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2014 Proposed Medicare Physician Fee Schedule

AAFP Response to the CMS 2014 Proposed Medicare Physician Fee Schedule

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/LT-CMS-2104ProposedMPFS-082913.pdf

AAFP Backgrounder - Scope of Practice: Pharmacists

...pharmacists and physicians, such as collaborative drug therapy management (CDTM). However, the AAFP believes that only licensed doctors of medicine, osteopathy, dentistry, and podiatry should have the statutory authority to prescribe drugs. The AAFP believes that independent...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/scope/BKG-Scope-Pharmacists.pdf

AAFP Backgrounder - Scope of Practice: Physician Assistants

...determination of scope of practice, adaptability of supervision requirements, determination of co-signature requirements, and maximum number of PAs a physician can supervise at one time. All states have passed legislation regarding the use of the term licensure to describe the...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/scope/BKG-Scope-PhysicianAssistants.pdf

AAFP Backgrounder: AAFP Backgrounder: Graduate Medical Education Legislation in the ...

...mix of trained physicians. However, research has shown the need for a greater investment in primary care physicians. A 2019 JAMA Internal Medicine study found that every 10 additional primary care physicians per 100,000 population was associated with a 51.5-day increase in life...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/BKG-GME116thCongress.pdf

AAFP Backgrounder: Graduate Medical Education

...AAFP Position To increase the number of family medicine graduates in the United States, the American Academy of Family Physicians (AAFP) is committed to removing significant barriers stifling the growth in family medicine specialty choice among U.S. medical graduates. AAFP policy...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/BKG-GME.pdf

AAFP Backgrounder: Marijuana

...that satisfy the needs of their patients. Despite the limited body of research supporting the medical properties of marijuana, a growing number of patients have turned to medical marijuana to treat symptoms associated with conditions like chronic pain or chemotherapy. The AAFP...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/misc/BKG-Marijuana.pdf

AAFP Backgrounder: Medicaid Expansion

...12.7 million individuals newly eligible for Medicaid under the law’s Medicaid expansion provisions.3,4 The greatest declines in the number of uninsured post-ACA have been in the 36 states and DC that expanded Medicaid eligibility to include largely working adults without children...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/medicaid/BKG-MedicaidExpansion.pdf

AAFP Backgrounder: Medicaid Work Requirements

...Justice Department has appealed the decisions and the cases are pending. Research Surrounding Work Requirements The New England Journal of Medicine concluded that despite many individuals losing Medicaid coverage following the introduction of work requirements on beneficiaries, that...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/medicaid/BKG-MedicaidWorkRequirements.pdf

AAFP Backgrounder: Physician Preceptor Tax Credits

...and coordinated care through robust family medicine preceptorship programs. Evidence shows that early and consistent mentorship of medical students by preceptors increases the likelihood of these students choosing family medicine as a career. The AAFP will continue to advocate for...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/BKG-PreceptorTaxCredit.pdf

AAFP Backgrounder: Primary Care Spend

...and efforts to increase the level of investment. Transparency in Primary Care Spending Despite an increase in the number of medical students choosing family medicine and other primary care specialties for residency, resources and investment within the United States remain skewed...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/apms/BKG-PrimaryCareSpend.pdf

AAFP Backgrounder: Sustain Primary Care

...of their patients, COVID-19 and non-COVID-related. The FFS payment model, by design, reimburses based on the number of services delivered. At the core of family medicine is a focus on health, wellness and prevention. These goals are not appropriately supported by our current payment...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/campaigns/action_week/BKG-SustainPrimaryCare.pdf

AAFP Backgrounder: Teaching Health Centers

...Background The THCGME program, administered by the Health Resources and Services Administration (HRSA), provides funding to increase the number of primary care medical and dental residents training in community-based settings across the country. Since most health care in the U.S....

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/BKG-TeachingHealthCenters.pdf

AAFP Comment Letter on 2019 Final Medicare Physician Fee Schedule - December 28, 2018

...actuarially based upon the framework of FFS payment. Thus, if current FFS payments are not improved, the current undervaluation of family medicine and primary care payment will result in a similar undervaluation of primary care in evolving primary care APMs. In the long run,...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/medicare/LT-CMS-2019FinalMPFS-122818.pdf

AAFP Comments on IRS Proposed Rule on Direct Primary Care Arrangements - August 10, 2020

...access to primary care for all Americans. DPC and other direct care models are increasing in popularity among our members and a growing number of family physicians are expressing an interest in the DPC model. However, there are identified barriers that may prevent some patients from...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/dpc/LT-IRS-ProposedDPCRule-081020.pdf

