• In The Trenches

    Giving Thanks for Good (and Maybe Better) Progress

    November 23, 2021, 1:10 p.m. — Last week, Reps. Ami Bera, M.D., D-Calif., and Larry Bucshon, M.D. R-Ind., introduced the Supporting Medicare Providers Act of 2021 (H.R. 6020), straightforward legislation the Academy wholeheartedly backs. The law would do precisely what the AAFP has asked of Congress since CMS issued its 2022 Medicare physician fee schedule proposed rule this past summer: extend for an additional year the 2021 Medicare conversion factor positive adjustment of 3.75%.

    Capitol building in fall

    As I told you earlier this month, the 2022 MPFS sets the conversion factor at $1.30 less than this year’s, necessitating, for the second year in a row, congressional intervention to avert a pay cut for family physicians. H.R. 6020 would achieve this, and the Academy is pressing for its passage — and asking you to help get it done

    An alternative bill addressing Medicare physician payment also arrived last week, but it targets the wrong problem and threatens to make things worse for family physicians. The Medicare Stability for Patients and Providers Act (H.R. 6048) would prevent CMS from implementing the 2022 MPFS’s update to clinical labor pricing, an aspect of the rule we’ve hailed as long overdue. The final rule will ensure that CMS is relying on modern wage data to determine Medicare payments for clinical labor, a significant win for AAFP members who rely on nurses and medical assistants to act as members of their patient care teams. H.R. 6048 would scotch that victory, and the Academy opposes it. Vehemently

    Dual Spending Bills Dominate the News Cycle

    Of course, the biggest headlines out of Congress lately are focused on a couple of sweeping packages.

    One of those, the $1.2 trillion bipartisan bill known as the Infrastructure Investment and Jobs Act (H.R. 3684), was signed into law this month. We like it! The law includes spending that has the potential to address some social determinants of health — for instance, $65 billion to improve broadband access in rural, tribal and underserved areas, along with considerable spending to advance “digital equity,” in line with recent Academy broadband advocacy.

    The other legislative package is the Build Back Better Act (H.R. 5376), which has passed the House of Representatives and is awaiting action in the Senate and which the Academy strongly supports. The version now before senators would invest in the primary care workforce, improve health equity, increase access to health coverage, address vaccine access and confidence, and strengthen our public health infrastructure. Among its numerous potential wins for family medicine:

    • $3.37 billion for the Teaching Health Center Graduate Medical Education program and $2 billion for the National Health Service Corps,
    • ongoing enhanced subsidies for Patient Protection and Affordable Care Act marketplace plans made possible by the American Rescue Plan,
    • a permanent increase of federal Medicaid funding for the U.S. territories (something for which the AAFP has long advocated
    • one year of postpartum coverage for women enrolled in Medicaid and CHIP,
    • every eligible provision from the very much AAFP-backed Momnibus package, and
    • critical measures to eliminate cost-sharing for routine immunizations for adults enrolled in Medicaid and Medicare.

    Build Back Better presents an enormous opportunity to advance a number of our priorities, which is why we’re engaging directly with Senate leaders this week. We are fighting to get it passed and deliver these important wins for family physicians and their patients before the end of the year.      

    State Legislative Conference Showcases Strong Advocacy

    Ninety-five attendees representing 36 state chapters joined this year’s AAFP State Legislative Conference Oct. 21-22 to hear about one another’s advocacy strategies and wins. Particular focus was on primary care spend, scope of practice, telehealth and administrative simplification.

    We also recognized two chapters that met the challenges of the COVID-19 pandemic and supported family physicians and their patients in unique and innovative ways. The 2021 Leadership in State Government Advocacy Awards went to the California and New Jersey AFPs.

    Facing the widespread closure of primary care practices because of COVID-related restrictions, the California chapter worked with fellow health care stakeholders to propose legislation designed to assist practices transition from fee-for-service to alternative payment models. The resulting bill hasn’t yet been signed into law, but it’s a true milestone in state-level payment reform.

    At the conference, Catrina Reyes, the chapter’s vice president of advocacy and policy, emphasized the importance of building coalitions and strengthening alignments. Under the big tent erected to get this bill going were consumer groups, patient advocates, labor organizations and employer groups.

    For its part, the New Jersey AFP aggressively backed its members when that state became one of the original COVID-19 hotspots. Its advocacy first centered on securing financial support and personal protective equipment for primary care offices, then pivoted to lobby for full PC inclusion in vaccine distribution — work that we all know must continue.

    “It’s hard to believe that, 18 months into this pandemic, we still have to remind policymakers of the importance of primary care practices and physicians to address vaccine hesitancy and tame this crisis, but here we are,” Claudine Leone, government affairs director for New Jersey AFP, told SLC attendees.

    Applications for next year’s advocacy awards will open to chapters in June 2022.


    Stephanie Quinn, AAFP senior vice president of advocacy, practice advancement and policy.  Read author bio »


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