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September 22, 2025

We’ve got your back on Capitol Hill—and we’re in overdrive advocating for you and your patients. Capitol Hill Report is your source for all things neurology advocacy, so keep reading and sharing to stay up to date. Plus, we want to hear from you: Let us know if your practice, research, or patients are affected by recent policy changes.  

Take action to protect access to telehealth 

Without Congressional action, Medicare recipients will lose access to critical telehealth flexibilities. and urge them to support continued access to telehealth past the September 30th deadline! 

Issue in focus

Possible government shutdown
The government’s fiscal year comes to a close on September 30. In order to keep the government funded and fully open, Congress needs to authorize funding through the appropriations process or pass a continuing resolution (CR) by that date. There are also several health care-specific programs and services that will expire on that date without congressional action, including community health centers, telehealth flexibilities, and the Conrad 30 program. As negotiations continue on Capitol Hill, we want to be sure AAN members know how this could impact neuroscience research, your practice, and your patients.  

Appropriations work to date: 
While Congress has not come to a final agreement on funding for Fiscal Year 2026, both the House and Senate appropriations committees have marked up their respective versions of the Labor, Health and Human Services, ºÃÉ«ÏÈÉú, and Related Agencies (Labor-H) bills. The bills contain funding for the Department of Health and Human Services (HHS) and its related agencies—including the National Institutes of Health (NIH). Both bills included an increase in funding levels for the NIH and increased funding levels for the National Institute of Neurological Disorders and Stroke (NINDS). The AAN asked the House and Senate to provide increased funding for neuroscience research at the start of the FY2026 appropriations process, and we appreciate that appropriators in both chambers continue to see the value in funding this important, life-saving research.  

These two bills also address the administration’s proposal to cap indirect cost expense at 15%. The Senate bill maintains current language that prohibits the NIH from making unilateral changes to indirect cost contracts, while the House version of the bill sets a 30% cap for any institution subject to the endowment tax. This means, if the House language is accepted in the final version of this bill, any institution that has at least 3,000 tuition-paying students and an endowment of $500,000 per tuition-paying student would have its indirect cost reimbursements capped at 30%. The House and Senate still need to negotiate a final version of the Labor-H bill, and the AAN will continue to push back against arbitrary changes to indirect cost reimbursement that would negatively impact neuroscience research.  

Path forward to September 30
Without final agreement on all 12 appropriations bills that need to be passed to fund the government, Congress will likely need to pass a continuing resolution to keep the government open past September 30. Democrats want to see a CR that includes several outstanding policy issues, specifically the extension of the Affordable Care Act enhanced advance premium tax credits that went into effect during the COVID-19 pandemic. House Republicans recently introduced language for a CR that funds the government through November 21 but does not address policies requested by the Democrats.  

On Friday, the House passed the Republican CR mostly along party lines. After that vote, the Senate considered a Democrat CR that failed to pass, then considered the House-passed CR, which failed to receive the necessary 60 votes to proceed. The House and Senate both don’t return from a scheduled recess until just before the shutdown deadline of September 30. The AAN will continue to work with policymakers to ensure that important government programs continue to be funded.

Extension of telehealth and Conrad 30
Both the Conrad 30 program and the COVID-19 public health emergency telehealth flexibilities need to be extended past September 30. The Republican CR proposed in the House does contain extensions to both programs through November 21. The AAN will continue to work with Congress to push for a permanent extension of telehealth flexibilities and a multi-year authorization for Conrad 30.

With the House-proposed CR failing to pass the Senate, it’s more important than ever that lawmakers hear from you about the importance of continued access to telehealth. Visit the to write your members of Congress today!

As negotiations over government funding continue, the AAN will be working tirelessly to advocate for increased funding for neuroscience research, continued access to telehealth, and the continuation of the Conrad 30 program. If you have any questions about our work on these issues, please contact us at advocacy@aan.com.

 
Latest advocacy news

AAN submits comments on Medicare fee schedule proposed rule 
On September 8, the AAN submitted comments in response to the 2026 Medicare Physician Fee Schedule proposed rule. The AAN’s comments provided the Centers for Medicare & Medicaid Services (CMS) with feedback on key policy changes, including changes to the Medicare conversion factor, policies impacting telehealth access, structural changes to the fee schedule, and modifications to the Quality Payment Program. 

AAN submits comments on J-1 student visa proposed rule
On September 19, the AAN submitted comments in response to the US Department of Homeland Security proposed rule that would set a fixed duration for all foreign student visas. The AAN’s comments oppose this proposal and provide reasoning for how it would negatively impact the neurology workforce.

Bill would create 14,000 positions, support hospitals 
As a member of the Graduate Medical ºÃÉ«ÏÈÉú (GME) Advocacy Coalition, the AAN signed onto a letter thanking Senators Boozman (R-AR), Warnock (D-GA), Collins (R-ME), Schumer (D-NY), and Representatives Sewell (D-AL) and Fitzpatrick (R-PA) for introducing the Resident Physician Shortage Reduction Act of 2025 (S.2439 / H.R.4731). This bill seeks to strengthen the physician workforce by creating 2,000 new Medicare-supported GME slots annually over seven years, totaling 14,000 positions, with a share specifically designated for hospitals serving high-need communities. 

Organizations call for APTC extension 
The AAN joined 90+ medical stakeholders last week in calling on Congressional leadership to enact legislation to extend the enhanced advance premium tax credits (APTCs) before their expiration in 2026. The letter outlines the benefits APTCs have provided in making health coverage more affordable for at-risk populations, as well as the consequences their expiration would have for consumers relying on the Health Insurance Marketplace. 

Societies urge CMS to reform MIPS approach 
The AAN joined with over 30 professional societies this month urging CMS to reform its approach to Merit-Based Incentive Payment System (MIPS) quality measurement. The letter noted that there is an urgent need for CMS to consider and accept more measures into the MIPS program to better ensure alignment with the growing number of episode-based cost measures, alternative payment models, and other quality and certification programs. The letter also urged CMS to work with specialty societies in support of measures that are clinically relevant and meaningful across practices and settings of care, as well as being administratively actionable and useful in providing better care and value for patients. 

Organizations call attention to troubling E/M payment policy 
The AAN also joined with over 20 specialty organizations this month urging CMS to address a troubling policy across several payers to negatively adjust payment for evaluation and management (E/M) services in contradiction to established E/M coding and billing guidelines. The letter asked CMS to work with professional societies on a solution that allows for oversight and promotes proper payment for E/M services. 

Executive order imposes $100,000 fee for H1-B applications
On September 19, the Trump administration announced a $100,000 fee for new H1-B visa applications. The AAN will monitor implementation of this fee and work with stakeholders to ensure it doesn't negatively impact access to care for people with neurological conditions.

CDC advisory committee updates vaccine recommendations
The CDC Advisory Committee on Immunization Practices met late last week to discuss updates to recommendations on several vaccines, including measles, mumps, rubella, and varicella, as well as vaccination for COVID-19 and hepatitis B. The AAN is closely monitoring the development and implementation of updated recommendations and their impacts on neurology patients and practice.

What we're reading

• CMS opens state applications for $50B Rural Health Transformation Program ()

• 55% of healthcare workers plan to change roles within 1 year: Survey ()