Ahead of its annual Leadership Day, ACP lists its top priorities for advocacy with congressional leaders
May 19, 2023 (ACP) — As summer nears, the American College of Physicians is pushing for lawmakers to pass several important bills that will make a big difference in the lives of patients and clinicians.
As summarized in an ACP action alert, this is a crucial time for members of Congress to hear from their constituents on the importance of expanding the physician workforce, improving patient access, promoting health equity, and reducing administrative burden.
More than 400 physicians, students and trainees from 48 states will travel to Washington, D.C., on May 23 to 24 for Leadership Day, ACP's national advocacy conference, to meet with their lawmakers and advocate for these issues, according to David Pugach, J.D., ACP vice president for governmental affairs and public policy.
“There are also a number of ways people can effectively advocate without traveling to D.C.,” he added. “One of the easiest options is through ACP's Legislative Action Center, which facilitates email and social media messages to lawmakers on these and other issues.”
Here is a look at several pieces of legislation that are being prioritized by ACP and that will be the focus of Leadership Day:
H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which preserves access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index for Medicare physician payments.
“This legislation would take a significant step toward ensuring that Medicare payments for patient care are sufficient for maintaining and improving access to care for Medicare beneficiaries,” Pugach said. “Medical practices have been challenged by increased practice expenses, staffing shortages and a myriad of time-consuming administrative issues that can lead to delays in patient care.”
As Pugach noted, Medicare payment rates for physicians have not just failed to keep up with inflation for more than two decades, but they have been cut on an annual basis in recent years. “The absence of inflationary updates means that from 2001 to 2022, Medicare physician payments have decreased by 26 percent when adjusted for inflation,” he said. “It is also worth noting that Medicare Part B, which covers office visits and outpatient services provided by physicians, is the only part of Medicare that does not provide inflationary updates.”
According to Pugach, ACP members need to help their congressional representatives understand the toll that flawed Medicare payment policies have taken on patient care. “Physician advocacy can go a long way toward building support for this legislation and helping it advance,” he said.
H.R. 952, the Kids' Access to Primary Care Act, which aligns Medicaid reimbursement rates with Medicare payments.
“Medicaid continues to be a crucial source of care for many of our patients, including children as well as pregnant and postpartum individuals,” Pugach said. “However, under Medicaid, on average, a clinician treating a Medicaid enrollee is paid about two-thirds of what Medicare pays for the same services and only half of what is paid by private insurance plans. The Kids' Access to Primary Care Act would align Medicaid reimbursement rates with Medicare payments for primary care services.”
ACP advocacy is especially crucial for this legislation. “The bill has a difficult path forward, as more support is needed for any legislation that is associated with increased Medicaid spending,” Pugach noted.
H.R. 2630/S. 652, the Safe Step Act, would require group health plans to provide an exception process for medication step therapy protocols to help ensure that patients can safely and efficiently access treatment.
“This legislation would help remove unreasonable barriers to patient care and reduce administrative burden for physicians by reforming step-therapy protocols. As physicians and patients know all too well, insurers' step-therapy policies can require patients to be placed on lower-priced medications before being approved for originally prescribed medications,” Pugach explained. “The Safe Step Act provides five exceptions to fail-first protocols and requires that a group health plan grant an exemption if an application clearly demonstrates any of several situations, such as when the patient already tried and failed on the required drug.”
There is good news about this legislation: The Safe Step Act was introduced in the House and Senate earlier this year, and co-sponsorship of the legislation is steadily growing in both chambers. “This is also one of the issues being prioritized at Leadership Day,” Pugach said.
H.R. 1202/S. 704, the Resident Education Deferred Interest Act, would allow borrowers in medical or dental internships or residency programs to defer student loan payments until the completion of their programs, and the related H.R. 2389, Resident Physician Shortage Reduction Act of 2023, would increase the number of Medicare-supported graduate medical education positions by 14,000 over seven years.
These bills aim to address the growing physician shortage. The Resident Physician Shortage Reduction Act of 2023 would increase the number of Medicare-supported graduate medical education positions by 2,000 per year for seven years. And the Resident Education Deferred Interest Act would allow borrowers to qualify for interest-free deferment on their student loans while in a medical or dental internship or residency program.
Both bills have been introduced in the House and Senate and have bipartisan support, Pugach said, but they need additional co-sponsors to help them advance.