Capitol Hill Report: Neurology Interests Make Gains on Capitol Hill

July 6, 2015

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

IPAB Repealed in the House, Senate Receives Bill
Congress took a break for the July 4 recess following some huge Supreme Court decisions the week before. The biggest verdict for health care interests was King v. Burwell, where the court, in a 6-3 vote, upheld health insurance subsidies for individuals on the federal health exchange created by the Affordable Care Act (ACA).

Even in the face of the Supreme Court decision on subsidies, Republicans vowed to continue to dismantle the ACA and had some success in the House with a vote that eliminated the medical device tax and another that repeals the Independent Payment Advisory Board (IPAB), HR 1190. With the support of the AAN, including an action alert to AAN members, the IPAB repeal bill passed 244-154. The 15 members of IPAB have not yet been appointed by the president, nor has anyone even been nominated. But if the board ever does convene it will have the explicit task of achieving savings in Medicare without affecting coverage or quality. The bill is now heading to the Senate where it needs 60 votes to bypass a threatened Democratic filibuster. President Obama has threatened to veto the measure if it is passed.  

After a close reading of the ACA it is clear that the only way IPAB can achieve its goal is by cutting Medicare physician payments and the only thing that could prevent the eventual cuts is a supermajority vote of Congress coupled by spending cuts designated to other federal spending by Congress.

Increased NIH Funding Moves Forward
The House and Senate Appropriations Committees are actually getting some work done that could lead to the funding of the government for FY 2016. For the last few years, partisan bickering has prevented passage of some of the 13 annual spending bills that need to be approved by October 1 of each year.

One of the most contentious is always the Labor, Health, and Human Services (LHHS) education bill that includes funding for the National Institutes of Health and other public health agencies. 

The House Appropriations Committee voted 30-21 voted in favor of a LHHS bill totaling $153 billion, including an additional $1.1 billion for the NIH and $140 million extra for the Center for Disease Control (CDC). Included in the NIH budget is $300 million in additional funds for Alzheimer's disease research, along with $95 million in new money for the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, two of the AAN's top appropriation priorities. Also of interest is a provision asking CMS to assist providers and hospitals in resolving issues with recovery audit contractors (RACs), encouraging CMS to find a better balance between eliminating fraud and abuse while not jeopardizing patient access to care and the financial stability of health care providers.

The Senate Appropriations Committee voted 16-14 to advance their own version of the FY 2016 spending bill, totaling $153 billion. Under the Senate plan, NIH would receive $32 billion, a $2 billion increase over current spending levels, while CDC would receive a $251 million cut. Alzheimer's research and the BRAIN Initiative would see significant increases similar to those included by the House.

AAN members and staff have met several times with the chairman of the LHHS, Sen. Roy Blunt (R-MO), to explain the importance of these vital programs. It is clear that the AAN and our allies have made an impact, as evidenced by this op-ed by Sen. Blunt outlining how critical investments in Alzheimer's research are for our country. 

Congress now has just four weeks before the month-long August recess and the lead up to the October 1 deadline. No need for panic yet, but if they miss the deadline the chance of a government shutdown always looms. 

Influential Georgia Senator Announces He Has Parkinson's
For years we've shared the fact that 1 in 6 Americans are impacted by neurologic disease. This reality applies to the community on Capitol Hill too, which is evident from the consistent stream of requests for neurology recommendations the AAN DC office gets from members of Congress and their staff.

This reality hit Capitol Hill in a big way last month when Sen. Johnny Isakson (R-GA) announced that he has Parkinson's disease. I saw the senator shortly after his announcement and he assured me he is receiving great care from his neurologist in Atlanta.

The conversation was fortuitous because Isakson has just been named as one of the co-chairs of the Senate Finance Committee Bipartisan Chronic Care Working Group along with Sen. Mark Warner (D-VA). At the moment of our conversation, AAN leadership was putting the final touches on aletter to his working group focusing on ways federal policy could be changed to improve care to those with chronic illnesses and save money, such as increased access to telestroke or increasing the use of advanced care planning. This focus on chronic conditions by the Senate Finance Committee is another example of how the repeal of SGR is really paying dividends by providing Congress with the time necessary to consider crucial public health changes. Another example detailed recently in the Capitol Hill Report is the 21st Century Cures Initiative, which is working its way to the floor of the US House. It feels great to talk about improving the health care system rather than just trying to keep Congress from cutting physician payments, although that topic will never be fully closed.



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