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Advocacy With Congress

The AMA lobbies the United States Congress to achieve medicine's legislative goals on a wide range of issues that affect the practice of medicine. Though not exhaustive, below is a list of legislative priorities. Learn more about the AMA’s instrumental role in securing regulatory improvements and significant legislative victories at the federal and state levels.
ACA Refinements

The Affordable Care Act (ACA) is a comprehensive health system reform law that will increase health insurance coverage substantially for the uninsured and implement long overdue reforms to the health insurance market. The new law includes many major provisions that are consistent with AMA policy and hold the potential for a stronger, better performing health care system. While the ACA represents a tremendous step forward on the path toward meaningful health system reform, it is not the last step, but rather the beginning.

The AMA is continuing to work with Congress and the Administration to refine certain provisions in the ACA.

Independent Payment Advisory Board (IPAB)

On February 14, 2013, Sen. John Cornyn (R-TX) introduced S. 351, the "Protecting Seniors' Access to Medicare Act of 2013," which would repeal the Independent Payment Advisory Board (IPAB). Rep. Phil Roe, MD (R-TN) introduced this bill as H.R. 351 in the House with bipartisan support on January 25. The IPAB is a panel that puts significant health care payment and policy decisions in the hands of an independent body of individuals with far too little accountability, and could adversely affect access to health care for Medicare patients. Patients and physicians are still struggling with the frequent threat of drastic cuts from the broken SGR Medicare physician payment formula. IPAB would be another arbitrary system that relies solely on payment cuts in an attempt to reduce spending in Medicare. The AMA strongly supports this legislation and looks forward to working with members of the House and Senate to achieve its enactment.

IPAB Summary

Letter to Sen. Cornyn, supporting S. 351, the "Protecting Seniors' Access to Medicare Act of 2013," March 19, 2013

Letter to Rep. Phil Roe supporting H.R. 351, the “Protecting Seniors Access to Medicare Act of 2013,” February 1, 2013

Letter to all Members of the House regarding H.R. 5, PATH Act, the combined IPAB Repeal and Medical Liability Reform bill," March 20, 2012

Letter to Chairman Camp, Ways and Means Committee, supporting H.R. 452, March 7, 2012

AMA letter to Energy and Commerce supporting H.R. 452, February 27, 2012

Letter to Sen. Cornyn supporting S. 668, the "Health Care Bureaucrats Elimination Act", July 6, 2011

Letter to Rep. Roe supporting H.R. 452, the "Medicare Decisions Accountability Act of 2011", July 6, 2011

Flexible Spending Accounts (FSAs)

The AMA continues to urge Congress to take action to lift the Affordable Care Act's restrictions on tax-preferred accounts, such as health savings accounts, for over-the-counter medicines.

Letter supporting H.R. 2194, the “Family and Retirement Health Investment Act of 2013,” March 3, 2014

FSA/OTC prescription requirement, Health Choices Coalition sign-on letter to Ways and Means Subcommittee on Oversight, April 25, 2012

Health Choices Coalition All Senate sign-on letter re: S. 1368, Senate Companion Bill to H.R. 2529, March 23, 2012

Health Choices Coalition All House sign-on letter re: H.R. 2529, "The Restoring Access to Medication Act," March 23, 2012

Letter to Sen. Hatch supporting S. 1098, Senate Companion Bill to H.R. 2010

Letter to Rep. Paulsen supporting H.R. 2010, the "Family and Retirement Health Investment Act of 2011, June 14, 2011

Health Choices Coalition sign-on letter to Congressional leaders urging action to lift ACA restrictions on FSAs for OTC medicines, May 10, 2011

Physician-Owned Hospitals

Existing legal restrictions on physician-owned hospitals put them at a competitive disadvantage, making it difficult for these care centers to respond to the health care needs of their local communities. AMA supports legislation that would allow physician-owned hospitals to expand and remain competitive, continue their solid record of providing the highest quality health care to patients, and contribute significantly to the communities they serve.

