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Tuesday Nov 18, 2014

Critical Issues at Stake for Primary Care in Lame Duck Session

I start this week’s posting with an urgent request. If you accept Medicaid in your practice and you do not want to see your payments for services provided to Medicaid patients slashed by, on average, 40 percent, I encourage you to take a few minutes today to send a letter to your representative and senators urging them to extend the Medicaid Primary Care Incentive Payment Program.  

Unless Congress acts, Medicaid payment rates for primary care services will return to 2012 levels levels on Jan. 1, 2015. Please visit Speak Out and send a letter to your elected officials today. After you send your letters, please encourage your colleagues, friends, and neighbors to do the same.

On Sept. 29, the AAFP sent a letter to House and Senate leadership urging action on this issue. We continue to actively lobby legislators to extend this provision, but we need your help!

With the mid-term elections in the rearview mirror, the 113th Congress has returned to Washington to complete its work in what could be an eventful lame duck session. Although the lame duck session will be relatively short in duration, the days will be jammed with lingering legislative items needing attention. Besides the Medicaid payment policy outlined above, there are several other items on the AAFP’s year-end to-do list for Congress.

One of the most important things Congress must do is fund operations of the federal government. Prior to the elections, Congress approved a continuing resolution funding the government through Dec. 11. Now Congress must develop and pass funding to sustain government operations through the end of the fiscal year, which ends on Sept. 30, 2015. This process is complicated by the need for additional funding to support domestic and foreign efforts to combat the Ebola virus and evolving foreign policy issues.

The AAFP has several priorities in play that will be directly impacted by the appropriations spending bill. At the top of that list is financing for the National Health Service Corps and other primary care programs included in the Health Resources and Services Administration budget. Also, there are some concerns that funding for primary care research at the Agency for Healthcare Research and Quality could be in jeopardy. The AAFP is actively promoting the continuation and responsible funding for each of these programs. On Oct. 28 we joined more than 100 organizations in sending a letter to House and Senate leadership urging them to avoid the “primary care cliff” by preserving funding for these important programs.

For physicians, fall is once again the time of year when we wonder if payments will be slashed by a draconian funding formula that has haunted physicians for more than a decade -- the sustainable growth rate (SGR). In March, Congress enacted a short-term extension of Medicare physician payments, preventing scheduled cuts of more than 20 percent. This short-term reprieve expires on March 31, 2015. At that time, Medicare payments will be slashed by 21.2 percent unless Congress intervenes. I laid out a compelling argument for why Congress should act in the lame duck in a recent column(themorningconsult.com) for The Morning Consult.

The AAFP is aggressively lobbying Congress to act in the lame duck session to enact SGR repeal legislation, and this also is an issue that we could use your help with. Your elected officials need to hear directly from you regarding the negative impact the failed SGR formula is having on your practice and the patients you care for. I encourage you to engage with us in this advocacy effort by visiting our Speak Out page.

The Administration recently requested emergency funding for the domestic and foreign Ebola response. Although the amount of spending is still under discussion, it will be significant. The AAFP supports the increased funding which would improve our public health system and expand our capabilities to identify, isolate, and treat patients with infectious diseases such as Ebola. As an organization representing physicians who find themselves at the leading edge of public health, we view this funding as essential.

The next item on the AAFP’s to-do list is the confirmation of Vivek Murthy, M.D., as Surgeon General. The AAFP recently joined with other physician organizations to articulate why the Senate should act immediately to confirm Dr. Murthy.(thehill.com) The health of our population is not a partisan issue, and our public health service is deserving of effective leadership, which Dr. Murthy would provide. The AAFP strongly supports his nomination and we are urging the Senate to act prior to adjournment to confirm Dr. Murthy.

Wonk Hard
On Nov. 1, CMS released the 2015 Medicare Physician Fee Schedule. This regulation establishes physician payment rates for the coming year and outlines several new policy changes within the Medicare program. The final regulation is painfully long, so the Academy has developed a manageable summary for family physicians. There also is a great AAFP News article that summarizes the major provisions of the final rule.

Posted at 08:00AM Nov 18, 2014 by Shawn Martin

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Shawn Martin, AAFP Senior Vice President of Advocacy, Practice Advancement and Policy.

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