Comment and Sign-on Letters: The Power of Persuasion In addition to meetings and other communications, the AAN formally communicates with members of Congress and federal agencies by writing letters on key issues affecting neurology. Such letters are important to the federal government, as they provide a formal record of support or opposition on a topic, as well as details on how policies affect different populations. When the Academy submits a letter on its own initiative, it’s referred to as a “comment letter.” When a letter originates as a collaborative effort between other medical specialty societies, patient advocacy groups, etc., it’s called a “sign-on letter.” So far in 2021, the Academy has sent nine comment letters and endorsed 34 sign-on letters on matters that affect members and their patients. Either way, such letters are written and/or reviewed by AAN physician experts and staff, and the AAN president also reviews if it is a new policy. These letters can also be endorsements of specific bills being introduced in Congress. The COVID-19 pandemic prompted many letters related to a host of health care matters, from telehealth issues to emergency medical supply concerns. In 2020, the Academy authored 10 letters to policy makers outlining neurology’s specific needs during the public health emergency and joined more than 35 sign-on letters related to COVID-19. A recent example of a comment letter, where the AAN sent statements to a congressional committee holding a hearing on telehealth, can be read at https://bit.ly/3opIupM.
AAN’s reputation of authority with key legislative and regulatory decision makers. Our comment letters have been cited often over the past several years by such influential publications such as Politico and STAT, helping solidify the AAN’s reputation when staff schedule meetings with these decision makers.
Collaborative Advocacy Strengthens Neurology Co-signing letters is not the AAN’s only collaborative advocacy work with coalitions of neurologic patient groups and other medical specialty societies. Here are some examples: The AAN convenes a quarterly meeting with neurologic patient groups including the ALS Association, Epilepsy Foundation, Michael J. Fox Foundation, National MS Society, Muscular Dystrophy Association, and others to coordinate advocacy efforts.
Another recent sign-on letter (https://bit.ly/2S25IpE) demonstrates how the AAN joined a letter with several other major medical groups to congressional leadership urging to extend the delay of the Medicare sequester through the end of 2021. Medicare sequestration would result in two-percent across-the-board reduction in Medicare payments. As a result of the advocacy efforts of the medical specialty community, the bill to delay sequestration was signed into law in April 2021.
The Regulatory Relief Coalition is a group of national physician specialty organizations, including the AAN, advocating for regulatory burden reduction in Medicare so that physicians can spend more time treating patients.
These letters also encompass our comments to federal agencies on proposed rules. Once legislation passes Congress, federal agencies must implement the law. Proposed rules are official documents that explains the agency’s plan for implementation and must be published in the Federal Register to notify the public and to give them an opportunity to submit comments. The AAN submits comments on a wide variety of proposed rules, most notably the annual Medicare Physician Fee Schedule proposed rule, which determines reimbursement rates for services under Medicare.
The Academy is a founding member of the American Brain Coalition, which represents professional neurologic, psychological, and psychiatric associations and patient organizations.
The AAN participates in the Graduate Medical Education Advocacy Coalition, convened by the American Association of Medical Colleges.
While these letters provide the Academy’s viewpoint, they are also effective in building the
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