AAFP Comments to CMS on MSSP/ACO Proposed Rule - October 15, 2018

...is related to at least two factors-being physician-led and having a strong primary care foundation. A September 2018 New England Journal of Medicine article found that physician-led ACOs generated savings that increased over a three-year study period compared to hospital-led ACOs.2...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/apms/LT-CMS-ACO-MSSP-101518.pdf

AAFP Comments to CMS on the 2018 Inpatient Proposed Rule

...that meets their needs. It should be noted that this will occur at a point when upgrading to 2015 Edition CEHRT could minimize the number of significant disruptions to patient care. As some members have begun the process of switching EHR systems, reports of information blocking...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/legal/administrative/LT-CMS-IPPSProposedRule-060817.pdf

AAFP Executive Summary of Alternative Payment Models - March 14, 2017

...view of the patient, who is much more than a set of organ systems and disease conditions. The goal of primary care is to ensure that medicine does not lose sight of the whole patient and the patient’s context, which affects a wide range of health outcomes. There is an emerging...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/apms/ES-AdvancedPrimaryCare-121316.pdf

AAFP Initial Summary of the 2020 Final Medicare Physician Fee Schedule - November 1, 2019

...be $36.0896. Based on CMS’ final rule, there would be no change in total Medicare allowed charges for family medicine in 2020, but total allowed charges for family medicine would increase 12% in 2021. Evaluation and Management In 2019 rulemaking, CMS finalized changes to simplify...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/feesched/ES-2020FinalMPFS-110219.pdf

AAFP Initial Summary of the 2020 Proposed Medicare Physician Fee Schedule - July 30, 2019

...office/outpatient E/M visits beginning in 2021. Thus, CMS proposes to: • Retain 5 levels of coding for established patients; • Reduce the number of levels to 4 for office/outpatient E/M visits for new patients; • Revise the times and medical decision-making process for all...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/feesched/ES-2020MPFS-073019.pdf

AAFP Letter for EandC Subcommittee on Health on ACA and Drug Pricing Bills Markup - ...

...debate, in part, because of the complexity of care family physicians provide and the fact that the number and intricacy of conditions, complaints, and diseases seen in family medicine is far greater than those seen by any other physician specialty. Ensuring access to...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/aca/LT-E&C-ACADrugPricing-03272019.pdf

AAFP Letter for the Senate Finance Committee RFI on Maternal Health - April 3, 2020

...Understanding family medicine’s potential role to improve pregnancy related health outcomes, the AAFP established a maternal health taskforce in 2018. The Academy’s programmatic and legislative priorities include retaining obstetric care professionals, supporting maternity care...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/women/LT-SenateFinance-MaternalHealth-040320.pdf

AAFP Letter in Response to OIG on Anti-Kickback Issues - December 27, 2019

...welfare and, more broadly, on protecting public health. Below are comments on portions of the proposed rule most applicable to family medicine. Deputy Administrator Alexander December 27, 2019 Page 2 of 4 C. Care Coordination Arrangements to Improve Quality, Health...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/apms/LT-OIG-SafeHarborsAntiKickback-122719.pdf

AAFP letter on the Reauthorizing and Extending America’s Community Health (REACH) Act ...

...framework as proposed in the Training the Next Generation of Primary Care Doctors Act of 2019 (HR 2915), which would allow expansion in the number of residents trained from 728 to 900. The benefits of primary care access are well-understood. For example, states with higher ratios...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-E&C-PrimaryCareExtensionsREACH-071719.pdf

AAFP Letter on the Senates HELP Committee’s Lower Health Care Costs Draft Bill - June ...

...the patients’ deductible. The AAFP supports this policy. We urge the inclusion of policies to reduce hospital admissions by increasing the number of primary care visits for patients with high deductible health plan (HDHPs), defined as any plan with a deductible of at least $1,350...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/vaccines/LT-Senate-HELPLowerHCCostsAct060519.pdf

AAFP Letter on the THCGME, CHC, NHSC, PCORI, and Medicaid Extensions Markup - July 11, ...

...all contribute to a more accessible and robust primary care delivery system. Combined, they stand to significantly increase the number of primary care physicians trained and practicing in areas that need them the most. The committee’s program extensions will provide critical program...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-ECHealthSub-CHIME-071119.pdf

AAFP Letter Opposing the 2015 Proposed Part C and D Rule

AAFP letter to CMS opposing provisions of 2015 proposed changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs.

