MARCH 2011

Message from the Stroke Advocacy Network | Legislative Update | What You Can Do Today!  

The Federal Budget Comes to Town

The federal budget process is underway in Washington, D.C., which means that stroke advocates will have plenty of opportunities in the coming term to speak out on funding for stroke programs and services.

Funding decisions for federal programs must go through several steps before they are finalized. The first step, the President’s Budget, outlines the Administration’s views on funding for various federal programs. The U.S. Congress develops its own budget outline called the Budget Resolution. This resolution is the Congressional perspective on funding and may be different from the Administration’s views. 

It is important to note that neither the President’s Budget or the Congressional Budget Resolution are the final word on funding levels for federal agencies. The actual specifics are finalized through the Budget Reconciliation and Appropriations processes.

The most striking part of the proposed budget as it relates to stroke is the focus on treating chronic diseases and conditions, including those that either lead to stroke or result from stroke. One highlight of the budget is a new competitive grant program called the Chronic Disease Prevention Program. This new initiative calls for moving existing money into one program for which states will apply to receive funds. While the new effort recognizes that chronic diseases should be treated holistically, it is possible that as a result of these changes, stroke programs will face increasing competition from other programs addressing chronic diseases.

Following are a few key provisions of the budget that relate to programs that may be of interest to stroke advocates:

• Funding for the Department of Health and Human Services: Under the proposed budget, funding for the Department of Health and Human Services (HHS), which administers many of the programs relevant to those affected by stroke, would be cut by 2 percent. This cut would prove challenging for agencies within HHS such as the Centers for Medicare and Medicaid Services (CMS) that have seen over 8 percent growth in recent years.
  
  
• Medicare Hearings and Appeals: The budget proposes to increase funding for the Office of Medicare Hearings and Appeals by almost $10 million, which may improve the appeals process for many stroke survivors.
  
  
• Access to Medicare Services: The proposed budget envisions the Affordable Health Care for All Act that would improve access to care through Medicare. Some of these provisions  include:
  • Closing the coverage gap for Part D prescription drugs by 2012;
  • Including annual wellness visits in Medicare services free of charge; and
  • Better coordination of care for Medicare patients through new programs.
    
    
• Medicare Payment Freeze: In January 2012, physicians serving Medicare patients were expecting a 25 percent cut in reimbursements for services. The budget proposes to freeze those payments at current levels as opposed to allowing the 25 percent fee to go into effect. This proposal may have a positive impact on patient access to care, especially for Medicare patients.
  
  
• The Prevention and Public Health Fund: Established and authorized in the Affordable Care Act to promote wellness and reduce the burden of chronic disease, the President’s FY12 Budget proposed $1 billion for its first year.
  
  
• National Institute for Neurological Disorders and Stroke: The budget suggests an increase of $29 million for the National Institute for Neurological Disorders and Stroke (NINDS), which is part of the National Institutes of Health (NIH). The mission of NINDS is to reduce the burden of neurological disorders through – among other things – research on the causes, prevention, diagnosis and treatment of neurological disorders and stroke. 
  
  

Revising Quality Measures for Acute Stroke Care

The CMS is developing new rules for quality measures that hospitals must report on in order to receive a cost-of-living increase for Medicare funds. National Stroke Association and other stroke-related interest groups have been working to ensure that stroke measures are included as one set of the quality measurements hospitals must address. The goal is to improve the quality of care provided by hospitals to stroke survivors.

The CMS is likely to act on this issue in April, and Stroke Advocacy Network members can help influence the final rules. Visit the Action Center to access an Action Alert that will help you connect with your legislators with a request for them to urge CMS to include these stroke-related measures.