Washington Update - November 3, 2017

On the Horizon

  • On November 8, the House Energy and Commerce Health Subcommittee will hold a hearing on MACRA and Alternative Payment Models: Developing Options for Value-based Care.

Washington Update - Full Report

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

Take Action

Help FamMedPAC Grow Even Stronger

Coming off its best cycle ever, FamMedPAC continues to help promote family medicine’s message in Washington and across the country. A strong FamMedPAC allows AAFP to remain the go-to resource for legislators in Congress who understand our unique role in America's health care. To make your 2017 contribution, please visit the FamMedPAC Contribution Page(contribute.pacbuilder.com).

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U.S. Congress

House passes Package with Top AAFP Priorities

On November 3, the full House passed the CHAMPIONING HEALTHY KIDS Act. (HR 3922(www.congress.gov)) to extend the Children’s Health Insurance Program (CHIP), Teaching Health Centers Graduate Medical Education (THCGME), National Health Service Corps (NHSC) and other health programs. The vote was 242 to 174. The AAFP had sent a letter to House Speaker Paul Ryan (R-WI) and Minority Leader Nancy Pelosi (D-CA) in support of the reauthorization of CHIP, THCGME, Community Health Centers, and the NHSC and looking forward to the identification and enactment of more bipartisan offsets for these critical programs.

Tobacco 21 in the Senate and House

The AAFP wrote to Sens. Brian Schatz (D-HI) and Richard Durbin (D-IL) and Rep. Diana DeGette (D-CO) in support of the Tobacco to 21 Act to raise the minimum legal tobacco age of sale to 21 from the current minimum legal age of 18.

Appropriations Faces Deadline

Bipartisan negotiations among the House and Senate and the Trump administration on FY2018 appropriations to fund the government by the December 8 deadline are underway. On October 30, the AAFP joined a letter from 66 members of the Health Professions and Nursing Education Coalition (HPNEC) to Congressional leaders urging them to support family medicine workforce programs administered by the federal Health Resources and Services Administration and authorized by Title VII of the Public Health Service Act. The AAFP also joined 52 groups on letters sent to the bipartisan House and Senate leadership and the House and Senate Appropriations Committees chairs and ranking members urging them to strike provisions from the FY 2018 Agriculture spending bill that weaken the Food and Drug Administration’s tobacco oversight rule.

MedPAC meets

On November 2, the Medicare Payment Advisory Commission (MedPAC) held two public sessions in Washington relating specifically to family medicine. MedPAC continued work on refining its evolving proposal to repeal and replace the Merit-Based Incentive Payment System (MIPS). The commissioners are mulling over a “voluntary value program” under which physicians would elect to be measured as part of a group, and the group would qualify for an upward adjustment depending on performance. The Commission also continued consideration of rebalancing the physician fee schedule to support primary care. Discussion centered on whether payment all E&M services should be boosted, or just those provided by primary-care specialties. Both proposals could be finalized as recommendations for inclusion in the March 2018 Report to Congress.

Centering on the States

Backgrounders, Backgrounders, Backgrounders

The Center for State Policy has produced the following backgrounders for state advocacy: CHIP, Climate Change and Air Pollution, Graduate Medical Education, Medicaid Primary Care Payment Parity(2 page PDF), Prior Authorization, Section 1115 Waivers, Section 1332 Waivers, and Student Loan Repayment Programs. The Center has also updated the following backgrounders: Direct Primary Care, Medicaid Expansion, Prescription Drug Monitoring Programs and Vaccine Exemptions.

Maine Ballot Measure Coming Up

On November 7, Maine voters will vote via ballot measure(maine.gov) on expanding Medicaid. Medicaid expansion has passed the Legislature only to be vetoed by Gov. Paul LePage (R) five times.

State AG Generic Drugs Lawsuit Grow

46 state Attorney Generals will seek to expand a lawsuit(www.ct.gov) alleging price fixing of generic drugs to 18 companies and 15 medicines. The original complaint filed last year was against six companies and two medicines. The updated suit alleges that the drugmakers devised illegal agreements to fix prices and allocate customers for several generic products.

Executive Branch

Regulations Sneak Peek Available

On November 2, CMS released two significant regulations impacting Medicare payments in 2018 to physicians. The AAFP is now analyzing and preparing summaries regarding the 2018 final Medicare physician fee schedule and the 2018 Quality Payment Program regulations.

Health Affairs Summit on Choosing Wisely Gains Attention

On October 24, Health Affairs convened a summit in Washington entitled “Choosing Wisely: Opportunities and Challenges in Curbing Medical Overuse.” The event, consisting of a series of structured panel discussions, coincided with the 5-year anniversary of the campaign. Several of the speakers represented Choosing Wisely grantees and shared their experience with the adoption of voluntary guidelines designed to steer physicians away from unnecessary and low-value services.

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