Capitol Hill Report: Neurologists Take Advocacy Best Practices into Congressional District Offices

SEPTEMBER 11, 2017

Here is the Latest From Washington

Congress returned from recess last week and got back to work on federal spending bills, hurricane relief, and many of the other issues. The AAN saw some immediate success from our efforts during the recess, including several August "Neurology off the Hill" visits to members of Congress in their district offices and comment letters discussing efforts to reduce regulatory burdens. Here are some of the highlights.

Neurologists Visit Lawmakers' Offices for "Neurology off the Hill"

Neal Parikh, MD - New York
“I, along with Dr. Janice Weisman, had the pleasure of visiting with Rep. Carolyn Maloney in her district office as part of the Neurology off the Hill initiative. The AAN's efforts gave us nearly 30 minutes of direct contact with our representative, her chief-of-staff, and even some summer interns! We discussed the FAST Act and NIH funding in great detail and continued the conversation by email after the meeting. The intimate meeting also allowed us a unique window into Rep. Maloney's passions in a way that will hopefully allow us to more effectively align our priorities with hers.”

Kara Stavros, MD - Rhode Island
“Participating in Neurology off the Hill was a valuable and empowering experience. My colleagues and I visited Rep. Langevin at his local office in RI. The local visit was longer and more intimate than meeting in his DC office, and it provided us the flexibility to discuss a variety of issues and to bond over our local connections. It was a great way to follow up on the issues we discussed in DC earlier this year (in particular, support for the BRAIN Initiative and the FAST Act) and to continue to build a relationship with Rep. Langevin and his office going forward. Plus, meeting locally allowed more of my colleagues to attend, giving us a more robust delegation and more supportive voices for the issues that matter to us and our patients! This was an invaluable opportunity to speak directly to a member of Congress.”

Sarah Song, MD - Illinois
“Our in-district visit "off the Hill" was fantastic! A group of stroke neurologists from Rush University Medical Center, Drs. Laurel Cherian, Alex Vargas, Nick Osteraas, and me, went to visit Rep. Quigley's office, located in the Lakeview neighborhood of Chicago, IL. I was the only one with experience doing in-person advocacy, but my three colleagues were excited and eager to participate. Beforehand, we discussed the different issues and decided to focus on the FAST Act, funding for the BRAIN initiative, and support for any health care legislation that advocated for the most Americans covered. We practiced several times, starting with introductions, and leading from issue to issue. On the day of our meeting, we met with Erica Reardon, the district policy advisor. She was very receptive to our conversation, and the newbies did great! I was so impressed with how well they were able to shift talking points and emphasize our asks. Since Rush does quite a bit of telestroke, we also pulled out our cell phones to show her a mock telestroke patient by using mobile technology, so Erica really understood how valuable and timely telestroke could be used. Overall, our meeting was encouraging and promising!"

View additional Neurology off the Hill pictures on Facebook.

AAN Comment Letters Aim to Reduce Administrative Burdens on Neurologists
By Daniel Spirn, Regulatory Counsel

Recently, the AAN submitted comments to the Centers for Medicare & Medicaid Services (CMS) on two proposed rules. The first, related to MACRA, helps establish the 2018 Quality Payment Program (QPP) rules. The second proposed rule involves the 2018 Medicare Fee Schedule.

Regarding the Quality Payment Program, the AAN advocated for many changes to benefit neurologists, including:

• More Improvement Activities to help neurologists score points under the Merit-based Incentive Payment System
• Reduce requirements governing electronic health record reporting
• Support for virtual groups and bonus points under the QPP for small, solo, and rural practitioners
• A need to increase the opportunity for neurology to have Advanced Alternative Payment Models

In the proposed Medicare Fee Schedule, the AAN was pleased to see CMS listen to our calls for reduced regulatory hassles on neurologists. In our letter to the agency, the AAN made several comments:

• Support the delay of the Appropriate Use Criteria program and more hardship exceptions
• Reduce the penalties associated with the Physician Quality Reporting System (PQRS), Meaningful Use, and Value Modifier Program
• The AAN offered several proposals on issues ranging from electronic health records to prescription drug monitoring programs in response to a CMS request regarding the reduction of regulatory hassles
• CMS is considering a dialogue on re-evaluating the documentation requirements surrounding E/M, and the AAN offered several steps CMS can take, including more conversations with the Academy on this issue in the future

News and Notes

• The Senate Labor/Health & Human Services Appropriations Subcommittee passed a 2018 FY funding bill that includes a $2 billion increase in funding for NIH, with a $140 million increase for the BRAIN Initiative, a top priority for the AAN.
• The FAST Act picked up 16 new cosponsors: 13 in the House, bringing the total to 143; and three in the Senate, bringing the total to 15.