Some priorities include physician payment reform, reducing administrative burden and strengthening the physician workforce
Feb. 9, 2024 (ACP) -- Fresh on the heels of some major advocacy wins in 2023, the American College of Physicians is off to a running start in 2024 with physician payment reform and reining in burdensome prior authorization processes at the top of its federal advocacy priority list for the new year.
The stakes are high, said David Pugach, ACP vice president for governmental affairs and public policy. "It is an election year, so it is harder to get things done, [as] Congress typically is in session for fewer days … to give members more time to focus on getting reelected and to campaign at home," he said. "It is all the more important that physicians are actively engaging with lawmakers and making sure their voices are heard now, as this is the best way to break through the noise and elevate the issues of importance for physicians and patients."
Among the top ACP advocacy priorities for 2024 is physician payment reform. "We are working to get Congress to pass or include legislation in a larger package that would stop or reverse the across-the-board cuts to Medicare payment," Pugach said. In 2024, the Centers for Medicare & Medicaid Services implemented a 3.4 percent across-the-board cut to physician Medicare payments. These hits are largely offset by an advocacy win in 2023: implementation of the G2211 code, which pays more for longitudinal, high-quality primary care. "When this code is used, it offsets about 90 percent of the cut to payment rates," he noted.
ACP is working to ensure that the Medicare Physician Fee Schedule provides physicians with payment updates that are consistent with the Medical Economic Index and reflect the increased costs of caring for patients. ACP is also advocating for policies that support physicians' transition from fee-for-service to value-based care.
With the goal of reducing administrative burden for physicians, especially associated with prior authorization, ACP also supports passage of the Improving Seniors' Timely Access to Care Act, which would require that Medicare Advantage plans establish an electronic prior authorization process that provides real-time decisions, and the Safe Step Act of 2023, a bipartisan bill that would ensure patient access to appropriate treatments based on clinical decision-making and medical necessity rather than arbitrary step therapy protocols. The Safe Step Act would also require group health plans to provide a transparent exception process for any medication step therapy protocol.
Members can access the Grassroots Advocacy Alert on this topic to help get these bills passed.
Another key advocacy initiative for 2024 is to strengthen the primary care and physician workforce largely by increasing investments in federal programs that support and bolster the workforce.
The Conrad 30 waiver program allows foreign medical graduates to apply for a waiver of the two-year foreign residence requirement, and it is up for reauthorization, Pugach noted.
"This program extends the visa waivers for physicians who train in the United States to allow them to work here longer, so long as they work in medically underserved areas," he explained. "This program needs to be reauthorized and expanded to allow for states to increase the number of waivers they offer."
Other hot-ticket advocacy goals for ACP in 2024 include:
- Increasing prescription drug access and affordability
- Preventing firearms-related injuries and deaths
- Supporting and enhancing health information technology so it enhances patient care
- Protecting the patient-physician relationship through the adoption of policies that safeguard access to reproductive health care, LGBTQ+ and gender-affirming care, and ensuring nonphysician health care professionals perform within their scope of practice.