Follow-up Capitol Hill Visit Focuses on Medicare Payment Fix, Adequate GME Funding

AAFP President-elect Jeffrey Cain, M.D., of Aurora, Colo., returned to Capitol Hill on Nov. 9 to continue pressing for a long-term Medicare payment solution and adequate funding for graduate medical education, or GME, programs during meetings with key congressional staff members.

Cain last visited Capitol Hill on Oct. 20 with several other AAFP leaders, including AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., AAFP Board Chair Roland Goertz, M.D., M.B.A., of Waco, Texas, and AAFP EVP Douglas Henley, M.D. The group met with a variety of congressional leaders and staff to push for a repeal of the SGR, a stable Medicare payment rate for a fixed number of years, and a higher payment rate for primary care physicians within that rate.

During this latest series of meetings, Cain met with a senior health care policy adviser for Rep. Allyson Schwartz, D-Pa., who soon is expected to introduce a bill that calls for a repeal of the SGR. Cain reiterated the Academy's position on Medicare physician payment, which includes instituting a stable payment rate, an increase for primary care and repeal of the SGR.

"We have to make sure family physicians are paid a fair price for taking care of Medicare patients," Cain said in an interview with AAFP News Now.

Cain's Capitol Hill visits came as the Joint Select Committee on Deficit Reduction, also known as the "supercommittee," continues to meet to develop a plan to achieve reductions in the federal deficit. If the government fails to enact the committee's recommendations by Dec. 23, across-the-board cuts totaling $1.2 trillion will be triggered automatically.

Cain also met with a senior policy adviser to Rep. Steny Hoyer, D-Md. The two discussed Medicare payment issues and the need to protect funding for GME programs as a way to sustain and strengthen family medicine residency programs. Hoyer is a member of the House Democratic leadership.

Cain said he described the SGR as "broken" during the meeting and noted that he hoped the Democratic leadership would encourage the bipartisan supercommittee to repeal the flawed payment formula as part of its final recommendations. Cain also discussed GME funding with the Hoyer aide, explaining that across-the-board reductions in GME would “disproportionately harm family medicine residency programs.”

Both Congress and the Obama administration have proposed cuts in GME funding as part of deficit reduction proposals. Cain pointed out that although subspecialist residency programs generate income for teaching hospitals that receive GME funds, family medicine residency programs often are not recognized as generating revenue and, thus, may be eliminated if GME funds are reduced.

"Primary care residencies rely on GME funds to be able to keep their doors open," said Cain.

Cain also met with health care aides to Sen. Robert Casey, D-Pa., about prescription drug abuse. Casey is co-sponsor of a bill introduced by Sen. John Rockefeller, D-W.Va., that would require physicians to undergo mandatory CME as a condition for prescribing certain drugs, such as opioids.

"We know that the diversion of (prescription) drugs involves a small number of physicians and a small number of patients," said Cain. "Requiring all physicians to undergo CME to prescribe targeted narcotics is taking a sledgehammer approach to a problem that would be better addressed with a scalpel."