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/LT-CMS-PartCD-022614.pdf

AAFP Letter Proposing Establishing a Standard Primary Care Benefit - April 26, 2017

...practicing under one or more of the following Physician Specialty Codes: 01 General Practice; 08 Family Medicine; 11 Internal Medicine; 37 Pediatric Medicine; and 38 Geriatric Medicine. o Patients would designate their primary care physician and that physician would be the site...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/aca/ES-StandardPrimaryCareBenefit-042617.pdf

AAFP Letter Responding to House Ways and Means Committee Rural and Underserved ...

...Higher premiums threaten the viability of some rural hospitals and make it difficult for rural areas to recruit or retain an adequate number and mix of physicians. Through the Federal Tort Claims Act (FTCA), the federal government offers a way for certain rural health centers to...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-HouseWM-TaskforceRFIResponse-112619.pdf

AAFP Letter Responsing to CMS RFI on Direct Provider Contracting - May 25, 2018

...The AAFP offers a number of recommendations in response to CMS’ questions on how the agency can test and implement a Direct Provider Contracting model for primary care that improves quality and outcomes for beneficiaries, that reduces costs for Federal health programs - and reduces...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/apms/LT-CMS-DirectProviderContracting-052518.pdf

AAFP Letter Supporting the Primary Care Enhancement Act of 2019 (H.R. 3708) - August ...

...these current legal barriers that prevent patients with HSAs from receiving care from family physicians practicing in a DPC model. A growing number of family physicians are choosing to practice in the DPC model and patient demand for DPC practices is growing. Additionally, employers...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/dpc/LT-RepsBumenauerSmith-PrimaryCareEnhancementAct-081219.pdf

AAFP Letter to ABMS Vision Committee on Continuing Board Certification - January 14, 2019

...c. As new advances in medicine and patient care emerge in clinical practice, the ABMS Boards should be encouraged to consider what core knowledge, judgment and skills are needed to be a diplomate in their core specialty or subspecialty and create assessments that are preferentially...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-ABMSVisionComm-ContBoardCert-011419.pdf

AAFP Letter to CMS and ONC with Administrative Simplification Requests - February 7, 2018

...allocation of physician time in ambulatory practice across four medical specialties in four states found, physicians from family medicine, internal medicine, cardiology, and orthopedics spent nearly 2 hours in the EHR and on other desk work for every 1 hour of direct patient care....

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/legal/administrative/LT-CMS-ONC-AdminSimplification-020718.pdf

AAFP Letter to CMS on E/M Documentation Requirements - April 23, 2018

...history and physical exam, or should these requirements be reduced (if reduced, how)? In general, the guidelines are a burden on family medicine that lacks an offsetting benefit to clinical care. The AAFP calls on CMS to address redundancies in documentation requirements to...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/LT-CMS-EMSuggestions-042318.pdf

AAFP Letter to CMS on Medicaid Access to Covered Medicaid Services - May 16, 2018

...low, especially for primary care, and the Medicaid bureaucracy impedes timely, adequate payment. In anticipation of an increase in the number of individuals enrolled under Medicaid expansion, the Affordable Care Act introduced a two-year Medicaid fee increase to boost Medicaid...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/LT-CMS-MethodsAssuringAccessCoveredMedicaidServices-051618.pdf

AAFP Letter to CMS on Section 5 of EO #13890 Regarding Supervision Requirements of ...

...the President’s Executive Order (EO) #13890 on Protecting and Improving Medicare for Our Nation’s Seniors. The EO directs HHS to propose a number of reforms to the Medicare program, including ones that eliminate supervision and licensure requirements of the Medicare program that are...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/scope/LT-CMS-SupervisionReqsNonPhysicians-011420.pdf

AAFP Letter to CMS on the 2018 Quality Payment Program Final Rule with Comment Period -...

...final rule with comment period, and looks forward to being a resource and partner to CMS in achieving the goals of MACRA. About Family Medicine Family physicians are dedicated to treating the whole person. These residency-trained, primary care specialists provide a wide variety of...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/LT-CMS-2018FinalQPP-121917.pdf

AAFP Letter to CMS on the GME Cap - January 16, 2019

...(institution) has five years to establish its Medicare GME funding cap on the number of residency positions, thereby establishing a permanent ceiling for Medicare GME funding. The cap is set at the number of residents at the institution five years after the first resident begins to...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-CMS-GMECap-011619.pdf

AAFP Letter to CMS with Final Comments on the 2019 Proposed Medicare Physician Fee ...

...proposed four major changes to the Medicare Part B Fee-For-Service program that would have an immediate and measurable impact on family medicine. Those items are: 1. simplify payment by adopting a single payment rate for evaluation and management (E/M) codes for new patients...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/LT-CMS-2019ProposedMPFS-090618.pdf

AAFP Letter to Congresional Leadership on THCGME Reauthorization and Recruitment - ...

