Washington Update - March 2, 2018
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AAFP Joins 74 Organizations Calling for Bipartisan Gun Violence Research
On February 22, the AAFP signed a joint letter, along with 74 health and medical organizations, requesting bipartisan gun safety solutions, including federal research and a stronger federal firearm background check system, in response to recent mass shootings.
Bills of Interest
- Conversion Therapy – A number of states (AZ(www.azleg.gov), CO(leg.colorado.gov), DE(legis.delaware.gov), FL(www.flsenate.gov), ID(legislature.idaho.gov), KS(www.kslegislature.org), KY(www.lrc.ky.gov), ME(www.mainelegislature.org), MD(mgaleg.maryland.gov), MI(www.legislature.mi.gov), MN(www.revisor.mn.gov), MO(house.mo.gov), NH(gencourt.state.nh.us), NY(assembly.state.ny.us), OH(www.legislature.ohio.gov), PA(www.legis.state.pa.us), VA(leg1.state.va.us), WA(lawfilesext.leg.wa.gov), WV(www.wvlegislature.gov), and WI(docs.legis.wisconsin.gov)) are considering legislation that would prohibit the use of conversion therapy on minors. Conversion therapy, or the attempt to change an LGBT individuals’ gender identity or sexual orientation, has been widely discredited by doctors and psychiatrists and is currently banned in CA, CT, DC, IL, NV, NJ, NM, OR, RI, and VT for individuals under age 18.
- Direct Primary Care (DPC) – FL(www.flsenate.gov), GA(www.legis.ga.gov), HI(www.capitol.hawaii.gov), IA(www.legis.iowa.gov) , MD(mgaleg.maryland.gov), PA(www.legis.state.pa.us), SC(www.scstatehouse.gov), and WI(docs.legis.wisconsin.gov) have introduced DPC legislation. Idaho(legislature.idaho.gov), Missouri(house.mo.gov), and Nebraska(nebraskalegislature.gov) have introduced legislation that would establish direct primary care pilot programs in Medicaid, public health districts, and state insurance programs.
- Individual Mandate – After the federal government eliminated the Affordable Care Act’s (ACA) individual mandate penalty in last year’s tax reform bill, several states (CT(www.cga.ct.gov), HI(www.capitol.hawaii.gov), and VT(legislature.vermont.gov)) have introduced legislation that would establish a state-level mandate to purchase health insurance. Washington(lawfilesext.leg.wa.gov), which does not have an income tax, is also considering legislation that would establish a task force to consider an individual mandate.
Governors Release Bipartisan Health Care Plan
On February 23, Governors John Hickenlooper (D-CO), John Kasich (R-OH), Bill Walker (I-AK), Tom Wolf (D-PA), and Brian Sandoval (R-NV) released A Bipartisan Blueprint for Improving Our Nation's Health System Performance(www.colorado.gov). The guiding principles are to improve affordability, restore stability to insurance markets, provide state flexibility and encourage innovation, and improve the regulatory environment.
HHS Listening Session on Administrative Burden Acknowledges AAFP Concerns
On February 22, CMS and the Office of the National Coordinator for Health Information Technology (ONC) held a joint meeting on reducing clinician burden as part of the Patients over Paperwork initiative. The AAFP attended the meeting and sent the agencies a letter on February 7 in advance of the meeting. During the session, HHS officials said quality measures and quality reporting are a growing problem when it comes to physician burden, a sentiment AAFP has repeatedly communicated. HHS officials noted their efforts to reduce administrative burden and asked participants if they would consider taking part in a pilot where CMS would test alternate ways of assessing quality.
Comments Sent to CMS on Part II of 2019 Parts C/D Call Letter
On February 27, the AAFP sent a letter to CMS in response to the 2019 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies. The response urged CMS and Part C/D plans to adhere to the AAFP’s prior authorization principles, and discussed ways to improve drug utilization reviews in Part D plans and how to better address the current opioid crisis.
Family physicians nominated to agency committees
- On February 21, the AAFP nominated Kenneth Lin, MD, MPH, FAAFP and Margot L Savoy, MD, MPH to the Breast and Cervical Cancer Early Detection and Control Advisory Committee.
- On February 27, the AAFP nominated Elizabeth Salisbury-Afshar, MD, MPH, FAAFP, FASAM, FACPM, and Saria Saccocio, MD, FAAFP, MHA to the Interagency Committee on Smoking and Health.
Medical Societies Urge HRSA to Fully Fund THCGME Programs
On February 22, the AAFP, along with six other medical societies, sent a letter to the Health Resources and Services Administration (HRSA) urging officials to provide adequate funding for the newly-reauthorized Teaching Health Center Graduate Medical Education (THCGME) program. Under the Bipartisan Balanced Budget Act (P.L. 115-123(www.congress.gov)), the THCGME program was funded at $126.5 million per year. The monies would support THC program operating costs at a level consistent with the 2016 George Washington University report(www.nejm.org) that recommended $157,000 per resident. It would also allow a limited number of new programs to apply for HRSA funding for the first time in years.