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Capitol Hill Report: Opioid Epidemic Declared Public Health Emergency

NOVEMBER 6, 2017

Here Is the Latest from Washington

AAN Members React to Opioid Emergency
The opioid crisis has had a staggering impact on communities across the US, but few places have seen the challenges of this epidemic more than West Virginia. AAN Government Relations Committee members David Watson, MD, and Mitzi Payne, MD, practice in West Virginia and see their patients and community struggling. “This is a public health emergency in my state,” said Watson.

President Trump on October 26 declared the opioid epidemic as a national public health emergency. This declaration allows federal agencies to make resources available to reduce deaths related to opioid abuse, which include telemedicine services for opioid treatment and assistance for people with opioid addictions seeking housing or employment. The Department of Health and Human Services can also allocate additional staff and increase flexibilities in programs to prevent addiction and support recovery. 

Neurologists like Drs. Watson and Payne have seen the devastating effects of opioid abuse in their practices and their communities. While most neurologists may not prescribe opioids, they treat many complications that result from opioid overuse and abuse. Babies diagnosed with neonatal abstinence syndrome (NAS) often visit pediatric neurologists to work through the symptoms of their condition and begin healing. Adults seeking help with addiction or working through recovery following an overdose may also see a neurologist as part of a care team. “The opioid crisis crosses all specialties,” said Watson, “but as protectors of the brain it is a problem that neurologists must address head on. This includes not only rehabilitation but also finding new and safe treatments for people with pain.”

Policy makers recognize the critical role that physicians, including neurologists, play in combating this epidemic and routinely ask AAN members and our lobbyists in DC about the impact this crisis is having on patients. The AAN supported 21st Century Cures, which allocated funding for the opioid crisis, and partnered with other physician organizations on sign-on letters supportive of more money to combat the epidemic. The Academy is working on the state and federal level to support actions that promote access to care for people struggling with opioid use disorders.

CMS Releases Final Rule on QPP
The Centers for Medicare & Medicaid Services (CMS) released finalized modifications to the MACRA Quality Payment Program's (QPP) Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs) participation options and requirements for 2018. Of the two programs, most clinicians will participate in MIPS. The final rule changes MIPS in the following ways:

  • Increases the low-volume threshold exclusion to $90,000 in Medicare Part B allowed charges or 200 Medicare Part B patients
  • Finalizes performance category weights:
    • Quality = 50 percent
    • Advancing Care Information = 25 percent
    • Improvement Activities = 15 percent
    • Cost = 10 percent
  • Delays the mandate to move to 2015 Edition Certified EHR Technology
  • Provides added flexibility for small group practices
  • Creates “virtual groups” for solo and small practices to aggregate their data for shared MIPS evaluation

Learn how additional provisions affect neurology. 

Neurologic Patient Groups Meet with AAN in Washington, DC
Representatives from nine neurology patient groups, including representatives from the Alzheimer's, Parkinson's, MS, and epilepsy communities, came together at our Washington office to discuss advocacy plans for 2018 and explore opportunities for collaboration. Each organization is preparing legislative priorities and getting ready for annual congressional fly-in days. In 2017, these nine groups brought nearly 2,500 advocates to Washington and are preparing for even larger events in 2018. Neurology patient groups, as well as the Academy, will continue to advocate for access to health care, affordable prescription medications, and telemedicine as some of their top issues. The AAN is excited to continue working together with neurology patient groups and ensuring the highest quality care is available to all patients living with neurologic disease.

AAN Supports Ongoing Funding for the Congressionally-Directed Medical Research Program
An important issue for neurology patient groups is the continued and strong funding for research through the Congressionally-Directed Medical Research Program (CDMRP) at the US Department of Defense. Since 1992, CDMRP has funded billions of dollars for important biomedical research, with millions of those dollars going to neurologic disease.

Funding for the CDMRP program has recently been put at risk during the 2018 appropriations process. The Senate passed the National Defense Authorization Act (NDAA), which effectively eliminated the CDMRP, while the House version preserved the program. A conference committee of members from both the House and Senate will resolve this and many other differences between the versions of the NDAA legislation.

Last week, the AAN weighed-in with the conference committee leadership to urge them to adopt the House language for CDMRP funding, so the critical neurologic research being funded by this program may continue. The CDMRP has been challenged before, yet the program has continued to endure thanks to the strong support from many members of Congress and the advocacy from organizations like the AAN. 

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