capitol hill report: LATEST EFFORTS ON TELEHEALTH, ADUCANUMAB, MEDICARE FEE SCHEDULE

July 26, 2021

Latest Advocacy News

The AAN joined the American Geriatrics Society and the Society of Nuclear Medicine & Molecular Imaging to send a letter to the Centers for Medicare & Medicaid Services (CMS) requesting coverage of beta amyloid PET scans to detect amyloid, following the FDA approval of aducanumab.
The AAN endorsed three new telehealth bills: The Permanency for Audio-Only Telehealth Act (H.R. 3447) introduced by Reps. Jason Smith (R-MO) and Josh Gottheimer (D-NJ); The Advancing Telehealth Beyond COVID-19 Act (H.R. 4040) introduced by Reps. Liz Cheney (R-WY) and Debbie Dingell (D-MI); and The Protecting Rural Telehealth Access Act (S. 1988) introduced by Sens. Joe Manchin (D-WV), Jeanne Shaheen (D-NH), Joni Ernst (R-IA), and Jerry Moran (R-KS).
On July 13, CMS issued a proposed rule updating payment policies and rates for physicians paid under the Medicare Physician Fee Schedule in 2022. Despite a difficult economic year, CMS expects payments across the specialty of neurology to increase in 2022 by one percent with variations depending on the individual provider’s practice. Read the AAN summary. The AAN will submit comments.
The AAN joined a broad coalition of physician and other health professionals in urging Congress to maintain the 3.75-percent increase to physician payments for another two years.

Issue In Focus

Brian Callaghan, MD, MS, FAAN, provided a statement on behalf of the Academy [watch beginning of video] at the July 15 Institute for Clinical and Economic Review (ICER) meeting on "Aducanumab for Alzheimer’s Disease: Effectiveness and Value." ICER is an independent non-profit research organization that conducts comparative clinical effectiveness reviews of prescription drugs, medical tests, devices, and health system delivery innovations. The organization engages with key stakeholders including patients and providers to inform its evidence reviews, which are often used by insurers to determine coverage. In 2020, ICER began working on its assessment of the new Alzheimer's drug, and most recently held this public meeting to deliberate and vote on the evidence presented in its report.

The AAN's comments at the meeting highlighted concerns with the irregular clinical trial process and the need for additional data. Callaghan also stated that the AAN agrees that due to the high systemic and out-of-pocket costs of the new drug, aducanumab could only be administered to a very small number of patients before the need for federal policy changes to address access and affordability.

Other neurologist participants in the meeting included:

Annette Langer-Gould, MD, PhD, and Jeffrey Klingman, MD, as members of the California Technology Assessment Forum (CTAF)
Victor Henderson, MD, FAAN, and Sarah Kremen, MD, participated in the Policy Roundtable

After the evidence was reviewed, the California Technology Assessment Forum voted unanimously that the drug does not provide benefits beyond the standard of care. A final evidence report will be released in August. Learn more about the ICER assessment here.

What We're Reading

CMS Proposes 2022 OPPS Rates, Higher Hospital Price Transparency Penalty (RevCycleIntelligence)
What FDA’s Accelerated Approval of Aducanumab Means for Other Neurology Drugs (Neurology Today)
Congress has a 'time-limited window' to shake up drug pricing, employers, health groups say (FiercePharma)