NeurosurgeryPAC in Action
The AANS has an active, valuable and effective Political Action Committee, or PAC, which provides organized neurosurgery with vital access to lawmakers on Capitol Hill and allows neurosurgeons to voice their views on critical issues facing their practice and their patients.
NeurosurgeryPAC's recent accomplishments include:
- As a leader of the Regulatory Relief Coalition, neurosurgery is calling on Congress to pass legislation to regulate the use of prior authorization by Medicare Advantage plans. Such legislation would increase transparency, streamline the prior authorization process, and minimize the use of prior authorization for services that are routinely approved. The Improving Seniors’ Timely Access to Care Act (H.R. 3107), introduced by Reps. Suzan DelBene (D-Calif.); Mike Kelly (R-Pa.); Ami Bera, MD, (D-Calif.); and Roger Marshall, MD, (R-Kan.). The bill would protect patients in Medicare Advantage from unnecessary prior authorization practices that limit their timely access to medically necessary care.
- The Safe Step Act (S. 2546/H.R. 2279) — introduced in the Senate by Sens. Lisa Murkowski (R-Alaska); Bill Cassidy, MD, (R-La.); and Doug Jones (D-Ala.), and in the House of Representatives by Reps. Raul Ruiz, MD, (D-Calif.) and Brad Wenstrup, DPM, (R-Ohio) — would place reasonable limits on step therapy. Step therapy is a troubling practice that requires patients to try — and fail — treatments preferred by their insurance company and pharmacy benefits manager before a doctor-prescribed option can be approved
- Neurosurgery is encouraging policymakers to establish network adequacy standards that require plans to offer a sufficient number and type of specialists and subspecialists in their provider networks, while at the same time maintaining patient choice through out-of-network options. We recommend that Congress pass legislation modeled after proven state approaches that protect patients from unanticipated medical bills for out-of-network care, while at the same time facilitating a process to quickly, efficiently and fairly resolve physician and health plan billing disputes using a “baseball-style” arbitration process. Bills supported by neurosurgery include:
- S. 1531, the STOP Surprise Medical Bills Act, introduced by Sens. Bill Cassidy, MD, (R-La.) and Michael Bennet (D-Colo.); Todd Young (R-Ind.); Maggie Hassan (D-N.H.); Lisa Murkowski (R-Alaska); and Tom Carper (D-Del.).
- H.R. 3502, the Protecting People from Surprise Medical Bills Act, introduced by Reps. Raul Ruiz, MD, (D-Calif.) and Phil Roe, MD, (D-Tenn.).
- The Competitive Health Insurance Reform Act (S. 350/H.R. 1418), introduced by Sen. Steve Daines (R-Mont.) and Rep. Peter DeFazio (D-Ore.), would repeal the McCarran-Ferguson antitrust exemption for health insurance companies and would authorize the U.S. Justice Department and Federal Trade Commission to enforce the federal antitrust laws against health insurance companies engaged in anticompetitive conduct.
- Organized neurosurgery is leading efforts to promote legislation that would ensure fair and adequate reimbursement for neurosurgical services. To provide access to vital surgical services, Medicare must maintain the 10- and 90-day global surgery payment package and CMS must not use flawed or incomplete data to revalue global surgery codes. We are working with Congress to prevent future cuts to global surgery services.
- Patients and physicians should be allowed to privately contract in Medicare without penalty to either party. Under current law, physicians who wish to contract privately must opt-out of Medicare for two years, and Medicare will not pay any portion of the physician's services. Through neurosurgery's efforts, Sens. Rand Paul, MD, (R-Ky.) and Lisa Murkowski (R-Alaska) introduced the Medicare Patient Empowerment Act (S. 2812), which would remove these restrictions by allowing physicians to remain in Medicare and enter into private contracts on a case-by-case basis.
- A long-time supporter of efforts to ensure that physicians of all specialties and in all regions of the country are fairly reimbursed for the medical services they deliver to Medicare beneficiaries, neurosurgery endorsed legislation to improve payments to neurosurgeons practicing in rural areas. Introduced by Rep. Abby Finkenauer (D-Iowa), (H.R. 3302), the Keep Physicians Serving Patients Act, would increase payments to rural providers.
- Championed by neurosurgery and introduced by Rep. Richard Hudson (R-N.C.), (H.R. 3656), the Accessible Care by Curbing Excessive lawSuitS (ACCESS) Act, is modeled after proven reforms already in place in Texas, California, and many other states around the country. The legislation would ensure full and unlimited recovery of economic damages and permits the additional recovery of up to $250,000 for non-economic damages, provide a reasonable statute of limitations for filing lawsuits, and limit attorney fees. The ACCESS Act protects the rights of states that have already enacted their own medical liability reforms or choose to do so in the future.
- To provide crucial medical liability protections for neurosurgeons that provide EMTALA-related care, Reps. Bill Flores (R-Texas); Roger Marshall, MD (R-Kan.); and Brian Babin, DDS, (R-Texas) reintroduced the Health Care Safety Net Enhancement Act (H.R. 3984).
