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Neurology Takes on MedPAC, Trial Lawyers

October 20, 2014

By Derek Brandt, Congressional Affairs Representative

Advisory Board Views Medical World as Primary Care vs. Specialists 
Even when Congress is out of town, the wheels of health care policy discussions continue to roll. One of the groups with a large voice is a congressional advisory board called the Medicare Payment Advisory Committee, or MedPAC.

MedPAC meets in Washington several times a year to discuss health care policy. Congress pays attention to MedPAC, which in recent years has been a leader in promulgating recommendations on physician payment issues.

Many of those recommendations have been designed to benefit primary care providers without acknowledging the similar challenges faced by cognitive specialists like neurology. You may have read about a few of their past proposals in the Capitol Hill Report, such as cutting Medicare reimbursements to all specialists by 18 percent to permanently fix the SGR, while holding primary care unharmed. Fortunately Congress has not taken MedPAC up on those ideas, but they are out there. 

Last week, I attended the October MedPAC meeting where the committee examined ways to verify and adjust relative value units in Medicare’s fee schedule for physicians and other health professionals. As an introduction to this topic, the commission discussed several past recommendations by the commission to boost primary care at the expense of all specialties. 

The commission’s November meeting will include a debate on the future of their signature recommendations in this area, the Medicare Primary Care Bonus, which expires next year. The AAN continues to pressure MedPAC to include neurology and other cognitive specialties in their attempts to improve the practice climate for primary care. We’ve sent comment letters, discussed our issues with several commissioners, testified during their meetings, and had members of Congress publically question MedPAC on the exclusion of cognitive specialists from their proposals. Our efforts are strengthened by the Cognitive Specialty Coalition, which consists of several other similar specialties such as rheumatology. Be sure to read future Capitol Hill Reports for a full analysis of MedPAC’s next meeting and its potential impact on neurology.


Will California's Election Reshape Medical Liability Laws?
By Mike Amery, Esq., Legislative Counsel

With Congress out and the election campaigns in full swing, I took the opportunity last week to join the California Neurological Society (CNS) at their annual meeting in Santa Barbara. 

California has done a great job at holding down malpractice rates, keeping physicians in practice, and maintaining access to care for patients. One of the reasons is California’s MICRA law, which caps malpractice awards for non-economic damages at $250,000. 

CNS members were energized over a ballot measure in California being pushed by the trial lawyers called Prop 46. The proposition would greatly increase the MICRA caps to $1.1 million, which would surely cause malpractice rates to increase.

Recognizing that it would be difficult to pass the proposal, the ballot measure also includes drug testing for physicians, and it is that issue proponents of the measure are using to push for passage.

I was impressed by the effort physician (and insurance) groups were putting up against the measure. I was aware of both the television and radio campaigns against Prop 46 and you couldn’t miss all of the anti-46 buttons and stickers among the attendees of the CNS conference.

Even if you aren’t from California, this will be an interesting issue to watch on election night. Many other states have followed California’s lead since MICRA passed in 1975 and could look to this election to create a trend of increasing damage caps and subsequent malpractice insurance rates.

The AAN is getting ready for the elections. We will start with a visit to the Fall Conference by US Rep. Joe Heck, DO, (R-NV). If you are coming to the conference, please do not miss this event on the evening of Saturday, November 1. Come see me at the BrainPAC booth for more details. 

The AAN and members of the Government Relations Committee will be hosting a post-election webinar on Thursday, November 6 at 5:30 p.m. ET. We will run through the results with a focus on where the Academy’s federal political action committee, BrainPAC, played a role and the impact expected on health care decisions. Register now for this free webinar


Odds and Ends 
By Tim Miller, Senior Program Manager, Communications and State Advocacy 

Congressman Mark Amodei (R-NV) recently visited with AAN Member Peggie Smith, PA-C, at Renown Health in Reno, NV, to learn more about how neurologists treat patients within the district he represents. View the AAN congressional site visit photo album on Facebook.

Applications are now being accepted for the 2015 Neurology on the Hill program. Apply and/or encourage your colleagues to apply for this highly successful program on March 2 and 3, 2015, and receive training from consultants, veteran advocates, and AAN staff who will bring you up-to-date on recent issues. Then participants go to Capitol Hill for face-to-face meetings with congressional members and their staffs.

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