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Stroke Advocacy Network Newsletter

MAY 2011

Legislative Updates | What You Can Do Today!  

Legislative Update 

Government Shutdown Avoided

Because Congress did not pass any of its regular spending bills by the beginning of the current fiscal year (FY 2011) on October 1, 2010, the government was running on a series of short-term funding mechanisms called continuing resolutions. In mid-February, House Republicans passed a spending bill (H.R. 1). The bill would have cut spending by nearly $100 billion, including a $1.6 billion cut from the National Institutes of Health (NIH). However, the Senate rejected the bill. The House and Senate began negotiating a compromise over federal government spending for FY 2011, and those negotiations came to a boil in April, when the government came within hours of shutting down. However, an agreement was reached before that deadline, keeping the government open for business.

That agreement was a final continuing resolution for the current fiscal year (FY 2011). It reduces spending by nearly $40 billion and funds the government through the end of the fiscal year on September 30, 2011. While many programs were hit hard by the cuts, the NIH budget was largely spared.

In the agreement, nearly $40 billion in spending was cut from previous (FY 2010) levels. The NIH was reduced by $210 million, leaving a total budget of $30.8 billion for FY 2011. The $210 million will be taken equally from the budgets of every office within NIH, including the National Institute of Neurological Disorders and Stroke.

National Stroke Association Virtual Lobby Days Starting on June 23

Starting on June 23, National Stroke Association will host virtual lobby days to encourage people to reach out to their members of Congress and tell their stories. Watch for information about this event in the near future. Your efforts will help strengthen the power of National Stroke Association’s message in Washington, D.C. We look forward to “seeing” you beginning on June 23!

Debate About Funding for the Next Fiscal Year (FY 2012) Has Begun

One day after passing the budget for FY 2011, the House passed Budget Committee Chairman Paul Ryan’s FY 2012 budget resolution. Representative Ryan’s resolution is a sweeping budget plan that reduces spending from $1.91 trillion to $1.019 trillion for FY 2012 (a difference of $891 billion). In comparison, the President’s FY 2012 total budget request is $1.121 trillion (a reduction of $789 billion).

In addition to reducing federal spending, the budget resolution also calls for major changes to the Medicare system for those under 55 years of age. In his plan, Rep. Ryan calls for a shift to a voucher system, providing an average of $11,000 to elderly and disabled Americans to purchase a private, Medicare-approved health insurance plan. Rep. Ryan’s proposal also converts the funding of Medicaid from its current system of the federal government matching state dollars to a block grant system. The new system would provide states with a fixed amount of money to spend on Medicaid services, with a federal spending cap focusing on cutting Medicaid costs by $770 billion over 10 years. Even though Rep. Ryan’s resolution passed the House, it is not expected to be adopted by the Senate.

Bill to Permanently Repeal the Medicare Therapy Cap Introduced

On April 14, Rep. Jim Gerlach (D-PA) and Sen. Benjamin Cardin (D-MD) introduced bills to permanently repeal the Medicare therapy cap. Rep. Xavier Becerra (D-CA) and Rep. Andre Carson (D-IN) signed on as cosponsors to the House version of the bill, the “Medicare Access to Rehabilitation Services Act of 2011” (H.R. 1546). A bipartisan group of nine Senators signed on as cosponsors to the Senate version (S. 829).

Originally passed with the Balanced Budget Act of 1997, the therapy cap limits the amount of money that Medicare can pay annually for speech and physical therapy combined and for occupational therapy. The cap is currently set at $1,870 per year.

Congress prevented the implementation of the provision until an exemption process was developed in 2006, which allowed patients who had reached the cap to receive additional therapy if the services are determined to be medically necessary. Congress has approved the exemption process each year since 2006, with the current exemption expiring on December 31, 2011. Both H.R. 1546 and S. 829 would permanently repeal the cap, instead of requiring the exemption process to be approved each year.

Bill Introduced to Allow Medicare to Cover Drugs for Off-Label Uses

Rep. Mac Thornberry (R-TX) introduced a bill (H.R. 1055) on March 11 that would allow Medicare participants of Part D to receive coverage for the use of “off-label” medications if the usage has been supported by clinical evidence in peer-review publications and meets guidelines to be established by the Secretary of Health and Human Services.

When the Food and Drug Administration (FDA) approves a drug for use, the approval comes with a list of specific purposes for the drugs’ usage, but physicians are free to prescribe drugs for any use. Doctors commonly prescribe drugs for off-label purposes, particularly with older, generic drugs. However, Medicare does not cover prescriptions for off-label purposes, with the exception of cancer treatments. Rep. Thornberry’s bill would allow Medicare to expand its coverage of off-label prescriptions.

"Doctors and patients should be able to choose the safest and most effective medications for their treatments," Rep. Thornberry said. "Right now, the requirements for coverage of the off-label use of a drug are burdensome and often result in Medicare patients not being able to get the drug coverage they need. Our bill helps fix that problem."

What You Can Do Today

SAN Action Center with url
  1. If you aren’t a member of the Stroke Advocacy Network, join today. It’s free and easy, and it will help you stay updated on what you can do to raise stroke awareness.

    Click here to join the Stroke Advocacy Network

  2. Write to your members of Congress through the Action Center. Send a letter to your legislators asking them to take action on stroke-related issues being debated in Washington, D.C.

    Click here to take action

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 Supported by Boehringer Ingelheim Pharmaceuticals, Pfizer, Inc., and The Medtronic Foundation.