- At the request of organized neurosurgery, Sens. Bill Cassidy, MD (R-La.) and Angus King (I-Maine) in the Senate, and Reps. Raul Ruiz, MD, (D-Calif.) and Larry Bucshon, MD, (R-Ind.) in the House, reintroduced the Good Samaritan Health Professionals Act (S. 1350/H.R. 6283). This legislation would ensure that health professionals who provide voluntary care in response to a federally declared disaster have appropriate medical liability protections. The bill aims to address the current inconsistencies in federal and state laws, which may leave physicians vulnerable to lawsuits.
An appropriate supply of well-educated and trained physicians is an essential element to ensure access to quality healthcare services for all Americans. Through the continued advocacy of neurosurgery, policymakers are beginning to understand that there are significant shortages of physicians in both primary and specialty care.
- Sens. Robert Menendez (D-N.J.); John Boozman (R-Ark.); and Charles Schumer (D-N.Y.) in the Senate, and Reps. Terri Sewell (D-Ala.) and John Kayko (R-N.Y.) in the House, introduced the Resident Physician Shortage Reduction Act (S. 348/H.R. 1763). This legislation would increase the number of Medicare-supported residency positions by 3,000 each year for the next five years for a total of 15,000 new residency slots.
- Reps. Brian Babin, DDS, (R-Texas) and Andy Harris, MD, (R-Md.), introduced the Resident Education Deferred Interest Act (H.R. 1554). The bill makes student loan borrowers eligible for interest-free deferment under the William D. Ford Federal Direct Loan Program if the borrowers are serving in medical or dental internships or residency programs.
- The Investment in Tomorrow’s Pediatric Health Care Workforce Act (S. 2443) was introduced by Sen. Jack Reed (D-R.I.) and would reauthorize the Pediatric Subspecialty Loan Repayment Program. This program supports pediatric medical specialists to help ensure that children have timely access to specialized care.
- Championed by neurosurgery and signed in to law last year, the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (P.L. 116-22), reauthorizes programs supporting the country’s response to disease outbreaks, nuclear fallout or other health emergencies. This law provides medical liability protections for volunteer physicians who have pre-registered with the Emergency System for Advance Registration of Volunteer Health Professionals or the Medical Reserve Corps. The law also contains language included in the MISSION Zero Act, which will assist U.S. military health care providers in maintaining a state of readiness by embedding military trauma teams and providers in civilian trauma centers.
- The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act (S. 2741/H.R.4932) was introduced by Sen. Brian Schatz (D-Hawaii) and Rep. Mike Thompson (D-Calif.). Supported by neurosurgery, this bill would expand access to telehealth services.
- The Concussion Awareness and Education Act (H.R. 280) was reintroduced by Rep. Joyce Beatty (D-Ohio). This legislation would provide for systemic research, treatment, prevention, awareness, and dissemination of information for sports-related and other concussions.
- The Protect Medical Innovation Act (S. 692/H.R. 2207), sponsored by Sen. Pat Toomey (R-Pa.) and Rep. Ron Kind (D-Wisc.), repealed the excise tax on medical device manufacturers and importers. This bill was incorporated into the Further Consolidated Appropriations Act (P.L. 116-94).
- The Further Consolidated Appropriations Act (P.L. 116-94) reauthorized the Patient-Centered Outcomes Research Institute (PCORI) for an additional 10 years. PCORI sponsors comparative effectiveness research to help physicians and patients better evaluate treatment options.
- Supported by neurosurgery, the Further Consolidated Appropriations Act (P.L. 116-94) the bill included $41.68 billion for the National Institutes of Health, an increase of $2.6 billion, or 6.7 percent, above FY2019. Priorities include:
- $500 million for the Brain Research through Application of Innovative Neurotechnologies (BRAIN) Initiative to map the human brain, a $71 million increase;
- $818 million for research on opioid addiction, development of opioids alternatives, pain management, and addiction treatment; and
- Funds for research on the deadliest cancers, which include anaplastic astrocytoma, diffuse intrinsic pontine glioma, glioblastoma, and high-risk neuroblastoma.
- Ellie’s Law (S.864/H.R. 594), introduced by Sen. Richard Blumenthal (D-Conn) and Rep. Yvette Clarke (D-N.Y.), would authorize $5 million each year in 2020 through 2024 for further comprehensive research at the National Institute of Neurological Disorders and Stroke on unruptured intracranial aneurysms.
- Introduced by Sen. Tom Udall (R-N.M.) and Rep. Ben Ray Lujan (D-N.M.)The Cerebral Cavernous Malformations Clinical Awareness, Research and Education (CCM-CARE) Act (S. 2010/H.R. 3573), would provide crucial insights into CCM by expanding research at the NIH, CDC and FDA, to increase awareness, treatment and prevention of CCM.
To check on the status of any of these pieces of legislation, please visit https://www.congress.gov/.