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March 27, 2026

Neurologists from all over the country headed to Washington, DC, last month to stand up for their patients and their field.

In one intensive two-day event, they learned about three big legislative issues facing neurology, teamed up with other participants from their states, and conducted an impressive 266 meetings with members of Congress and their staff. It was Neurology on the Hill, the AAN’s annual fly-in—and the energy was palpable. 

“It was a continuum of all ages of neurologists, all stages of training, all subspecialties coming together for one goal,” said Lauren Bojarski, DO, one of the participants.

Participants come prepared to speak with legislators on several priority issues. This year, those issues were fixing the Medicare payment system, protecting access to telehealth, and investing in neurological research.

Fixing Medicare payment

It’s well-known among physicians that the Medicare payment system has serious issues. One problem is the budget neutrality requirement in the Medicare Physician Fee Schedule, which lists payment rates for thousands of services. Budget neutrality requires that whenever a new service is added or modifications are made to existing codes that cost above a certain threshold, the conversion factor must be cut. This results in across-the-board cuts to payment rates for all provider services to account for the new cost. 

This creates a constant cycle of cuts, which—combined with inflation—causes devastating impacts for physicians and their practices. According to the American Medical Association, Medicare payment to physician practices has dropped more than 30% since 2001 after adjusting for inflation in practice costs.

These issues don’t just affect neurologists and other physicians—they also affect patients. A pair of recent studies in Neurology^®, the AAN’s journal, found nearly one in five Medicare recipients to receive neurological care, and that the median wait time for Medicare recipients to see a neurologist was A better payment system could lead to more neurology practices seeing more patients. 

Neurology on the Hill participant Elliot T. Dawson, MD, FAAN, said many neurologists know stories of practices shutting down.  

“There are long wait times—and those wait times can be half a year or more,” he said. “There just aren’t enough providers out there. The need for neurologists will only increase, and that gap in access results from insufficient numbers entering the specialty, backwards economic realities for those looking to start, maintain, or grow their own practice, and insufficient incentives for employers to hire more neurologists.”

Dawson and the other neurologists asked their members of Congress to support legislation that provides an automatic inflationary update tied to the Medicare Economic Index for physician reimbursement under Medicare. They also asked for support for legislation that updates the budget neutrality triggers in the MPFS.

Protecting telehealth access

Telehealth has become a widely used resource for patient care in recent years, and it’s especially useful for people with neurological conditions that make travel difficult.

Access to telehealth, however, is far from guaranteed for Medicare beneficiaries. Before the pandemic, Medicare only covered telehealth for beneficiaries who were at a hospital or another medical facility, not at their own homes. Pandemic-era flexibilities changed that—and with the help of advocacy by neurologists and other stakeholders, they’ve received numerous temporary extensions from Congress.

Bojarski, who specializes in memory care, said telehealth has opened up a world of change. She practices in West Virginia, where most of the population lives in rural areas—so some of her patients need to drive as long as four hours to see her in person. That’s difficult or even impossible for many of them and their families. 

“Telehealth makes it so I can see them and help them even in their late stages of dementia,” she said. “I’m able to give them their quality treatment without them having to move. They just take out their cell phone, and I can see them right there and help them if they have hallucinations or anxiety.”

The temporary, short-term extensions aren’t enough to protect telehealth availability for Medicare beneficiaries. This became especially clear last year during the record 43-day government shutdown. The latest extension hadn’t been approved prior to the shutdown, so Medicare beneficiaries who rely on telehealth couldn’t see their neurologists. 

“We should never allow our patients to go without care for that long if it’s something we can change,” Bojarski said. “It can be really scary to have a neurological condition. I give people medicines to help them through some of the worst times in their life—and I can do that with telehealth.”

With this recent situation in mind, Bojarski and the other neurologists asked their members of Congress to co-sponsor the CONNECT for Health Act. This legislation would protect continuity of care for by making telehealth flexibilities permanent for Medicare beneficiaries. 

Investing in neurological research

Crucial to breakthroughs in neuroscience research, funding from the National Institutes of Health (NIH) helps countless people with neurological conditions. Congressional funding for neuroscience research has led to breakthroughs like tPA for stroke and—more recently—deep brain stimulation to treat the symptoms of movement disorders.

The BRAIN Initiative, a landmark public-private collaboration at the NIH, has sparked innovative translational neuroscience innovation. That research advanced understanding of neuronal networks, those networks’ role in brain health and disease, and enabled novel forms of treatment. Funding for the BRAIN Initiative largely comes from the 21^st Century Cures Act, a 2016 law meant to accelerate innovation in health care—and that funding expires this year. 

With this funding gap around the corner, former National Institute for Neurological Disorders and Stroke (NINDS) director Walter J. Koroshetz, MD, FAAN, attended Neurology on the Hill to speak about the BRAIN Initiative to participants.

“Dr. Koroshetz highlighted that before the BRAIN Initiative, medicine didn’t have the necessary tools to understand or assess how the brain works,” Dawson said. “Understanding the connections and networks within the brain is an advent—an exciting promise for understanding how disease works and ultimately providing more treatments.”

The BRAIN Initiative has enabled researchers to create advanced technologies that can map, monitor, and modulate functions of the brain. Its work could be a key to future breakthroughs in neurology—but not if funding lapses. 

Base funding for the initiative was decreased since pandemic-related legislation gave the program a large funding boost in 2023. However, that legislative funding has dropped and base funding has not been restored, resulting in a funding cut. Cures Act funding runs out in 2026—making the need for restored base funding urgent.

The neurologists asked Congress to provide $468 million in base funding for the BRAIN Initiative in fiscal year 2027. This number represents the highest amount of base funding Congress has provided for the program.

“The holy grail is understanding how the brain works at a new fundamental level,” Dawson said. “That will ultimately provide treatments that patients need right now.”

Get involved in advocacy

Neurology on the Hill happens every year in February. US AAN members who want to participate should make sure they’re receiving Capitol Hill Report, a biweekly email newsletter that provides updates on AAN advocacy—it’ll have links to apply for the 2027 event in October. There’s also Neurology off the Hill, which takes advantage of Congress’s August recess to help neurologists meet with their members of Congress in their home states. 

One way to get involved all year long is through BrainPAC, the AAN’s political action committee representing the profession of neurology. This is an essential tool in educating federal legislators about critical issues facing neurologists and their patients, and only US citizens and permanent residents who are members of the AAN can contribute to it. Together, Neurology on the Hill attendees contributed more than $100,000 to BrainPAC!

Another way to get involved is through Action Alerts, which the AAN sends US members via email and on the Advocacy Action Center online. These alerts help you contact your members of Congress about legislation that could affect you and your patients. While you’re at it, consider signing up for the Political Outreach for Neurological Support (PONS) network for exclusive advocacy updates and quarterly webinars.

Action Alerts have generally been only for AAN members—but during Neurology on the Hill, the AAN also sent an Action Alert to subscribers of , our public brain health website and resource hub. This message saw a strong response, and more than 3,500 members of the public added their voices to the event by reaching out to their congressional representatives, asking them to help protect telehealth access and neuroscience research.  

Learn more about all the ways AAN members can get involved in advocacy!