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Congressional Support Grows for Key AAN Legislation
Capitol Hill Report
The New York and Kentucky delegations advocated on Capitol Hill.
Capitol Hill Report presents regular updates on legislative and regulatory actions and how the Academy ensures that the voice of neurology is heard on Capitol Hill. It is emailed to US members twice monthly and is posted at AAN.com/view/HillReport. Below are some recent highlights.
Congressional Support Grows for Key AAN Legislation
Issue in Focus
In June, the AAN’s signature bipartisan prior authorization legislation, the Improving Seniors’ Timely Access to Care Act of 2021 (H.R. 3173), obtained a record-breaking 296 cosponsors. The legislation in the previous Congress maintained 280 cosponsors. In this Congress, the legislation’s large cosponsor list triggers the discharge petition, which is a procedural motion that allows a bill that has passed 290 cosponsors and has maintained that number for 25 legislative days to skip committee procedure and a vote is scheduled on the consensus calendar. This news is particularly timely, considering in late May more than 160 AAN members from across the country traveled to Washington, DC, to share AAN advocacy priorities with Congress in one unified voice. Among these advocacy priorities were addressing the overly burdensome barriers to care by supporting the Improving Seniors’ Timely Access to Care Act of 2021 (S. 3018/H.R. 3173) and cosponsoring the Safe Step Act (S. 464/H.R. 2163). The AAN’s efforts to reform prior authorization protocols got a boost recently when the American Hospital Association recommended that the US Department of Justice establish a task force to examine routine denials from major health insurance companies. “Together with the COVID-19 pandemic and the inefficiency of prior authorization, patients have been subjected to further delays in their neurologic care,” said AAN President Orly Avitzur, MD, MBA, FAAN. “Prior authorization needs to be brought into the 21st century. For this reason, the AAN is pleased to support the Improving Seniors’ Timely Access to Care Act of 2021 to create an electronic prior authorization program, increase transparency to assist in choosing the right plans, and ensure requests are approved by qualified medical personnel. This legislation is undoubtedly a step in the right direction for neurologists and their patients.”
Latest Advocacy News
Sixteen senators and four representatives submitted letters in support of the AAN’s request to significantly boost the annual appropriations for VA Neurology
Centers of Excellence. Nineteen senators and 64 representatives submitted letters in support of robust funding for the BRAIN
Initiative, an annual medical research priority for the AAN. The AAN, along with 120 other organizations, endorsed the “Characteristics of a Rational Medicare Physician
Payment System” published by the American Medical
Association. This set of principles provides a framework for payment reform as an early step in a broader effort to develop consensus across the house of medicine.
There’s Still Time to Register for the New Summer Conference
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This one-of-a-kind conference opportunity will offer the latest updates in the science and education of one of the most rapidly evolving fields in modern neurology and feature a variety of styles including didactic lectures, hands-on experiences, casebased presentations, and more. Upon completion, participants should be able to: Recognize and diagnose neurologic autoimmunity Interpret diagnostic testing for neurologic autoimmunity Avoid neurologic autoimmunity misdiagnosis and recognize the pitfalls Manage and treat neurologic autoimmune disorders Visit AAN.com/SummerConference to browse the full program and secure your spot today.
Conference Directors
Anastasia Zekeridou, MD, PhD
Mayo Clinic in Rochester, MN, will co-direct the Autoimmune Neurology program
Stacey Clardy, MD, PhD, FAAN
University of Utah, will co-direct the Autoimmune Neurology program
Nicole Beaton Sur, MD
University of Miami, will direct the Neurology Year in Review program
Choose the Registration Package That’s Right for You!
Full Registration
Experience the meeting in person in San Francisco and through virtual replay! The single registration fee includes access to sessions, events, Poster Hall, and the Exhibit Hall in San Francisco, and the virtual platform with session recordings through August 15, 2022.
Virtual Registration
Attend wherever you have an internet connection! Watch all sessions live-streamed, and access session recordings in the online platform through August 15, 2022. Note that the events, information in the Exhibit Hall, and Posters are NOT available virtually or on demand and are only available with in-person attendance.
Upgrade to Gold Registration
No matter which package you choose, when you upgrade to Gold you extend access to content through the Virtual Rewind in the Online Learning Center until May 30, 2023!
July 15–16, San Francisco and Virtual
COVID-19 and Safety
Because of our commitment to creating a safe and healthy environment for participants, all in-person attendees in San Francisco are required to be “up to date” with their COVID-19 vaccines (as defined by the CDC). The current CDC definition of “up to date” is: “A person is up to date with their COVID-19 vaccination if they have received all recommended doses in the primary series and one booster when eligible. Getting a second booster is not necessary to be considered up to date at this time.”
Neurology Video Journal Club Premieres
The Neurology® Video Journal Club was recently launched by the AAN’s flagship scientific publication. Learn from experts as they discuss recent Neurology journal articles and hot topics in the specialty. Articles and discussants are selected by the editors of Neurology.