Letter to Rep. Sam Johnson supporting H.R. 2027, the “Expanding Patients’ Access to Quality Care Act of 2013,” May 12, 2014

Section 2706(a), Non-Discrimination

On July 24, 2013, Rep. Andy Harris, (R-MD), introduced H.R. 2817 to repeal Section 2706(a), the “Non-Discrimination in Health Care Providers” provision of the Affordable Care Act. Section 2706(a) states that in making decisions about which providers can participate or will be covered under a health plan, an insurer may not discriminate against health care providers acting within their state scope of practice law. AMA supports repeal of Section 2706(a), as it represents federal intrusion into scope of practice, generally the province of state law and regulations.

Antitrust Reform

The AMA continues to be concerned about increasing health plan consolidation, as well as the regulatory barriers that restrict physicians' ability to work together, and has made improving the antitrust environment for physicians a top priority. The AMA is actively supporting H.R. 1409, the "Quality Health Care Coalition Act of 2011," which was introduced by Representative John Conyers (D - MI). H.R. 1409 would allow health care professionals to jointly negotiate with health plans regarding terms that affect patient care, enabling physicians to advocate for quality care for their patients and reinforcing the patient-physician relationship.

Letter to Rep. Goodlatte re: H.R. 1409, October 27, 2011

Letter to Rep. Conyers supporting H.R. 1409, the "Quality Health Care Coalition Act of 2011," April 19, 2011

Combating Drug Diversion

Passage of H.R. 3528, the “National All Schedules Prescription Electronic Reporting Reauthorization Act of 2013” (NASPER 2013) and full appropriations is urgently needed to ensure that physicians across the country have a critical tool at the point-of-care to combat prescription drug abuse while ensuring patients with legitimate need of pain management continue to have access. Unfortunately, the appropriations to fully fund, modernize, and optimize NASPER prescription drug monitoring programs (PDMPs) have not kept pace with the rapid escalation in abuse and diversion of prescription drugs. Fully-funded PDMPs would provide more physicians with access to reliable, real-time information about prescriptions patients have obtained (and filled) from other prescribers, particularly controlled substances.

In a January 7, 2014 letter, Dr. Stack responded to additional questions stemming from the November 2013 House Energy and Commerce Hearing: “Examining Public Health Legislation to Help Local Communities”

AMA urged immediate passage of H.R. 3528 (NASPER 2013) and full appropriations with a strong emphasis on the public health focus of NASPER in a November 2013 statement to the House Energy and Commerce Committee.

Letter to Senator Edward Markey supporting S. 2645, “the Recovery Enhancement for Addiction Treatment Act,” (TREAT Act) July 2014

Letter to Sen. Rockefeller applauding his leadership on combating drug diversion, October 2013

Diabetes Prevention

Nearly 11 million seniors, or 26.9% of the Medicare population, have diabetes and half of all seniors over age 65 have pre-diabetes. In addition, one in every three Medicare dollars is spent on diabetes and its complications. Interventions targeted at preventing or delaying the onset of serious and debilitating illnesses like diabetes must be a national priority because diabetes is a costly and devastating disease that places people at high risk for severe complications and other chronic diseases. With access to appropriate intervention and information, diabetes can be prevented, even for those at the highest risk.

Sen. Jeanne Shaheen (D-NH) introduced S. 539, the "National Diabetes Clinical Care Commission Act," on March 12, 2013. H.R. 1074, the companion bill, was introduced in the House by Rep. Pete Olson (R-TX). The legislation would create a Commission that will focus on improving diabetes care delivery, patient outcomes and cost effectiveness. AMA supports this legislation.

On March 5, 2013, Senator Al Franken (D-MN) and Rep. Susan Davis (D-CA) introduced the “Medicare Diabetes Prevention Act of 2013” (S. 452/H.R. 962), a bipartisan bill which would provide coverage for the National Diabetes Prevention Program under the Medicare program. The National Diabetes Prevention Program at the Centers for Disease Control and Prevention is a public-private partnership that provides low-cost, evidence-based community programs to prevent diabetes. Providing Medicare coverage for the National Diabetes Prevention Program will help seniors avoid diabetes and other chronic illnesses. The AMA joined the American Diabetes Association and others from the medical community in expressing its support for this legislation.

