AAFP Federal Advocacy Update, September 2022

See What the American Academy of Family Physicians (AAFP) Federal Advocacy Team Has Been Working On.

AAFP Continues Push for Prior Authorization Reform

Why it matters:
The AAFP applauds the House of Representatives for passing the Improving Seniors’ Timely Access to Care Act, which would reduce administrative tasks that interfere with patient care by streamlining prior authorization in Medicare Advantage plans.

AAFP Board Chair Sterling Ransone, MD, FAAFP, said, “The average physician spends two business days per month completing prior authorizations. That means two days spent away from patients. Now, the Senate must pass the Improving Seniors’ Timely Access to Care Act to streamline the prior authorization process and remove barriers to care.”

We urge the Senate to swiftly pass the Improving Seniors’ Timely Access to Care Act to ensure seniors in Medicare Advantage plans have timely, equitable access to care.

Take Action: Contact Your Senators about the Need for Prior Authorization Reform

Kelley vs. Becerra Ruling Jeopardizes Preventive Care

Why it matters:
A federal court ruled that it is unconstitutional to require private health insurance to cover preventive services recommended by the U.S. Preventive Services Task Force. If this ruling stands, patients will likely face higher costs and restricted access to preventive health care services such as cancer screenings.

What we’re working on:

  • AAFP Board Chair Sterling Ransone, MD, FAAFP, said, “Family physicians are alarmed by the U.S. District Court’s decision. If [this] ruling stands, it will jeopardize health outcomes by creating financial barriers to screenings, counseling and preventive medications that improve our patients’ health. The AAFP calls on lawmakers, insurers and health plan sponsors to ensure patients can continue to access high-value, essential preventive services without cost-sharing.”
  • The AAFP issued a joint statement with the American Medical Association and other health organizations to sound the alarm on the negative impact an adverse ruling on Kelley v. Becerra would have on patients.

AAFP Responds to Medicare Physician Fee Schedule

Why it matters:
In July, the Centers for Medicare and Medicaid Services (CMS) released the 2023 Medicare physician fee schedule and Quality Payment Program proposed rule. It includes an estimated 4.5% reduction in the Medicare conversion factor – the multiplier CMS uses to calculate payment rates. Coupled with steep increases in practice costs, this may result in untenable Medicare payment cuts for family physicians in 2023 and jeopardize patients’ timely access to essential care.

The AAFP and other health care organizations are urging Congress to stop forthcoming Medicare payment cuts and enact reform to protect patients’ access to high-quality care.

What we’re working on:

  • The AAFP submitted a comment letter to the Centers for Medicare and Medicaid Services, urging CMS to continually invest in community-based primary care. We posit that, without congressional intervention, the implementation of the CY 2023 MPFS and QPP proposed rule will undermine the viability of community-based primary care practices. We’re also calling on Congress to avert Medicare Part B payment cuts set to go into effect by increasing the 2023 Medicare conversion factor.
  • The AAFP endorsed the bipartisan Supporting Medicare Providers Act of 2022, which is a critical first step in ensuring financial stability for physicians impacted by payment cuts in the fee schedule. Importantly, this legislation signals that more administrative and legislative action is needed to ensure sustainable Medicare physician payment, a smooth transition to value-based care and greater attention to decreasing health disparities.
  • The AAFP is also urging Congress to provide positive annual updates for Medicare physician payments based on the Medicare Economic Index (MEI) to account for increasing practice costs.

Take Action: Contact Congress about the Medicare Physician Fee Schedule

Family Physicians Concerned by Lack of COVID-19 Funding

Why it matters:
The AAFP urges Congress to immediately appropriate additional COVID-19 funding to ensure that all patients continue to have access to comprehensive care, treatment, testing and vaccines, and that we are prepared for future variants. Sustained and adequate funding is essential for the federal government and public health agencies to support the country’s ongoing efforts to prevent and mitigate the harmful effects of COVID-19 on patients.

The Health and Human Services’ Assistant Secretary for Preparedness and Response announced that the federal government will run out of funds in 2023 and will need to move vaccines and therapeutics to the commercial marketplace.

What we’re working on:

  • We urge Congress to restore funding for the Health Resources and Services Administration COVID-19 Uninsured Program, which reimburses physicians and clinicians who render COVID-19 testing, treatment and vaccines to uninsured individuals to provide financial stability for safety-net practices and ensure access to care for uninsured patients across the country. The Uninsured Program has paid for more than 30,000 COVID-19 tests, treatment for more than 34,000 individuals and for the administration of more than 18,000 COVID vaccines.
  • We also continue to call for relief funding to ensure that all populations have access to community-based testing, which is a key step to linking people to treatment and reducing disparities in COVID-19 health outcomes.

Congress Must Reduce Medical Student Debt Burden

Why it matters:
Student debt is a major source of stress for medical students and new physicians. Loan forgiveness programs such as the Public Service Loan Forgiveness program have become a potential lifeline for those struggling with student debt. This program and others like it must be expanded at the federal level to improve access to health care in underserved communities, diversify the health care workforce, advance health equity and address the physician shortage.

What we’re working on:

  • AAFP wrote to the Department of Education to call for expanded eligibility for participation in the Public Service Student Loan Forgiveness Program. We also support expanding funding for federal loan forgiveness programs that target family medicine and primary care.
  •  We’re advocating for Congress to pass the REDI Act, which would allow medical students to qualify for interest-free deferment of their student loans while in a residency training program, creating more financial viability for physicians to specialize in family medicine and primary care.

Take Action: Contact Congress about Reducing Medical Student Debt

AAFP President Urges Primary Care Practices & Payers To Partner To Address Patients’ Mental Health Needs

Why it matters:
In a piece for MedPage Today, AAFP Board Chair Sterling Ransone, MD, FAAFP, wrote, “As we continue to navigate the COVID-19 pandemic, the mental health needs of kids and adults continue to rise,” but “many of these needs remain unmet.” While “the current landscape seems bleak…the path forward is clear: We must integrate mental health services into primary care settings.” Ransone concluded, “It’s more important than ever for primary care practices and payers to work together to eliminate barriers to mental health care for patients and proactively support primary care’s ability to address patients’ physical and mental health concerns. The American Academy of Family Physicians is actively working with other medical societies and payers to accelerate progress.”

What we’re working on:
Advocating for policies that support the integration of behavioral health into primary care. This integration exists along a spectrum, ranging from consistent coordination of referrals and exchange of information to co-locating behavioral health services within the primary care practice. 

For the latest policy updates impacting family medicine, follow AAFP Advocacy at @aafp_advocacy.

Post author: AAFP National, aafp.org/advocacy

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