• Fighting for Family Medicine

    Fighting for Family Medicine: Recent AAFP Advocacy Wins

    Legislative and Regulatory Accomplishments During the 116th Congress

    Examining the critical campaigns — and crucial wins — of AAFP advocacy efforts points the way forward as the battle for family medicine goes on.


    Supporting Family Physicians During the COVID-19 Pandemic

    Family physicians have been on the front lines of the fight against COVID-19, and since the start of the pandemic, the Academy has been pushing Congress and the administration to deliver what its members need to care for their patients, keep themselves safe and sustain their practices through economic uncertainty.

    These efforts have yielded significant wins through the Families First Coronavirus Response Act, the , and other supplemental funding legislation, as well as through regulatory actions taken by the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS), including:

    • $175 billion in HHS Provider Relief Funding for health care providers to recoup some of their financial losses due to COVID-19;
    • Paycheck Protection Program funds to provide short-term, forgivable loans to help small business increase cash flow;
    • Medicare Accelerated and Advance Payment Program funds to provide advance access to capital for Medicare providers;
    • ·elimination of patient cost-sharing for COVID-19-related diagnostic and treatment services while allowing health plans to waive deductibles for telehealth services;
    • elimination of prior-authorization requirements for all COVID-19-related diagnostic services;
    • suspension of Medicare geographic and originating site restrictions for telehealth;
    • enabling FQHCs and Rural Health Clinics to provide telehealth services;
    • payment parity for Medicare telehealth services;
    • Medicare coverage and payment parity for audio-only E/M visits;
    • relief from Medicare Quality Payment Program reporting requirements; and
    • relief for Medicare alternative payment model participants.

    The AAFP co-hosted a virtual briefing to educate members of Congress and their staff on the need to support primary care during COVID-19. The event featured remarks by co-chairs of the Congressional Primary Care Caucus and drew more than 150 attendees.

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    Family physicians play an essential role in helping our nation recover from COVID-19 and preparing for future public health emergencies. The Academy is fighting for additional, targeted financial relief and increased Medicaid and Medicare payment for primary care. The Academy is also fighting to preserve key telehealth flexibilities so that family physicians can continue to provide virtual care, as well as advocating for limited liability protections for physicians responding to the pandemic.


    Reducing Administrative Burden for Physicians

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    The Academy is working with Congress and CMS to halt implementation of the Medicare Appropriate Use Criteria (AUC) program.
     

    Funding Teaching Health Centers

    In July, the Health Resources and Services Administration announced seven new Teaching Health Center Graduate Medical Education program grants for the 2020-21 academic year. The announcement marked the first new awardees in seven years and occurred due to the AAFP’s successful, years long effort to increase THCGME program funding and stability.

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    The CARES Act extended the THCGME program through November 30, 2020, to ensure that these programs do not lose funding in the middle of the COVID-19 pandemic. The AAFP continues to advocate for long-term program extension and increased program funding.


    Ensuring Access to Primary Care

    The AAFP partnered with other physician organizations to help introduce legislation in both the House and the Senate to increase Medicaid reimbursement rates for primary care services to at least Medicare levels.

    This year, support for primary care access legislation increased in Congress, specifically to reduce barriers for those who have high-deductible health plans. Since the AAFP helped create the Primary Care Patient Protecting Act of 2018, a bill to ensure that patients can access primary care prior to meeting their insurance deductibles, legislation has been introduced during the 116th Congress with the same intent, including an identical bill introduced in the Senate and another proposal to waive deductible for chronic-disease care.

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    The Academy has called on Congress and CMS to move forward with the planned payment increases and documentation changes for Medicare E/M services slated to take effect January 1, 2021. The Academy will continue working with its champions in Congress to pass legislation to increase Medicaid payments for primary care and eliminate cost barriers to primary care.

    Addressing Health Disparities

    In a letter to HHS, the AAFP urged federal officials to improve the collection and reporting of COVID-19 health disparities data. In response to these concerns, Congress approved language to strengthen data collection requirements within the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

    Policymakers also approved the Paycheck Protection Program and Health Care Enhancement Act, which requires HHS to stratify data by race, ethnicity, age, sex, and geographic region. In June, HHS announced guidance requiring health professionals and public health departments to include demographic information in COVID-19 diagnostic test reports.

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    The Academy will continue supporting health equity through policies to increase primary care access, improve data collection, address social determinants of health, and enhance health care quality. In a June letter, the Academy shared its COVID-19 equity proposals, such as the COVID-10 Racial and Ethnic Health Disparities Taskforce Act and the Social Determinants Accelerator Act. The AAFP provides ongoing expert recommendations to address the disparities that exist within maternal health and rural health.


    Providing Research-Basis for Clinical Expertise to Improve Individual and Population Health

    The AAFP successfully supported a 10-year reauthorization of the Patient-Centered Outcomes Research Institute (PCORI) in order to fund the primary care research needed to extend the nation's capacity to design and implement vital patient-centered outcomes research.

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    The AAFP will continue to advocate for the primary care research funding necessary to expand the capacity for practice-based research, which is particularly critical in the face of the changes in medical practice brought on by COVID-19.


    State Level Support and Advocacy

    The Center for State Policy has tracked more than 22,000 bills across the 46 state legislative and four territorial bodies in session this year and responded to 238 chapter inquiries in the first half of 2020 on issues ranging from scope of practice to payment reform to administrative burden.

    The Center announced new priority issues and additional resources for states to achieve their advocacy goals, including template letters, state-by-state fact sheets, and legislative policy backgrounders, with a special emphasis on resources to address the COVID-19 pandemic.

    As rotating first co-chair for the nonpartisan Partnership for Medicaid, the AAFP has reinvigorated the group and engaged with key congressional staff, administrative agencies, and policy speakers to secure Medicaid payment and coverage improvements.