Chaos in Virginia and Impact on Neurology

June 23, 2014

By Mike Amery, Esq., AAN Legislative Counsel

Chaos in Virginia
It has been a couple of weeks but it is worth noting how the loss by Republican Majority Leader Eric Cantor impacts neurology.

I actually had coffee in Washington with Cantor the morning of his defeat. He seemed confident and who wouldn’t be when your pollster’s numbers say you’re up by 34 points. But in reality, the pollster failed to properly project the turnout—by a lot!

The majority leader always has been kind to neurology and sympathetic of our views on key issues as his father has Parkinson’s Plus. Cantor addressed Neurology on the Hill a few years ago and shared his experience that made it clear he understood the struggles of patients and families with significant neurologic conditions. 

Picking up the Pieces
Throughout last week, talk of the Cantor defeat and the impending leadership election dominated the events I attended. Republicans elected Rep. Kevin McCarthy (CA) as their new majority leader. We have a good relationship with him and he has a good health staff that we can work with. 

The real race in question was who would fill the chief whip, which is the third position in the Republican leadership team. The leading candidates were Rep. Peter Roskam (IL), who was the lead sponsor of our NCS/EMG congressional letter in late 2012, and Steve Scalise (LA). We will have to build a better relationship with Scalise, who clinched the post.

Campaigns in High Gear Equal Opportunities
In 2012, the average cost to win a US House seat was $1.7 million. Want a seat in the Senate? You’ll need on average $10.6 million. 

What that means is members of Congress are scurrying to raise the money that will solidify their chances for re-election in November. For the Academy and BrainPAC, this means great opportunities to get our issues heard by some of the top members in Congress. 

Over the last two weeks, Derek Brandt and I attended more than 20 events that included more than 50 current members of Congress such as Speaker John Boehner (R-OH), Minority Leader Nancy Pelosi (D-CA), Senate Budget Committee Chair Patty Murray (D-WA), and House Energy & Commerce Committee Chair Fred Upton (R-MI). 

Members on both sides of the aisle say that the chance for a permanent SGR repeal in a lame duck session of Congress after the November elections is possible. In any agreement could be things good or bad for neurology. An example is an extension of the Medicaid bump. Would AAN members be included? Our goals are to make sure that when these questions are answered we have done everything we can to make sure Congress is well aware of our positions. This means we will take advantage of every resource opportunity we can until they turn out the lights on the 113th Congress.  

Regulatory Corner
By Daneen Grooms, AAN Regulatory Affairs Manager

AAN to CMS: Preserve Neurology GME Slots
As the population ages, there is strong evidence that there will not be an adequate supply of neurologists to meet the demand.  In fact, a recent study of the neurologic workforce concluded that in 2012 there was an 11-percent shortage of neurologic full-time equivalents to meet the needs of patients. In 2025, this shortage will be nearly 20 percent. We note that similar shortages also are being described in primary care. Yet, the Centers for Medicare & Medicaid Services’ (CMS) policy goals only focus on increasing training in primary care and general surgery. The AAN recently sent a letter to CMS describing in detail the neurology workforce crisis. We urge CMS to view neurology as a shortage specialty whose residency slot allocations must be protected because many of the diseases impacting the Medicare population are neurologic conditions, such as Alzheimer’s disease and stroke. To assure an adequate supply of neurologists in the future, it is critical that CMS increase the residency cap for neurology as is currently being done with primary care.


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