CONGRESS MAKES PROGRESS ON NEUROLOGY ISSUES

August 8, 2022

Latest Advocacy News

• The AAN urged Congress to stave off an 8.55-percent Medicare physician payment cut that is scheduled to go into effect at the end of 2022 and to also provide an inflationary update based on the Medicare Economic Index to combat rising practice costs.
• The Centers for Medicare & Medicaid Services recently announced an indefinite delay in implementation of the Appropriate Use Criteria program. As such, there is currently no timeline for when the AUC program will transition from the education and testing phase, into the payment penalty phase This delay is in alignment with the AAN’s ongoing advocacy on this topic, which has urged CMS and Congress to reconsider the utility of this program, given the burdens it is likely to place on providers.

Issue in Focus

It’s been an abnormally busy week in Congress, as both chambers aim to wrap up their legislative sessions prior to leaving for the August recess. Outlined below are several key developments, including progress on two Neurology on the Hill 2022 priorities—prior authorization reform and telehealth.

• The Advancing Telehealth Beyond COVID-19 Act of 2022 (H.R. 4040) passed the House on July 27 by a vote of 416–12. This legislation mirrors our Neurology on the Hill 2022 telehealth ask, ensuring that Medicare beneficiaries continue to have access to telehealth in Medicare by extending key flexibilities that were enacted during the public health emergency until at least December 31, 2024. Act now and tell your senators to support the extension of these flexibilities by passing H.R. 4040 through the Senate!
• On July 29, the AAN led a letter to the House and Senate Judiciary Committees urging them to take swift action on the Conrad State 30 and Physician Access Reauthorization Act (H.R. 3541/S. 1810) before the end of the 117^th Congress. This letter was joined by 62 other organizations representing a broad range of constituencies, including patients, physicians, hospitals, and immigration organizations.
• Neurology on the Hill 2022’s #FixPriorAuth ask, the Improving Senior’s Timely Access to Care Act (H.R. 8487), finally received a hearing in the House Ways & Means Committee and was reported out favorably with overwhelming bipartisan support. This legislation, which would reform the use of prior authorization requirements in Medicare Advantage plans, has been a focus of AAN advocacy efforts for several years. The next step for this bill is consideration by the full House of Representatives.
• Last week Democrats released and passed through the Senate the Inflation Reduction Act, a package that proposes significant health care, climate, and tax policies via the reconciliation process that only requires a simple majority of votes. The AAN has been supportive of provisions in the package that would lower the cost of prescription medications, cap out-of-pocket drug costs for Medicare recipients, and extend Affordable Care Act insurance subsidies for three years. A House vote is expected on Friday, August 12.
• The Senate released its draft FY23 Appropriations packages on July 28. Congressional leaders have not agreed to a topline number, although Senate Appropriations Chair Patrick Leahy (D-VT) has expressed his desire to finish the process by the end of this Congress. The bills include $2.768 billion for NINDS, an increase of $150 million from FY22. Within NIH, the BRAIN Initiative is funded at $700 million, $80 million more than was appropriated in the House version of the bill. All four Neurology Centers of Excellence (Epilepsy, Headache, MS, Parkinson’s) are mentioned in the bill, with the Parkinson’s Center being appropriated $12 million, a 50-percent increase from FY22. The committee also recognizes the importance of increased investments for the expansion of MS Centers. Now that both chambers have released draft language, negotiations are able to begin. It is still unlikely an agreement will occur before government funding runs out, creating the need for a continuing Resolution resolution come October 1.
• The Medical Marijuana and Cannabidiol Research Expansion Act (H.R. 8454) passed the House and was received in the Senate on Wednesday. This bill creates a registration process for researchers and manufacturers of medicinal marijuana and cannabidiol (CBD). It specifically allows physicians to discuss both the potential harms and benefits of medicinal cannabis with patients and requires relevant federal agencies to report findings on the therapeutic potential for conditions as well as its impact on developing adolescent brains and ability to operate motor vehicles. The AAN has repeatedly provided support for research in this area, discussed in our position statement.

What We're Reading

• Blots on a Field? A neuroscience image sleuth finds signs of fabrication in scores of Alzheimer’s articles, threatening a reigning theory of the disease (Science)
• Alzheimer’s researchers are looking beyond plaques and tangles for new treatments (NPR)
• Pfizer loses U.S. appeal over co-pays for heart failure patients (Reuters)