Merino
“The new Video Journal Club is another opportunity for the journal to disseminate the discoveries that we publish and to place research findings in their clinical context,” said Neurology’s Editor-in-Chief José G. Merino, MD, MPhil, FAAN. “Clinicians and researchers will discuss the methods, findings, and strengths and limitations of selected papers published in Neurology and, most importantly, discuss the implications of the research for clinicians. We expect that this format will also be useful to residents and fellows who are learning to appraise and use clinical research papers. And we hope that authors will appreciate the greater visibility of their work that this series provides.” The tentative schedule and topics for the first year include: May—Stroke June/July—Cognitive/Dementia/
Alzheimer’s Disease August/September—Migraine October/November—Epilepsy December/January—Parkinson
Disease February/March 2023—Multiple
Sclerosis Each video discussion will last between 15 and 30 minutes and will cover a summary of the study, what the paper adds, limitations of the study, implications for clinicians, and what comes next from clinical and research perspectives. New videos will post online on Fridays, so check back weekly for new content. Visit Neurology.org/video-journal-club to learn more and enjoy these thoughtprovoking discussions.
EDUCATION
ABPN Grant Offers Complimentary Access to AAN CME Opportunities
For a second year in a row, the American Board of Psychiatry and Neurology (ABPN) is offering a generous grant to the Academy that will provide all AAN members and ABPN diplomates free access to three popular AAN online CME opportunities. To access the programs, AAN members should log in to the Online Learning Center at Learning.AAN.com with their AAN ID or associated email address and search for these products. Please note: Members who have previously claimed credit for sessions attended at the 2021 Fall Conference or completed these products will not be able to claim credit twice. 2021 AAN Fall Conference On Demand
Available now through August 15, 2022
Fall Conference On Demand is the comprehensive digital library of content with more than 20 hours of presentations from the virtual 2021 AAN Fall Conference and offers up to 43 CME credits. This program offers timely clinical updates from noteworthy experts on the hottest topics in neurology, real-world issues in practice management, and innovative science. NeuroSAE® 16th Edition
Available now through December 31, 2022
This 16th edition of the AAN’s popular online self-assessment exam with opportunities to earn up to eight self-assessment
CME credits. AAN Patient Safety Education Program
Available July 15 through December 31, 2022
The updated edition of this popular patient safety course offers 4.0 SA CME PS credits and is designed to help participants meet the ABPN’s one-time requirement of diplomates to complete an approved patient safety course within three years prior to their board certification/ recertification, or in their first C-Continuing Certification block. Participants will learn to identify and apply mitigation strategies to potential patient safety risks. For questions, contact onlinelearningcenter@aan.com.
UCNS 2022 Continuous Certification Reading Lists and Quizzes Now Available
The United Council for Neurologic Subspecialties Continuous Certification (C-cert) reading lists are now available at UCNS. org/ReadingLists for diplomates in all UCNS subspecialties. Diplomates who have paid their 2022 C-cert administrative fee will receive links to access their subspecialty quizzes via email. 2022 marks the third year of C-cert, a program in which diplomates maintain their certification by meeting annual requirements as opposed to the previous time-limited certificates and high-stakes recertification examination process. C-cert activities provide subspecialty learning and knowledge assessment to ensure that diplomates are staying up-to-date on the latest science, treatments, and therapeutics relating to their subspecialty, and include reading the annual subspecialty reading list of journal articles and taking and passing a 25-question online post-reading quiz to assess knowledge gained from the journal article content. UCNS certification is continuous and does not expire when diplomates meet the annual C-cert requirements. For questions, contact Bryan Hagerla, C-cert Manager, at bhagerla@ucns.org.
Submit Journal Articles for 2023 C-cert Reading List
All certified diplomates and the subspecialty sponsoring organization members are encouraged to submit journal articles or practice guidelines that meet the submission criteria for the 2023 C-cert subspecialty reading lists. All submissions will be reviewed by the subspecialty’s examination committee, a committee of subject matter experts who are nominated by the subspecialty’s sponsoring organization(s). Learn more and access the C-cert reading list submission criteria at UCNS.org/ArticleSubmission.
UCNS Annual Report Highlights 2021 Accomplishments
Despite the myriad challenges of the COVID-19 pandemic, the United Council for Neurologic Subspecialties successfully adapted to meet—and often exceed—its 2021 goals. The recently published 2021 Year in Review outlines some of these accomplishments, including gains in UCNS certification recognition, a summary of the subspecialty of the overall certification and accreditation status, and the results of a diplomate survey which provides valuable feedback on the new continuous certification process. Some goal highlights include the receipt of 13 new program accreditation applications, bringing the total number of accredited programs to 223; and 164 certification applications received with 90 percent of candidates passing certification exams. By year-end, the UCNS had 120 new diplomates and a total of 3,001 diplomates in eight neurologist subspecialties. You can view the full 2021 report and compare the UCNS’s annual growth to previous years’ reports at UCNS.org/AnnualReports.
