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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 Advocacy: Health Care Coverage

Learn about the AAFP's advocacy work around changes in health care coverage systems and processes, including changes to the ACA, CHIP, and more.

Advocacy : Advocating for You: Advocacy Topics

https://www.aafp.org/advocacy/advocacy-topics/health-care-coverage.html

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 -Scope of Practice: Pharmacists

Background information from the AAFP on scope of practice for pharmacists.

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/scope/BKG-Scope-Pharmacists.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: Education and Training - Family Physicians vs Nurse Practitioners

...and the clerkships grants students the Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) degree, which entitles them to start full clinical training in a residency program. Most family medicine residency programs, which are accredited by the Accreditation Council for...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/scope/FPvsNP.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: Legislative Interference

...HC, Henley DE, Alden ER, Hoyt DB. (2012). Legislative Interference with the Patient -Physician Relationship. New England Journal of Medicine. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMsb1209858 2 Marshall C. (2013). The Spread of Conscience Clause Legislation....

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/legal/BKG-LegislativeInterference.pdf

AAFP Backgrounder: Marijuana

Background information from the AAFP on marijuana.

Advocacy

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

AAFP Backgrounder: Medicaid Expansion

The AAFP is strongly supportive of policies to expand health insurance coverage to all Americans. The AAFP supports expanding Medicaid eligibility as a path to make health care available to all by increasing access to care and enabling physicians to provide cost efficient, quality care.

Advocacy

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

AAFP Backgrounder: Medicaid Work Requirements

...Temporary Assistance for Needy Families (TANF). Analyses of these programs suggest that work requirements do not spur a significant number of beneficiaries to seek and gain employment7 and that the evidence to support the idea that work has a positive impact on health and health...

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 information from the AAFP on Teaching Health Centers..

Advocacy

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

AAFP Backgrounder: The Importance of Primary Care

Background information from the AAFP on the importance of primary care.

Advocacy

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

AAFP Chapter Letter in Support of THCGME Reauthorization - February 11, 2020

...with the Community Health Center Program and the National Health Service Corp Program, are essential resources to begin to increase the number of primary care physicians and to ensure they work in communities that need them most. Together, they achieve our shared goals of improving...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-HouseSenLeaderships-ChapterSupportLetterTHCGME-021120.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 2021 Medicare Physician Fee Schedule - September 28, 2020

...family medicine and primary care. We look forward to working with CMS on designing and implementing policies that support these shared goals through both the Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP). Our members are on the frontlines of medicine,...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/feesched/LT-CMS-Response2021MPFSProposedRule-092820.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 Comments to CMS on the 2022 Medicare Physician Fee Schedule Proposed Rule - ...

The AAFP submitted detailed comments in response to the CY 2022 Medicare Physician Fee Schedule and Quality Payment Program proposed rule. Key issues include: fair valuation and payment for primary care services, facilitating the transition to value-based care, reducing administrative ...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/payment/medicare/feesched/LT-CMS-MedicarePhysicianFeeScheduleProposedRule-091021.pdf

AAFP Comments to CMS on the FY 2022 IPPS Proposed Rule - June 7, 2021

The AAFP commends CMS for prioritizing health equity in these proposals. To more comprehensively address physician shortages and maldistribution, we strongly recommend that CMS also prioritize applications for new GME slots from hospitals that train a high proportion of physicians who ...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-CMS-FY2022IPPSProposedRule-060721.pdf

AAFP Comments to DEA on MAT Interim Final Rule - December 23, 2020

AAFP comments on the DEA Medication-Assisted treatment interim final rule.

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/risk/LT-DEA-MATFinalRule-122320.pdf

AAFP Comments to DHS on Proposal to Eliminate the H-1B Visa Lottery - December 1, 2020

...Department proposes to grant petitions based on wage level, awarding them first to those with the highest wages. Due to existing caps on the number of H-1B physicians that are accepted, this means that petitioners with lower wage levels will never be selected and it is unlikely that...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/LT-DHS-H1BLotteryProposedRule-120120.pdf

AAFP Comments to HHS on Proposed Rule to Automate Prior Authorizations - December 23, 2020

The AAFP is in favor of requirements for payers to automate and respond to prior authorization requests in a timely manner, so we are concerned that this proposal will not have a meaningful impact on reducing administrative burden, since it does not include Medicare Advantage plans or ...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/legal/administrative/LT-HHS-PriorAuthProposedRule-122320.pdf

AAFP Comments to HHS on SUNSET Proposal - December 2, 2020

...the regulation. More specifically, the Department proposes to require that all regulations are assessed for their impact on a substantial number of small entities. For those that are deemed to have a significant impact, HHS will have to more formally review them to determine whether...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/legal/administrative/LT-HHS-CommentsSUNSETProposal-120220.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 Executive Summary: 2020 Year End Funding Bill and COVID-19 Emergency Funding Key ...

On Dec. 22, President Trump signed legislation into law which funds the federal government for the remainder of fiscal year 2021 and provides about $900 billion in COVID-19 emergency funding. The bipartisan agreement is the fourth legislative package passed in response to the COVID-19 ...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/crisis/ES-2020YearEndBillHighlights-122220.pdf

AAFP Fact Sheet on the Teaching Health Centers Graduate Medical Education Program

...Increases the number of physicians who serve underserved populations 2 3 Reauthorize the Teaching Health Center Graduate Medical Education (THCGME) Program THCGME residents train in the primary care specialties of family medicine, internal medicine, pediatrics,...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/FS-THCGME.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

...• 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 office-based E/M codes and require performance of history and exam only as...

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 https://www.hindawi.com/journals/scientifica/2012/432892/...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/coverage/aca/LT-E&C-ACADrugPricing-03272019.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. https://www.govinfo.gov/content/pkg/FR-2019-10-17/pdf/2019-22027.pdf https://www.govinfo.gov/content/pkg/FR-2019-10-17/pdf/2019-22027.pdf...

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 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 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 ACIP Outlining Concerns and Principles for a Future COVID-19 Vaccine - ...

...National Center for Immunization and Respiratory Diseases 1600 Clifton Road NE MS-H24-8 Atlanta, GA 30329 Re: October Meeting, Docket Number CDC-2020-0100 Dear Members of the Advisory Committee, On behalf of the American Academy of Family Physicians (AAFP), which represents more...

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/vaccines/LT-ACIP-COVID19Vaccine-103020.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 Opioid Action Plan - October 10, 2019

...public health emergency that negatively impacts population health, community well-being, economic readiness, and social welfare. The rising number of opioid overdose deaths is both a symptom of our nation’s health care challenges and a separate problem that requires urgent action....

Advocacy

https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/risk/LT-CMS-OpioidRFI-101019.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

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