Capitol Hill Report

Read the Academy's bi-weekly update on legislative and regulatory advocacy for neurology. 

Breaking News from Washington, DC

Congress Passes FAST Act

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AAN Wins! congress passes fast act

February 9, 2018

Congress Funds Government, Passes FAST Act

After a brief government shutdown Congress passed a continuing resolution to maintain government funding until March 23 and agreed on budget parameters that significantly increase total government funding for 2018 and 2019.

The bill contains several significant priorities of the AAN, including the final passage of the Furthering Access to Stroke Telemedicine (FAST) Act.

Working with the American Heart Association and American Stroke Association (AHA/ASA), the AAN has been a lead advocate for the FAST Act over the last three years.

  • The FAST Act changes federal policy to allow Medicare to pay for telestroke services in all geographic areas, not just rural as allowed by current law.
  • This policy change should increase access to critical, timely care for those suffering from stroke.
  • This was a top priority for AAN’s Neurology on the Hill in 2016 and 2017.
  • First introduced in the 114th Congress in 2015.
  • Introduced in the 115th Congress in early 2017 in the House as H.R. 1148 by Rep. Morgan Griffith (R-VA) and Rep. Joyce Beatty (D-OH).
    • Received 177 House cosponsors before final passage. This puts HR 1148 in the top 50 for number of cosponsors of the 4,956 bills introduced in the House this year.
    • Introduced in the Senate as S. 431 by Sen. John Thune (R-SD) and Sen. Brian Schatz (D-HI).
      • Received 16 Senate cosponsors before final passage.
  • In July 2017, AAN Board member Brett Kissela, MD, FAAN, testified in favor of the FAST Act in front of the House Energy & Commerce Committee which later passed the bill from committee on a unanimous 51-0 vote.

The AAN advocates for neurology in Washington on many issues. Some issues have the support of large numbers of medical specialties and/or patient groups. Others are more specific. The FAST Act is one of those specific bills that would not have moved forward without the dedicated efforts of the AAN and the AHA. The AAN thanks all the AAN members who participated in NOH, contacted their members of Congress, and in many ways brought this issue to the attention of Congress. Victims of stroke will be better off as a result.

The budget resolution also addressed other major AAN priorities including:

  • $2 billion increase for the National Institutes of Health for 2018-2019
  • $6 billion to combat the opioid crisis
  • Elimination of the Independent Payment Advisory Board, a provision of the Affordable Care Act that greatly threatened physician Medicare payments and access to care for patients
  • Extended the Children’s Health Insurance Plan for another four years, to a total of 10 years
  • Permanently repealed the therapy caps that threatened rehabilitation services
  • MACRA fixes, including the elimination of MIPS payment adjustments applying to Part B drugs 

AAN Committees Set 2018 Priorities

Government Relations Committee
By Nicholas Johnson, MD, FAAN

I chair the AAN’s Government Relation Committee (GRC). The GRC is comprised of 17 AAN members from all over the US and is charged with directing the Academy’s advocacy efforts on the federal and state levels.

Prior to the passage of the continuing resolution and the budget resolution, the GRC met to set priorities for 2018. We were aware that the FAST Act had a good chance at passing, so the committee shifted to focus on:

  • Regulatory burdens facing neurologists such as prior authorization requirements
  • Drug costs and the impact on patients with neurologic conditions
  • Boosting research dollars for the National Institutes of Health, including the BRAIN Initiative and funding for research on opioid treatments

These will likely be the issues at the top of the list for the AAN’s Neurology on the Hill event when 216 AAN members representing all 50 states and DC will come to Washington in late February.

The AAN also collaborates with patient groups and other medical specialties to advocate for important issues such as appropriate physician payment systems, medical malpractice liability reform, graduate medical education, access to neuroimaging, and many others. Throughout 2018, the GRC will constantly monitor what’s happening in Washington and make sure that AAN members are well apprised and active. Please email us at to get involved in AAN advocacy.

Medical Economics and Management Committee
By Orly Avitzur MD, MBA, FAAN

I chair the Medical Economics and Management Committee (MEM). Between MEM and our four subcommittees, we have more than 40 volunteer members—neurologists, business administrators, and an advanced practice provider—from across the country who work to improve the economics of clinical practice.

We met in January to advance these priority issues:

  • Support members participating in the Medicare Quality Payment Program (QPP)
  • Reduce regulatory burdens
  • Consider the viewpoints and struggles of small and solo practices in the resources we develop
  • Educate members through multiple venues, including webinars, free quickinars, in-person courses, and simple Top 5 lists
  • Increase business administrator membership
  • Ensure appropriate coding and reimbursement
  • Use data to demonstrate the value of neurologists
  • Influence insurer medical policies that impact neurologic care
  • Help members use health information technology to enhance care

If you have ideas for tools that would support your practice or concerns that you want heard, we’d love to hear from you. Contact

AAN, CMS Continue Dialogue on Burdens of Prior Authorization

  • Continuing our efforts from last year, in early February the AAN once again joined a small group of medical societies to discuss the burdens of prior authorization in the Medicare Advantage program. We met with several staffers from the Centers for Medicare & Medicaid Services (CMS), including Cheri Rice, the acting deputy director of the Center for Medicare.
  • During our meeting, we expressed our hope that CMS will continue to address this example of administrative burden. The AAN shared stories involving neurologists, prior authorization in Medicare Advantage, and the impact it has on patients.

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