New Editions, Format of NeuroSAE Now Available continued from cover
Neurology self-assessment and lifelong learning component (part 2) for continuing certification, have been updated and expanded. Rather than the previous format of offering two 100-question editions twice per year, NeuroSAE will now be offered in a shorter, more digestible format will provide increased convenience and accumulated access to 200 new questions per year. Written by neurologists for neurologists, each new case-based NeuroSAE examination will offer convenient 30-minute learning opportunities and clinical questions to help you test your knowledge and stay current. Upon completion of all eight annual editions, participants can earn up to 16 selfassessment CME. NeuroSAE is a free AAN member benefit. Learn more and access the first two editions at AAN.com/NeuroSAE.
On Cusp of 100th Birthday, Guinness World Record Holding Member Also Achieves FAAN Status
On July 10, Howard J. Tucker, MD, FAAN, will turn 100—years young! And the inspiring Guinness World Record holder for the oldest practicing doctor in the world has no plans of slowing down anytime soon. In fact, while the Guinness milestone may arguably mark the Cleveland, OH, native’s crowning achievement in a more than 75-year career filled with impressive achievements, he recently sought— and attained—yet another milestone within his beloved Academy: that of the prestigious FAAN (Fellow of the American Academy of Neurology) designation. So, what keeps this beguiling centenarian inspired and motivated to not only continue practicing neurology, but endeavoring to reach further milestones? Tucker didn’t even need a second to think about it. “First thing, neurology is fascinating. Second thing, I am learning new things every day. Third thing, it’s a lot of fun. And fourth thing, retirement is the enemy of longevity. If I were to go into a nursing home, I would shrivel up.” Tucker is at no risk of shriveling. “Stay active and alert and motivated and you lead a more content life,” says the man who still loves to snowshoe regularly during the long Ohio winters. He finally decided to give up downhill skiing after fracturing his odontoid 11 years ago at the age of 88. “I hit a tree, wiggled my toes and hands, and thought I’d just go ahead and finish the ski down the hill where I could then ice up,” he recounted. “But they ended up taking me down in a toboggan, and after an x-ray discovered the fracture. So, I don’t ski anymore.” Tucker even remains active with the AAN, having attended Annual Meetings as recently as 2019. “Going to the Annual Meeting is always an inspiration and a learning experience, and I love staying up-to-date on new discoveries, treatments, and directions,” he said. “Last AAN meeting I went to was in Philadelphia—pre-COVID—and I was attending a course where they were discussing epilepsy, and they never mention the antiepilepsy drug phenytoin, which was, of course, discovered by Dr. H. Houston Merritt. I stood up and questioned this and was surprised to learn that phenytoin is now considered a second-tier drug, because even though safe, it can cause osteoporosis and change in facial features. Up until these newer drugs like levetiracetam came out, phenytoin controlled 90 percent of cases, so I was reluctant to give up Dilantin—especially after working under Dr. Merritt's training! So, I learned something there which I thought was exciting!” One can only imagine the changes Tucker has seen and experienced throughout his lifetime and storied career in neurology. And while he wouldn’t hesitate to praise the field’s progress over the last quarter century, he does lament what he sees as a loss of communication between health care providers and their patients. “I would say that neurology, like every other phase of clinical practice, is losing some of the essential communication with patients. While radiology has made gigantic leaps, I never just rely on x-rays. I always take a complete exam and a full, careful history, which takes about five minutes. If you take a thorough history, know which questions to ask, and think all the questions through carefully, you should never be too surprised about what you are going to find,” he explained. Having started medical school in 1947 at Cleveland Clinic before transferring to Tucker Columbia in New York for his residency training between 1951 and 1953, followed by a several-year stint in the Navy, ABPN certification in 1956, and then back to Cleveland Case Western Reserve beginning in 1957, Tucker still recalls his many early inspirations and the germane advice he received from his early neurology mentors and heroes. To today’s budding young neurologists just starting out in their careers, Tucker is quick to advise, “When you hear people who ask, ‘Can I get a second opinion?’ say ‘Yes!’ Don’t be possessive and insecure.” And to seasoned neurologists? “Always consider opinions from someone a little younger, who may know the latest stuff. Don’t be chagrined by getting an opinion from younger neurologists—this is a good thing to bring new perspective!” Even as he is poised to celebrate his 100th birthday this month, Tucker still isn’t ready to hang up his neurology coat. “Retirement is fine for some people—and I don’t knock it—but I can’t grasp it or put my head around it.” Carry on, Dr. Tucker. Carry on. You can learn more about Tucker’s Guinness World Record status at www.guinnessworldrecords.com/world-records/75949oldest-practicing-physician. Happy Birthday
