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Stroke Advocacy Network eNews - January 2016

IN THIS ISSUE: Telemedicine Initiative | Increased Funding | Regulatory Roundup

National Stroke Association Endorses Bill to Expand Access To Telemedicine

National Stroke Association has endorsed the Interstate Medical Licensure Compact drafted by the Federation of State Medical Boards.

The compact—which has been approved by 12 states—aims to expand access to quality healthcare, especially for those in rural and medically-underserved areas of the country. The compact will expedite the licensing process for qualified physicians and reduce barriers to obtaining licensure in multiple states and jurisdictions.

By significantly streamlining the licensure process for out-of-state physicians, the compact is expected to expand access to healthcare and facilitate new modes of healthcare delivery, such as telestroke care and telemedicine.

“The compact will continue to ensure state-based regulation of the medical profession while simultaneously promoting access to qualified and experienced physicians in high-need specialties and in rural and underserved areas,” said Matt Lopez, CEO of National Stroke Association. “Not only does the compact protect patients but it will increase the availability of telestroke care and telemedicine monitoring that can help control stroke risk factors like high blood pressure and diabetes.”

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Federal Bill Increases Stroke Research Funding

In December, the House and Senate passed and President Obama signed the omnibus spending bill that provides significant increases for stroke-related medical research and represents a victory for the stroke community’s advocacy efforts.

Check out the funding trends for critical research programs below:


2013 Funding

2014 Funding

2015 Funding

2016 Funding

National Institutes of Health (“NIH”)

$29.212 billion

$30.16 billion

$30 billion

$32 billion

National Institute of Neurological Disorders and Stroke (“NINDS”)

$1.534 billion

$1.588 billion


$1.696 billion

BRAIN Initiative


Approx. $40 million

$65 million

$85 million

Precision Medicine Initiative




$130 million


Here’s more about these research programs:

The National Institutes of Health is a federal agency that aims to promote the health of the U.S. by providing leadership, guidance, and funding to support a range of medical research activities.

The National Institute of Neurological Disorders and Stroke works to increase scientific knowledge about the brain and nervous system and to use that knowledge to reduce neurological disease.

The BRAIN Initiative is a new presidential initiative promoting research that will deepen our understanding of precisely how the human brain works and will enable researchers to develop innovative technologies to treat, cure, and even prevent brain disorders.

The Precision Medicine Initiative aims to advance research, technology and policies to promote a new era of medicine in which researchers, providers and patients work together to develop individualized care and treatment plans that take into account variable genes, environment, and lifestyle.

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Learn more about regulatory issuesRegulatory Roundup

During the last quarter of 2015, National Stroke Association was hard at work providing feedback on a variety of regulatory issues. Below is a summary of the comments we submitted.

Comments on the CDC Healthy People 2020 Goals

As a member of the Atrial Fibrillation (“AFib”) Optimal Treatment Task Force, National Stroke Association submitted comments on the Centers for Disease Control and Prevention’s heart disease and stroke prevention guidelines in its Healthy People 2020 initiative. The AFib Optimal Treatment Task Force works to address disparities in the diagnosis and prophylactic treatment of stroke among individuals who suffer from AFib. Individuals with AFib are not only five times more likely to experience a stroke, but AFib-related strokes are twice as deadly than non-AFib related stokes.

We requested that the CDC modify its existing heart disease and stroke prevention guidelines in its Healthy People 2020 initiative to address two AFib-specific points. We asked that the guidelines clearly articulate that AFib is a controllable risk factor in stroke prevention and we requested that the CDC’s updated guidelines address the under use of anticoagulations in older AFib patients.  We believe that these two additions to the current guidelines will increase awareness about the use of anti-coagulants to control this risk factor.

Comments on Section 1557 of the Affordable Care Act

National Stroke Association commented in support of a new non-discrimination rule under Section 1557 of the Affordable Care Act. The proposed rule prohibits discrimination in healthcare programs on the basis of multiple characteristics, including sex, sex stereotypes, and gender identity. The proposed rule would be the first federal prohibition directly prohibiting sex discrimination in healthcare settings.

The third leading cause of death among women in the U.S. is stroke – compared to the fifth leading cause of death for men. In addition, 60,000 more women than men experience stroke each year. In order to reduce the national incidence of stoke, it is imperative that women receive equal access to healthcare programs and products. The proposed rule would not only ensure women equal access the healthcare marketplace but will also provide the Office for Civil Rights the tools to enforce this non-discrimination policy.

Comments on Revisions to Requirements for Discharge Planning

National Stroke Association supports a new requirement for increased discharge planning between patients and their care providers. Discharge planning is a necessary component of quality healthcare for both stroke survivors and their caregivers. Currently, discharge planning for outpatients is not required by healthcare facilities. Being released from the hospital without a discharge plan greatly increases stroke survivors’ chances of readmission or other negative health outcomes.

The Centers for Medicare and Medicaid Services’ proposed rule does not require discharge planning for all observation status patients. National Stroke Association recommended that the scope of the proposed rule be extended to include all patients who stay overnight in a hospital and are classified as observation status, but not covered by the current proposed rule.

Coalition Comments on Section 1557 of the ACA

As a member of the Coalition to Preserve Rehabilitation, National Stroke Association joined in submitting comments on the proposed non-discrimination rule under section 1557 of the Affordable Care Act using the Secretary of Health and Human Services to explicitly articulate what constitutes prohibited discrimination in insurance plan and benefit design. Plan and benefit designs often discriminate against people with disabilities and multiple states are in violation of breeching non-discrimination codes within the ACA. Our comments call on the Secretary to clarify whether current plan and benefit designs, such as limitations or caps on coverage or services, limitation and exclusions of certain devices, related discriminatory treatment of covered benefits, and plans that limit rehabilitative or habilitative services, are prohibited as discriminatory under the new proposed rule.

Comments on Managed Care Plan Networks

Together with over 100 other organizations, National Stroke Association joined in submitting comments on the National Association of Insurance Commissioners (NAIC) Managed Care Plan Network Adequacy Model Act. The act often guides state and federal regulators in evaluating the adequacy of insurance networks offered for sale in plans to the public. Comments on the model act urged three main revisions.  First, the comments recommended that the act should require active approval of networks adequacy prior to the insurance products being sold to the public. Second, we recommend the act require quantitative measures to evaluate network adequacy. Finally, we recommend that all tiered networks be regulated under the model act to prevent discriminatory network design and ensure network adequacy.

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