January 23, 2017

By Mike Amery, Esq., Senior Legislative Counsel

Inauguration Preoccupies DC

The big news in Washington last week was, of course, the swearing in of Donald Trump as the 45th president of the United States. The AAN's office in DC is just a few blocks from the Capitol Building, so we had a front-row seat for the conversion of the Capitol area for the event.

All in the name of security, concrete barriers and fencing surrounded just about everything from the Supreme Court to the Washington Monument and from Union Station to the other side of the House office buildings. Despite this, the AAN's work continued all week long, including meeting with key congressional offices in preparation for the AAN's upcoming Neurology on the Hill event.

AAN to Advocate on Key Member Concerns

As President Trump spent his first weekend in the White House, the AAN was busy preparing the policy agenda for 2017 during a meeting of the Academy's Government Relations Committee (GRC). The GRC's mission is to engage AAN members in advocacy in support of the profession of neurology and patients with neurologic disease. The committee consists of 17 AAN members from all over the country appointed to two-year terms by the president of the AAN.

Topping the list this year is drug pricing and access. A recent poll of AAN members ranked this issue as one of the highest in importance. With some MS drug prices now approaching $70,000 a year and other neurologic drugs increasing consistently, access to pharmaceuticals is a key issue for many patients who rely on neurologists. Drug costs also add to regulatory burdens on neurologists in the form of increased demands for prior authorization and will even impact future ratings under the new physician payment systems.

There are a number of proposals for reigning in drug spending including re-importation from foreign countries and allowing Medicare to negotiate prices. President Trump broke with many Republicans, saying that pharma is “getting away with murder” and that “we need new bidding procedures” for the government. Others argue that this puts the government in the position of a price fixer because its purchasing power is so great. The AAN is working on a paper that will actively investigate these issues.

The Furthering Access to Stroke Telemedicine (FAST) Act also rose to the top as a priority issue. In 2016, the AAN was able to garner 172 cosponsors for this legislation that would allow Medicare to reimburse for the use of telemedicine for stroke in urban and suburban settings. Federal law already allows payment in rural areas.

Rep. Morgan Griffith (R-VA) was the lead sponsor of the FAST Act in the 114th Congress and has agreed to introduce it in the new 115th Congress. Rep. Joyce Betty (D-OH), a stroke survivor, will again be the lead Democrat. In the Senate, we lost the lead sponsor from the 114th Congress, Sen. Mark Kirk (R-IL) who lost his re-election bid last November. We recently approached a prominent Republican to be the lead sponsor in the Senate. Look out for further developments on this front in future editions of the Capitol Hill Report. 

Another top issue cited by AAN members is continuing the Academy's focus on funding for neurologic research. Attendees of Neurology on the Hill in 2015 and 2016 helped produce big wins in this area, particularly for the BRAIN Initiative at NIH, which recently had $1.51B in new funding authorized by the 21st Century Cures Act passed by Congress at the end of 2016.

In 2017, the AAN will continue efforts to ensure that congressional appropriations follow the path recommended by 21st Century Cures Act, in addition to normal appropriations that make up the bulk of funding for the NIH. AAN members can count on the Academy to lead the effort on Capitol Hill to emphasize the importance of brain research at Neurology on the Hill and throughout the year.