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The Stroke Treatment and Ongoing Prevention (STOP) ActH.R. 3658 – is making the rounds in Congress again. The House of Representatives has passed the legislation, which was sponsored by Lois Capps (D-CA). Congress has considered similar bills in the past, but they have been bogged down for various reasons, such as funding the Iraq war. Now, in the 108th Congressional Session, they are ready to try again.

The bill – one of the AAN's top legislative priorities – aims to raise public awareness of stroke – its causes, symptoms, and preventative measures – as well as improve physician training and stroke treatment and rehabilitation programs. Among its provisions, it proposes:

  • Annual funding of $5 million for the next five years for the HHS to conduct a national multimedia stroke awareness and prevention campaign and to support the Paul Coverdell Stroke Registry and Clearinghouse, for gathering stroke data and disseminating it to researchers;
  • Annual $4 million funding for the next five years for grants for residency and continuing medical education training programs on the prevention, diagnosis, treatment, and rehabilitation of stroke for physicians and other health care professionals.
  • A total of $50 million over a five-year period for up to seven pilot programs using telehealth networks to improve stroke care.

Commenting by phone, Edgar Kenton III, MD, Chair of the AAN Practice Committee and Chief of Cerebrovascular Diseases at Mainline Jefferson Health System in Philadelphia, PA, acknowledged that the STOP Act is not exactly what they wanted, since the funding for the bill is tied to trauma centers and there is concern that funds will not trickle down to stroke care specifically. However, it provides a foot in the door. If this is passed, he explained, it will send a message that the government is behind stroke care and prevention, and will provide a base for further legislation.

At press time, the bill was being reviewed by the Senate Committee on Health, Education, Labor, and Pensions. A companion bill of the same name (S. 1909) was also introduced in the Senate by Thad Cochran (R-MS). While it has 23 sponsors, it has not received any attention from the Health, Education, Labor, and Pensions Committee. Dr. Kenton noted that the AAN Stroke System Task Force, the Legislative Affairs Committee, and the Center for Health Care Policy are working with key legislators in the Senate to pass this bill, and are also working to mobilize people on the state level – particularly in Tennessee, Senator Bill Frist's home state. “If we can get Senator Bill Frist on board, he can cary a fair amount of weight,” explained Dr. Kenton, since he is Senate Majority Leader and a physician.


Patients who qualify for Medicare Parts A and B have until the end of September to apply to a demonstration program to help them pay for their multiple sclerosis (MS) drugs. Medicare is getting a jump-start on the 2006 prescription drug benefit by helping 50,000 seniors with cancer and several other chronic conditions – including MS – pay for drugs they can take at home, many of which are prohibitively expensive.

The project, called the Medicare Replacement Drug Demonstration, will focus on drugs considered replacements for those covered in Medicare Part B, which are administered in the physician's office. Neurologist Jack S. Burks, MD, told Neurology Today that “patients will be able to take any drug at home with or without having to switch treatment. All FDA approved drugs are covered. Now MS patients in this demo project will have a choice of treatment under Medicare.” Dr. Burks is Clinical Professor of Medicine (Neurology) at the University of Nevada School of Medicine in Reno and President of the Multiple Sclerosis Alliance.

The covered drugs consist predominantly of cancer drugs, but three MS drugs are included: interferon beta-1a (Avonex, Rebif), interferon beta-1b (Betaseron), and glatiramer acetate (Copaxone). Medicare estimates that MS patients in the program will save 75 percent of their costs on these drugs – and low-income participants could save up to 100 percent.

Medicare started accepting applications for the program on July 6th, and will continue to do so though the end of September. If more than 50,000 applications are received, participants will be randomly selected. Coverage could begin as early as September 1st this year, and will continue until the Medicare prescription drug benefit kicks in in 2006. Details of the program are available online here: and on the AAN Web site, and applications for the program can be downloaded here:

Dr. Burkes said his reaction to the program is “positive for my patients who will get treatment but disappointment for those that lose in the ‘lottery.’ Rationing health care that can prevent disability and medical complication is never welcomed.” He encourages neurologists to help their MS patients on Medicare apply for the program, which means “urgent appointments and filling out the Medicare forms as soon as possible.”