...their 2020 matriculating classes. At the same time, applicants are evaluating programs to determine where they will complete their family medicine residency training. Although the recruitment process ends in March of 2020, actions taken by Congress in the next few weeks could...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-Congress-THCGMEReauthRecruit-101719.pdf

AAFP Letter to EandC Health Subcommittee on Drug Pricing Bills - March 13, 2019

...drug pricing debate, in part, because of the complexity of care they provide and the fact that the number and intricacy of conditions, complaints, and diseases seen in family medicine is far greater than those seen by any other physician specialty. Ensuring access to medications is...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/aca/LT-ECHealthSub-DrugPricing-031319.pdf

AAFP Letter to HHS on Health System Resilience - July 8, 2020

...of Health and Human Services 200 Independence Avenue S.W. Washington, D.C. 20201 Captain Paul Reed Deputy Assistant Secretary for Health, Medicine and Science Office of the Assistant Secretary for Health U.S. Department of Health and Human Services 200 Independence Avenue S.W....

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/strategy/LT-HHS-HealthSystemResiliance-070820.pdf

AAFP Letter to HHS Requesting Information on Drug Prices - July 16, 2018

...in the drug pricing debate, in part because of the complexity of care provided and the fact that the number and complexity of conditions, complaints, and diseases seen in family medicine is far greater than those seen by any other physician specialty. Ensuring access to medications...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/medicare/LT-HHS-DrugPrices-071618.pdf

AAFP Letter to HRSA on Rural Health Care Access - October 9, 2019

...the number of residency positions and support for residency programs; and • Create policy, collaboration and resources to help family physicians improve rural health disparities. The underlying reasons for rural health care crisis are multifactorial but include lower payments...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/LT-HRSA-RuralHealthCare-100919.pdf

AAFP Letter to ONC on Information Blocking - June 3, 2019

...Michael L. Munger, MD, FAAFP Board Chair About Family Medicine Family physicians conduct approximately one in five of the total medical office visits in the United States per year-more than any other specialty. Family physicians provide comprehensive, evidence-based, and...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/health_it/emr/LT-ONC-InfoBlocking060319.pdf

AAFP Letter to Senator Gardner on Rural Physician Workforce Production Act - February ...

...the communities they serve need. These financial incentives would extend to urban hospitals as well, for the specific purpose of growing the number of residents they train in rural training tracks. The Rural Physician Workforce Production Act represents a promising way to make...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-SenatorGardner-RuralPhysicianWorkforceProductionAct-%20020419.pdf

AAFP Letter to Senator Hyde-Smith on Rural Physician Workforce Production Act - ...

...the communities they serve need. These financial incentives would extend to urban hospitals as well, for the specific purpose of growing the number of residents they train in rural training tracks. The Rural Physician Workforce Production Act represents a promising way to make...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-SenatorHyde-Smith-RuralPhysicianWorkforceProductionAct-%20020419.pdf

AAFP Letter to Senator Tester on Rural Physician Workforce Production Act - February 4,...

...the communities they serve need. These financial incentives would extend to urban hospitals as well, for the specific purpose of growing the number of residents they train in rural training tracks. The Rural Physician Workforce Production Act represents a promising way to make...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-Senator-RuralPhysicianWorkforceProductionAct-%20020419.pdf

AAFP Letter to the 116th Congress: House Representatives Introducing the AAFP - January...

...legacy fee-for-service system. Furthermore, family physicians believe that the regulatory and administrative oversight of the practice of medicine has devolved from a well-intentioned focus on quality and performance improvement to a practice-level paperwork morass that drives...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/misc/LT-House-116Congress-AAFPIntro-012319.pdf

AAFP Letter to the CDC on Tobacco - February 6, 2019

...populations, prevent long-term addiction to tobacco products, curb spending due to tobacco-related illnesses and reduce the overall number of long- term tobacco users. Approximately 40,000 deaths annually due to lung cancer and heart disease can be attributed to secondhand smoke....

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/tobacco/LT-CDC-Tobacco-020619.pdf

AAFP Letter to the FCC on Telehealth in Rural America - January 31, 2018

...based on differing definitions of "rural," studies based on the demand to hire physicians by hospitals/physician groups, or based on the number of individuals per physician in a rural area, continue to indicate a need for additional physicians in rural areas. A balanced and...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/health_it/telehealth/LT-FCC-RuralTelehealth-013118.pdf

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