Neurology on the Hill 2022: Takeaways and Progress

David Evans, MBA, shared his experience from this year’s event and spoke about the progress that’s been made in advocating for patients in the last several years at the AAN's Neurology on the Hill conference.

This week, on May 23 and 24, 2022, the American Academy of Neurology (AAN) hosted its annual Neurology on the Hill conference event in Washington, DC. Crowds of physicians, clinicians, researchers, and scientists crowded the capital to advocate for necessary policy changes to help advance the clinical care of patients with neurologic diseases across the United States.

Each year, the conference goal is for attendees to gain perspective from congressional leaders, consultants, and AAN staff about the processes in politics to better equip themselves to directly address senators and representatives about the issues that matter to their patients. In past years, the efforts have focused on topics such as lowering the out-of-pocket medication costs for Medicare Part D drugs, expanding access to telestroke services, and supporting drug price transparency, among others.

To find out more about this year’s turnout and the issues being advocated for, NeurologyLive® reached out to David Evans, MBA, chair, American Academy of Neurology Health Policy Subcommittee. Evans was on-site in Washington, DC, and shared his experience from the event, as well as spoke about the progress that’s been made in advocating for patients in the last several years at this annual event.

NeurologyLive®: What are the main focuses of Neurology on the Hill this year?

David Evans, MBA: The American Academy of Neurology had 3 areas of focus for our congressional visits during this year’s Neurology on the Hill. Our initial ask was focused on decreasing the barriers to care that are essential to ensure patients receive appropriate care in a timely manner. This ask was comprised of two bills, with the first being The Improving Seniors’ Timely Access to Care Act of 2021 (S. 3018/H.R. 3173), which would streamline the prior authorization process in Medicare Advantage and increase transparency by establishing an electronic prior authorization program, to include a list of services that should be done through real-time adjudication by the payer. It will also standardize the process for services that are routinely approved, and ensure decisions are made by qualified medical personnel. The second is The Safe Step Act (S. 464/H.R. 2163), which implements a clear step therapy exception to complement comparable state bills with limited reach. These state bills have been very effective to ensure patients are not being forced to change medications that have shown to be effective, only because they had a change in job or insurance. This federal bill expands the reach of the state bills by expanding it to include employer-sponsored plans.

Our second ask was to extend the telehealth flexibilities that were widely adopted during the Public Health Emergency and were essential to ensure continued access to healthcare, especially for those that had compromised immune systems and limited mobility. There are several bills floating around, but we are supporting the Telehealth Extension & Evaluation Act (S. 3599/H.R. 7573). This Act extends the current telehealth flexibilities for at least two years after the expiration of the Public Health Emergency, which provides additional time to gather data to better study this issue and enact an evidence-based approach to permanent reforms.

The last ask was to increase the neurology workforce by expanding graduate medical education through the Resident Physician Shortage Reduction Act of 2021 and by reauthorizing and strengthening the Conrad 30 Program. Both bills will help in addressing the current and projected workforce issues encountered by patients needing care from a neurologist.

How does the focus this year differ from prior years? Does that reflect any positive progress?

As you can see, this year has a common thread, and it is all about ensuring patients have access to neurologic care. We all know the cost, not only in dollars, but also in delays in receiving care due to prior authorization programs. We need a major rethink, and we need regulators and commercial payers to be at the table on how to address these. The cost is not only a burden on the healthcare system, but also costly to payers, and about 95% of our services are eventually approved. We aren’t asking to not be held to evidence-based guidelines for care, or that payers should not have medical policies. The American Academy of Neurology is asking to modernize the prior authorization process with the same technology used in every other sector and to not delay timely access to care. This is especially critical with the progressive nature of what neurologists treat. With that, telehealth has exposed so much in our health care system that results in limiting access to care to those who need it most. It is important to ensure that access to healthcare is equitable, regardless of one’s zip code.

What has the experience been like this year, in terms of turnout and your personal experience in DC?

Amazing! Everyone was fired up and ready to advocate for their profession and their patients. The American Academy of Neurology’s “Neurology on the Hill” allows us to tell our stories to lawmakers whose decisions can have a direct impact on everyone’s daily lives. We come prepared with that in mind.

Is there a take-home message for the physician community?

We encourage the physician community to think about our role in advocating year-round. It’s important that our legislators hear from the physicians in their community and understand the challenges facing the health care system as we emerge from the pandemic.

How can neurologists who could not make the trip help to advocate for patients?

Neurologists may apply to attend Neurology on the Hill in the future. There are opportunities for Neurology Off the Hill, where the AAN will help to facilitate a visit with your representative(s). Read the AAN’s Capitol Hill Report and look for AAN emails on timely issues of importance, which will route you to a site with a prepared letter that can be done quickly and sent to your representatives in seconds. We can all do our part to affect change.

Transcript edited for clarity.