August 22, 2016

Members of Congress Engage with Neurology

By Becky Horton, Program Manager, Advocacy Engagement

Last week, Sen. Orrin Hatch's health policy staff met with AAN members Drs. Nick Johnson (chair of the AAN's Government Relations Committee) and Steve O'Donnell at the University of Utah Center for Neurosciences. They focused their discussion on the importance of stroke telemedicine, especially as the Furthering Access to Stroke Telemedicine (FAST) Act continues to gain cosponsors in the House of Representatives. Drs. Johnson and O'Donnell also provided a neurologist's perspective for relevant issues such as drug pricing and MACRA implementation.

In Minnesota, AAN Board Member Dr. Sarah Benish hosted Rep. Erik Paulsen (R-MN) at the Minneapolis Clinic of Neurology in Edina. Dr. Benish, along with Kurt Neil, executive director, provided an overview of their day-to-day activities in a physician-owned private practice. The Minneapolis Clinic of Neurology is the largest physician-owned single-specialty neurology clinic in the nation, which gave Paulsen unique insight into the challenges of practicing medicine while operating a small to mid-sized business. Dr. Benish and Mr. Neil gave the congressman a tour of the facility and highlighted different equipment, particularly their mobile MRI machine. They also discussed issues affecting their practice such as reporting through PQRS, the impending MACRA implementation, and specialty drug costs. According to Dr. Benish, Minnesota is a favorable state to practice neurology, and she expressed the importance in balancing federal and state regulatory environments.

We all know that neurology is a complicated specialty, and in-person interactions with members of Congress are essential in helping more people understand the unique challenges of our field. Most importantly, members of Congress need to be reminded of the needs of patients with chronic neurologic diseases.

The AAN urges you to meet with your members of Congress whenever possible to help further their understanding of neurology and the diseases you treat. Don't know who represents you in Congress? Find your representative and find your senators now.

Highlights from the AMA State Advocacy Roundtable

By Grant Niver, Program Manager, State Affairs

Earlier this month, the American Medical Association's Advocacy Resource Center held its annual State Legislative Roundtable in Chicago, IL. The event provides an opportunity for policy staff at physician specialty associations and state medical associations to come together and discuss issues and trends that are taking place in state legislatures across the country. Becky Horton and I were in attendance to bring the AAN's perspective to the roundtable and enhance our advocacy efforts at the state level. The following are a few trends that were discussed.

As we move further into the 21st century, state legislatures have been moving quickly to adopt laws regulating the practice of telemedicine, with 31 having passed legislation so far. Telemedicine legislation and regulation have almost uniformly been focused on two issues: coverage parity and establishment of the patient-physician relationship. States will continue to weigh how best to ensure coverage of telemedicine and debate how to properly establish a relationship with a patient via telemedicine. The AAN developed a position statement on telemedicine in 2014 and continues to support legislation across the country.

Prescription Drug Abuse, Treatment, and Prevention
In 2014, nearly 30,000 Americans died due to opioid-related causes. In response, the AMA started the Task Force to Reduce Opioid Abuse which is comprised of more than 25 physician organizations, including the AAN. As a result of this group's efforts, four additional states expanded access to naloxone, a special narcotic drug that reduces the effects of other narcotics. Medical association attendees were encouraged to take action in their state to persuade physicians to register for and use prescription drug monitoring programs, make the case for enhanced education and training related to safe opioid prescribing practices, and continue efforts to enact laws that increase access to naloxone as well as create prescribing guidelines for opioids. 

Scope of Practice 

As medical teams integrate nurses and physician assistants in care delivery, regulation of health care practice continues to increase. State legislatures in 2016 considered more than 500 bills seeking to eliminate team-based care models of health care delivery and/or expand the scope of practice of non-physician health care professionals. Collectively, state medical associations were able to defeat many of them. Tracking and acting on scope of practice legislation continues to be a priority for the AAN. 

Other issues on the agenda included health insurance mergers, strategies for protecting the patient-physician relationship, drug pricing, Medicaid expansion, and a federal update from the AMA government affairs team on Capitol Hill.