July 24, 2017

By Brett M. Kissela, MD, MS, FAAN, member of the AAN Board of Directors

The AAN has asked me to guest write Capitol Hill Report this week to give my firsthand impressions of testifying on behalf of the AAN on the FAST Act before a congressional committee last week.Within the AAN, I am currently a member of the Board of Directors and serve on the Government Relations Committee.  I am a stroke neurologist who serves as professor and chair of Neurology and Rehabilitation Medicine at the University of Cincinnati (UC). I am also a proud member of our UC Stroke Team, where we take acute stroke calls to serve the entire Cincinnati metropolitan region, including 27 hospitals. For several years, we have used telemedicine to evaluate patients at outlying hospitals, and recently have begun to implement telemedicine at our urban and suburban hospitals too. We have made this move because telemedicine is a tool that allows rapid visual assessment for optimal decision making about appropriate acute stroke therapies. Time is brain, and telemedicine saves valuable time, leading to better outcomes for our patients.

The AAN first proposed that Congress expand Medicare reimbursement for telestroke to non-rural areas in early 2015. Since then, the AAN efforts via Neurology on the Hill, grassroots advocacy, and DC lobbying have been extraordinarily successful in gaining congressional support for the Furthering Access to Stroke Telemedicine (FAST) Act (H.R. 1148/S. 431). In addition to the legislation passing the Senate Finance Committee as part of the CHRONIC Care Act, S. 870, it now has 128 cosponsors in the House. This level of support caught the eye of the House Energy and Commerce (E&C) Committee, which has jurisdiction over many health care issues. The E&C Committee invited the AAN to present testimony in favor of the FAST Act last week.

I was honored to represent the AAN before the E&C Health Subcommittee led by Chair Michael Burgess, MD, (R-TX), who I am pictured with below, and Ranking Member Gene Green (D-TX). Frankly, after I accepted I was a little scared and intimidated by participation in such an important and very formal process. Luckily, I had participated in the Palatucci Advocacy Leadership Forum in the past and thus have had some training for such an occasion. I presented for my allotted five minutes on our personal success of using telestroke at UC, giving examples of stroke patients that have been able to return to normal life after being treated with tPA.

I was impressed by the knowledge of the committee members and their level of support for telestroke. Many mentioned H.R. 1148 in their opening statementsand their questions allowed me to expand my description of the benefits of tPA and telestroke. Rep. Griffith, the House author of H.R. 1148, focused on the costs of the bill, and I was able to explain the cost savings of telestroke in helping patients avoid expensive long-term care. 

I want to thank the AAN advocacy staff for arranging this great opportunity. In addition to testifying before the committee, I attended a fundraiser for an Ohio member of Congress with a contribution from BrainPAC; met Sen. Sherrod Brown (D-OH), a supporter of the Senate version of the FAST Act; and visited the offices of my other members of Congress, Sen. Rob Portman (R-OH) and Rep. Steve Chabot (R-OH).

We cannot complain about changes affecting our profession if we don't stand up and advocate for ourselves. Please consider participating in AAN advocacy efforts as you see fit-consider applying for the Palatucci Advocacy Leadership Forum or Neurology on the Hill, or respond to our email action alerts to contact your members of Congress. If I can do it, so can you!