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Capitol Hill Report: AAN Advocacy Pushes FAST Act, Increased Research Funding Forward

June 20, 2016

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

FAST Act Gains More Than 100 Cosponsors 
AAN Government Relations Committee member Eddie L. Patton, MD, MS, of Sugarland, TX, joined Derek Brandt and me on Capitol Hill last week amid a very eventful week in D.C. that saw the Furthering Access to Stroke Telemedicine (FAST) Act (HR 2799) reach 110 cosponsors.

There isn't anything magical about the 100 cosponsor number, but in conversations I have recently had with both House Majority Leader Kevin McCarthy (R-CA) and House Majority Whip Steve Scalise (R-LA), they have made it clear that one thing that will get the FAST Act noticed prior to election day is the number of supporters we can garner in the House.

Dr. Patton urged several members of Congress from the Texas delegation to support the FAST Act including the offices of House Rules Committee Chair Pete Sessions (R), and House Ways & Means Committee Chair Kevin Brady. He met with Rep. Brian Babin, DDS (R), who agreed to sign on right in the office. Dr. Patton was also able to thank others who have already cosponsored the FAST Act, including Rep. Bill Flores (R) of east Texas and his home district Congressman Pete Olson (R).

The FAST Act also received publicity last week when Senate Finance Committee Ranking Member Ron Wyden (D-OR) touted his support for improving a stroke patient's access to a neurologist via telemedicine in this editorial and in a keynote speech he gave on chronic care reform at the Brookings Institution.

Research Funding Moves Forward in a Big Way
The other great news from Congress was passage of a fiscal year (FY) 2017 funding bill by the Senate Appropriations Committee that would greatly increase financial support for several of AAN's research priorities, including one of our requests from this year's Neurology on the Hill.

In March, 185 AAN advocates asked for increased funding for the BRAIN Initiative at NIH. Last week, in a bipartisan vote, the Senate Appropriations Committee approved a $100 million increase for the BRAIN Initiative ($250 million total) for FY17. This is a tremendous commitment by the committee members and a testament to the effort of AAN advocates and Sens. Richard Blumenthal (D-CT) and Ed Markey (D-MA), who sent a letter in support of the BRAIN Initiative. The bill now must move through the full Senate and then to the House of Representatives, where Neurology on the Hill participants were able to garner the signatures of 55 House members on a letter of support.

The Senate package also included significant increases in funding for the overall NIH budget by $2 billion to a total of $34 billion, which included a $400 million increase for Alzheimer's disease research ($1.39 billion total).

Making Our Case to House Republicans
I spent last weekend in western Pennsylvania at the annual summer retreat for the National Republican Congressional Committee, where I was able to talk with a couple dozen members of the House Republican Conference including Speaker Paul Ryan and key members of the important House Energy & Commerce Committee including Reps. Greg Walden (OR), Tim Murphey (PA), Cathy McMorris Rodgers (WA), Steve Scalise (LA), and Bill Johnson (OH).

I thanked many of them for cosponsoring the FAST Act, but there's a lot of follow up to do with congressional staff for those who haven't yet signed on. On our way to 200 cosponsors!


Advocating for Neurologists on MACRA Rule 
By Daniel Spirn, Regulatory Counsel

The AAN is continuing to work on its response to the proposed MACRA rule released in April. We will be submitting comments to CMS before the June 27, 2016, deadline. In our response to CMS, we call upon the agency to:

  • Provide additional flexibilities for small and solo practices so they are not disproportionately burdened by the new Medicare rules.
  • Expand the ability of neurologists to participate in clinical practice improvement activities and stress that CMS must only hold neurologists responsible for the costs over which they have direct control.
  • We are also concerned with the limited number of current alternative payment options (APMs) available to neurologists. CMS set high barriers to qualify as an “Advanced APM” and this is a concern to many stakeholders, including the AAN.

As a reminder, MACRA permanently repeals the sustainable growth rate (SGR) methodology for determining updates to the Medicare physician fee schedule. It stabilizes payments with 0.5 percent positive annual updates from July 1, 2015, through 2019. Beginning in 2019―based on 2017 performance data―physician payments will be based on their participation in one of two pathways: the Merit-based Incentive Payment System (MIPS) or Alternative Payment Models (APMs).

The AAN has tools and resources to help your practice prepare for MACRA:

  • Watch the AAN's video series about MACRA
  • View a guide that helps explain MACRA
  • Read a list of things you can do today to prepare for MACRA
  • Review AAN Practice Management Webinars on MACRA
  • Contact the AAN with your MACRA questions 

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