-based Modifier. The letter notes in the “MACRA law and regulations, policymakers in Congress and the administration clearly understand that fair and accurate measurement of physicians' performance will not be possible until better tools become available.” That is why we strongly encourage leadership in the administration and at the Department of Health and Human Services to consider further reductions in regulatory burdens on neurologists, especially as they work to comply with MACRA. Learn more about MACRA.

We also joined a large coalition calling upon the federal government to defer the implementation of 2015 Edition of Certified Electronic Health Record Technology (CEHRT) until such technology is widely available, and in any event, no sooner than January 2019. We do not believe the technology will be readily available to neurologists across a wide array of practice venues and that the use of 2015 Edition of CEHRT should remain voluntary.

Finally, the AAN signed on to principles to reform the prior authorization process. The goal is to reduce the administrative burdens and barriers to timely patient care associated with prior authorization and other utilization management programs.

The AAN takes the challenge of reducing regulatory hassles on our members seriously. It is a top priority for the Academy and has been outlined as a key regulatory goal by the AAN's Medical Economics and Management Committee. We will continue to seek out every legal and regulatory avenue possible to reduce burdens on our physicians, and in turn, increase the joy of practice for neurologists across the United States.


Congress Stands Strong in Support of NIH, BRAIN Initiative Funding
By Mike Amery, Esq., Senior Legislative Counsel

A few weeks ago, President Trump proposed his 2018 budget and included a staggering $5.9 billion cut to the National Institutes of Health (NIH). A cut of this magnitude would represent a reduction of almost 20 percent from 2017 funding levels.

Support for the NIH has been a hallmark of AAN advocacy for decades. For the last three years, we have prioritized funding for the BRAIN Initiative at the NIH through Neurology on the Hill and as a part of our year-round advocacy based in Washington. The results of these efforts have been profound, the BRAIN Initiative is slated to receive $160 million in 2017, and in each of the last four years since this program was created, funding levels have increased by significant margins. This is not the time to turn back on funding for research.

Fortunately, the president's proposal is just that, a proposal. Article 1, Section 7, of the US Constitution, states that “All bills for raising revenue shall originate in the House of Representatives; but the Senate may propose or concur with amendments as on other bills.” This constitutional provision covers appropriations bills, which applies to funding for the NIH and other federal agencies. This means that the power of the purse resides first in the House. Congress is free to ignore the presidential proposal. From the conversations I am having across the Hill, it appears to me that Congress intends to do just that, ignore it. 

One key player on NIH funding will be Rep. Fred Upton (R-MI). Upton recently stepped down after six years as chair of the House Energy & Commerce Committee. His crowning achievement in this position was the passage of the 21st Century Cures Act last year after a lengthy two-year campaign to sell the bill in both the House and Senate.  This legislation included an increase of $4.8 billion for NIH. Upton's comment on NIH cuts to me was, “Not on my watch!”

On the other side of the Capitol, I spoke with Sen. Roy Blunt (R-MO), who is a major champion of medical research and serves as chair of the Senate Appropriations Committee. Blunt, who has led recent efforts to substantially increase the federal commitment to funding research on Alzheimer's (which the AAN has also strongly advocated for) told me that the president's budget was the wrong way to go and that cuts wouldn't be coming through his committee. Blunt is the right senator to say that NIH cuts are the wrong thing to do.

Blunt's comments have been echoed across the Hill by many others including Sen. Bill Cassidy, MD, (R-LA) who confidently said, “NIH cuts aren't going to happen” at a meeting I attended with other physician specialty lobbyists.

I want to thank the hundreds of AAN members who reached out to their members of Congress in response to the AAN's action alert supporting the NIH and the BRAIN Initiative. The result of this effort was that 64 members of the House signed a “Dear Colleague” letter to the House Appropriations Committee in support of robust funding for the BRAIN Initiative. A special thank you from the AAN goes out to Reps. Earl Blumenauer (D-OR), Cathy McMorris Rodgers (R-WA), Bill Pascrell, Jr. (D-NJ), and Tim Murphy (R-PA) for leading this critical letter and to the following members of Congress who signed it:

  • Donald S. Beyer Jr. (D-VA)
  • Suzanne Bonamici (D-OR)
  • Brenden F. Boyle (D-PA)
  • Julia Brownley (D-CA)
  • Bradley Byrne (R-AL)
  • Tony Cárdenas (D-CA)
  • Kathy Castor (D-FL)
  • David N. Cicilline (D-RI)
  • Yvette D. Clarke (D-NY)
  • Emanuel Cleaver, II (D-MO)
  • Steve Cohen (D-TN)
  • Chris Collins (R-NY)
  • John Conyers, Jr. (D-MI)
  • Kevin Cramer (R-ND)
  • Elijah E. Cummings (D-MD)
  • Carlos Curbelo (R-FL)
  • Danny K. Davis (D-IL)
  • Suzan DelBene (D-WA)
  • John K. Delaney (D-MD)
  • Mark DeSaulnier (D-CA)
  • Keith Ellison (D-MN)
  • Elizabeth H. Esty (D-CT)
  • Brian K. Fitzpatrick (R-PA)
  • John Garamendi (D-CA)
  • Raúl M. Grijalva (D-AZ)
  • Brian Higgins (D-NY)
  • Jim Himes (D-CT)
  • Eddie Bernice Johnson (D-TX)
  • Henry C. "Hank" Johnson, Jr. (D-GA)
  • John Katko (R-NY)
  • William R. Keating (D-MA)
  • Joseph P. Kennedy, III (D-MA)
  • Ron Kind (D-WI)
  • Ann McLane Kuster (D-NH)
  • Barbara Lee (D-CA)
  • Ted W. Lieu (D-CA)
  • John Lewis (D-GA)
  • Dave Loebsack (D-IA)
  • Zoe Lofgren (D-CA)
  • Sean Patrick Maloney (D-NY)
  • Doris Matsui (D-CA)
  • Eleanor Holmes Norton (D-DC)
  • Chellie Pingree (D-ME)
  • Stacey Plaskett (D-VI)
  • Jared Polis (D-CO)
  • Jamie Raskin (D-MD)
  • Kathleen M. Rice (D-NY)
  • C.A. Dutch Ruppersberger (D-MD)
  • Linda T. Sanchez (D-CA)
  • Jan Schakowsky (D-IL)
  • Adam B. Schiff (D-CA)
  • David Scott (D-GA)
  • Terri Sewell (D-AL)
  • Louise Slaughter (D-NY)
  • Jackie Speier (D-CA)
  • Paul D. Tonko (D-NY)
  • Jackie Walorski (R-IN)
  • Tim Walz (D-MN)
  • Peter Welch (D-VT)
  • John A. Yarmuth (D-KY)

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