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April 21, 2025

The state of Medicare and Medicaid

We want to make sure you know we have your back. We’re actively responding, relentlessly pushing forward, and ensuring your voice is heard loud and clear on Capitol Hill. Please keep reading Capitol Hill Report—and tell your colleagues—for a rundown of how your AAN is in overdrive advocating on your behalf. We’re analyzing and monitoring all changes made by Congress and the administration to evaluate any impacts on neurology and the patients we serve. If your practice, research, or patients have been impacted by recent changes at the federal or state level, please let us know by emailing advocacy@aan.com.

Issue in focus

As the administration and Congress begin negotiations on budget reconciliation, patient access to care has been front and center. The administration is looking to make certain tax cuts permanent and fund additional resources at the border. To do that, Congress is being asked to make cuts from other areas in order to offset these additional expenses. In the health care space, the conversation has centered around Medicare and Medicaid.  

As Congress continues to work on this process, it’s important they hear from you about protecting patient access to Medicare and Medicaid. Use this to write your members of Congress today and ask them to protect these important programs!  

Medicare 
While the policymakers have made it clear they don’t want to negatively impact seniors’ access to Medicare coverage, they are considering several policy changes that may result in savings. These include making Medicare payments “site neutral," which would stop providers who work in a hospital or hospital-owned setting from charging higher reimbursement rates than those in non-hospital-owned settings, making changes to the inpatient-only list, and adjusting rules around “bad debt." Reforms to Medicare are not expected to be the main driver of savings in a reconciliation package, but the AAN will continue to monitor legislative proposals from Congress and assess their impact on patients with neurological conditions.

As part of these negotiations, champions for neurology and other physician specialties in Congress are also seeking to include a fix to physician reimbursement under Medicare. Congress was unable to pass legislation that would stop the 2.8% cut to the Medicare Physician Fee Schedule (MPFS) that went into effect on January 1, 2025. Our supporters in Congress, led by physicians elected to the House and Senate, are looking to address that cut and include more long-term reforms to the MPFS. These include an inflationary update to reimbursement tied to the Medicare Economic Index (MEI) and adjusting the triggers for budget neutrality requirements in the MPFS. The AAN is tirelessly working every day for you and your patients in Washington, DC, to get these measures included in budget reconciliation or passed as standalone legislation. Use this to let Congress know this is important to neurologists and patients with neurological conditions in their state. 

Medicaid 
There has been a lot of conjecture about potential reforms to Medicaid as part of budget reconciliation. The main committees of jurisdiction over federal Medicaid policy, Energy & Commerce, and Health, ºÃÉ«ÏÈÉú, Labor, and Pensions, are tasked with cutting a significant amount of money from their jurisdictions to fund other spending. While we expect some of that will come from changes to the federal funding of Medicaid programs, it’s important to note that there have been no concrete proposals made to date for how the committees will consider addressing the program.  

The AAN is committed to ensuring all patients with neurological conditions have access to the high-quality neurological care they need. The AAN is working with Congress to ensure that our patients are not negatively impacted by any proposed policy changes. As we monitor the work of these committees, we will continue to inform you about what’s happening, how it affects you, and what you can do to stand up for your practice and your patients. You can use this to let your members of Congress know just how important Medicaid is to patients in your state.  

The AAN continues to advocate for fair and increased reimbursement for members of the neurology care team. If you have any questions about what’s happened to date, what we’re doing to advocate for you, or how you can get involved, please don’t hesitate to contact us at advocacy@aan.com.

Latest advocacy news

AAN monitoring leaked draft document proposing to decrease Department of Health and Human Services budget 
A leaked draft document indicates that the President's Fiscal Year 2026 budget proposes to decrease the budget for the Department of Health and Human Services (HHS) by over $40 billion dollars. While the leaked document is a preliminary memo that may not ultimately be finalized, the proposed cuts include a $20 billion cut to the National Institutes of Health, among other significant cuts to agencies, including the Centers for Disease Control and the Food and Drug Administration. Upon official release, the President's budget proposal serves as a benchmark for ongoing congressional budget negotiations, but ultimately any cuts to HHS would need to be negotiated and passed through Congress. The AAN is continuing its work to educate policymakers regarding the critical need for robust neuroscience research funding and ongoing support for crucial functional areas impacting neurology across HHS. 

AAN sends introductory letter to CMS Administrator Dr. Mehmet Oz 
The AAN sent a letter last week to Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz to introduce the AAN and recognize Dr. Oz’s confirmation. This letter is the first opportunity for the AAN to form a productive relationship and discuss some of our top priorities related to Medicare.  

AAN submits written testimony in support of increased funding for neuroscience research 
The AAN submitted written testimony earlier this month in support of increased funding for neuroscience research to the House Appropriations Subcommittee on Labor, Health and Human Services, ºÃÉ«ÏÈÉú, and Related Agencies. This letter specifically asked for increased funding for the National Institute of Neurological Disorders and Stroke (NINDS) and the BRAIN Initiative. 

AAN sends letter supporting permanent standard time 
The AAN sent a letter this month in support of permanent standard time to the Senate Commerce Committee. This letter was sent in advance of a hearing on “locking the clock” at which AAN member Karin Johnson, MD, FAAN, testified.  

What we're reading

• Understanding Prior Authorizations and Other Forms of Utilization Management, and How Delays in Healthcare Impact Both Patients and Doctors (Podcast - Your Health Your Wealth Podcast on or )
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