November 18, 2016

On the Horizon

  • Congress will recess for the Thanksgiving holiday and reconvene the week of November 28

Washington Update - Full Report

Download this week's report(2 page PDF).

U.S. Congress

House Passes AAFP-supported Bill to Improve Diabetes Care

On November 14, the House of Representatives passed by voice vote the National Clinical Care Commission Act (HR 1192(kevinmccarthyforms.house.gov)) to create a commission which would include leaders of the federal government as well as several private sector experts in diabetes and its disease complications. The AAFP was one of 48 organizations signing a letter dated November 15 to the Senate HELP Committee urging quick action now that HR 1192 has passed the House.

AAFP Urges Congress to Support FDA Rule on e-Cigarettes

The AAFP joined a letter dated November 17, from 13 physician organizations urging Congress to allow the Food and Drug Administration’s (FDA) final rule on e-cigarettes to be implemented. The House fiscal year 2017 Agriculture Appropriations bill (HR 5054(www.congress.gov)) includes two legislative riders related to tobacco regulation.  The one rider addressed by our letter would change the “grandfather date” in order to exempt e-cigarettes, cigars, and other tobacco products now on the market from an important FDA product review requirement. The Senate bill does not contain any tobacco policy riders. It is not clear whether the Congress will finalize the Agriculture spending bill for FY 2017 which might include legislative riders or instead enact a stop-gap spending bill through March 2017. 

Centering on the States

State Ballot Initiatives Results

Results of the 2016 state ballot initiatives of interest:

  • Death with Dignity: Colorado passed Proposition 106, which outlines the case in which doctors would be able to prescribe medication that can be self-administered to bring about death for terminally-ill patients.
  • Obesity: Three California municipalities, Albany, Oakland, and San Francisco and Boulder, Colorado passed local ballot measures to tax sugar sweetened beverages. 
  • Pharmaceutical Drug Pricing: California’s Proposition 61, which would have established pricing standards for prescription drugs, was defeated with 54% voting no.
  • Tobacco: Four states had cigarette and tobacco tax initiatives on the ballot. California passed a proposal to increase the cigarette tax by $2.00 per pack, with equivalent increases on other tobacco products and e-cigarettes. Colorado, Missouri, and North Dakota’s initiatives failed.
  • Universal Healthcare: Colorado’s amendment 69, the ballot measure known as ColoradoCare, that would have created a universal healthcare system, was defeated with nearly 78% voting no. 

Feedback Requested for State Legislative Toolkits

The Center for State Policy is looking into creating state legislative toolkits to help chapters advocate on priority issues. The toolkits could include model legislation, Speak Out templates, social media campaigns, draft letters of support, and draft editorials. Please take our survey(www.surveymonkey.com) to help determine which subjects matter most to you and your chapter.

The Executive Branch

Surgeon General Report on Addiction Released

On November 17, the U.S. Surgeon General released its first ever report on alcohol, drugs and health: Facing Addiction in America(addiction.surgeongeneral.gov). The report finds alcohol and drug misuse and severe substance use disorders to be one of America’s most pressing public health concerns, with close to 21 million Americans suffering from addiction. The economic impact of drug and alcohol misuse and addiction amounts to $442 billion annually.  The impact of diabetes is $245 billion. The report concludes with five messages and implications for policy and practice which focus on expanding access to effective, evidence-based treatments for those suffering from addiction.

AAFP sends HC-PLAN letter on primary care models

The AAFP sent a letter on November 15 to the Health Care Payment Learning and Action Network (HCP-LAN) in response to the draft white paper titled, “Primary Care Payment Models.” The AAFP applauded the Work Group for developing a draft white paper on Primary Care Payment Models (PCPM). The AAFP supports the mission of the HCP-LAN and believes it will play an integral part in consistent deployment of alternative payment models (APMs) across all payers. The AAFP letter discussed that for APMs to be truly successful in improving care and reducing cost, APMs need a strong foundation of primary care. In addition, transformation should not be overly complex and burdensome to operationalize. There is not a one size fits all as patient panels or populations and primary care practices vary. In keeping with the goals of the U.S. Department of Health and Human Services (HHS) regarding APMs, the AAFP urged the HCP-LAN to recognize that further work needs to be done to improve quality and patient engagement while reducing total cost of care.

Regulatory Brief

  • On November 10, CMS released(www.cms.gov) the 2017 premiums for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.
  • On November 15, CMS announced(innovation.cms.gov) the CPC+ payer and region list.
  • On November 17, CMS launched(www.cms.gov) a new online tool to share electronic data for the Medicare Quality Payment Program automatically. According to CMS, this new release is the first in a series that will be part of CMS’s ongoing efforts to spur the creation of innovative, customizable tools to reduce burden for clinicians, while also supporting high-quality care for patients.
  • CMS will host the following free educational call, registration(blh.ier.intercall.com) is required:
    • Medicare Diabetes Prevention Program Model Expansion, November 30, 1:30pm
    • IRF and LTCH Quality Measure Report Call, December 1, 1:30pm
    • National Partnership to Improve Dementia Care & QAPI Call, December 6, 1:30pm
    • 2016 Hospital Appeals Settlement Update Call, December 12, at 1:30pm. 

FamMedPAC

Congress returned to Washington this week and FamMedPAC was invited to meet with newly elected and returning Members.  The PAC also participated in one fundraising event for a returning incumbent Member of Congress.  The PAC is continuing fundraising through the end of the year, and has received over $930,000 in donations. 

The PAC participated in the following events this week:

  • New Democratic Coalition, an organization of pro-business moderate Democrats in the U. S. House, held a reception to thank their supporters and to introduce newly elected Members of Congress.
  • Rep. Phil Roe (R-TN), a physician and member of the House Doctors Caucus, held a thank-you luncheon for his supporters.  Sen. Bob Corker (R-TN) also attended.
  • Rep. Michael Burgess (R-TX), a physician and member of the House Doctors Caucus held a fundraising lunch for his leadership PAC, the Lone Star Leadership PAC.
  • Rep. Steny Hoyer (D-MD), the Minority Whip in the House, held a reception to introduce newly elected Democratic Members of the House.

Take Action

This week, the AAFP activated a Speak Out campaign regarding the Teaching Health Center Graduate Medical Education (THCGME) program. THCGME is having a measurable impact on the primary care workforce by training hundreds of residents in community-based settings around the country. However, the program’s funding expires on October 1, 2017.  AAFP members were asked to send a personalized letter to their Representatives, urging them to cosponsor the bill expressing support for a sustainable funding source, H.Res. 899(www.congress.gov). As of mid-day November 18, this campaign has generated 169 letters. Click here if you would like to send the Speak Out.