AMA letter to Sen. Shaheen supporting S. 539, the "National Diabetes Clinical Care Commission Act"

ADA-generated sign-on letter to Senator Franken supporting S. 452, the "Medicare Diabetes prevention Act of 2013"

H.R. 1074 co-sponsorship list
S. 539 co-sponsorship list
H.R. 962 Co-sponsorship list
S. 452 Co-sponsorship list

HIV Organ Policy Equity (HOPE) Act

On February 14, 2013, Senator Barbara Boxer introduced S. 330, the "HIV Organ Policy Equity (HOPE) Act." This bipartisan legislation would serve to establish safeguards and standards of quality for research and transplantation of HIV-infected organs to HIV-positive recipients. It would also make important, common-sense reforms to current organ transplant law by repealing the current ban on organ donations from HIV-positive donors to HIV-positive recipients.

Letter to Reps. Lois Capps and Andy Harris supporting H.R. 698, the “HIV Organ Policy Equity (HOPE) Act,” March 28, 2013

Letter to Senators Boxer and Coburn supporting S. 330, the “HIV Organ Policy Equity (HOPE) Act,” March 19, 2013

H.R. 698 co-sponsorship list
S. 330 co-sponsorship list

Hospital Observation Status

On March 14, Representative Joe Courtney (D-CT) introduced H.R. 1179, the "Improving Access to Medicare Coverage Act of 2013." The companion bill, S. 569, was introduced in the Senate by Senator Sherrod Brown (D-OH) on March 14, 2013. This legislation would require the time period of outpatient "observation" care in a hospital to be counted toward satisfying the three-day inpatient hospital requirements for coverage of skilled nursing facility services under Medicare. The AMA strongly supports this legislation.

May 20, 2014 AMA Statement to House Ways & means re: Medicare Two-Midnight Policy

Letter to Sen. Sherrod Brown supporting S. 569, the “Improving Access to Medicare Coverage Act of 2013,” June 13, 2013
Letter to Reps. Courtney and Latham in support of H.R. 1179, the "Improving Access to Medicare Coverage Act of 2013."

H.R. 1179 co-sponsorship list
S. 569 co-sponsorship list


In a January 17, 2012, letter to the Congressional Leadership, AMA called on Congress to stop the required implementation of the International Classification of Diseases, 10th Revision (ICD-10) originally scheduled for October 1, 2013. In response to AMA advocacy, the Department of Health and Human Services (HHS) announced a one year delay of ICD-10 implementation – now scheduled for October 1, 2014. AMA had recommended that ICD-10 implementation be delayed by a minimum two years.

The transition from ICD-9 to ICD-10 will create substantial administrative and financial burdens for physician practices, with no direct benefit to patient care, by increasing the number of diagnosis codes from 13,000 to 68,000. This transition will also compete with other costly physician practice transitions underway today associated with quality and health IT programs. The ICD-10 transition costs will range from $83,290 to $2.7 million depending on the size of the medical practice.

As Health Insurance Portability and Accountability Act (HIPAA) covered entities, physicians must comply with the ICD-10 mandate and will bear the entire costs of the transition. Additionally, under ICD-10 if physicians submit the wrong seven digit diagnosis code they risk non-payment altogether.

On April 24, 2013, Rep. Ted Poe (R-TX) introduced H.R. 1701, the "Cutting Costly Codes Act of 2013," which would prohibit the Secretary of HHS from replacing the current ICD-9 with ICD-10 diagnostic code set. Senator Tom Coburn introduced S. 972, the Senate companion bill, on May 16, 2013. These bills would also require the Government Accountability Office to conduct a study on ways to mitigate the disruption of health care providers resulting from the replacement of ICD-9 with new coding standards required by HIPAA.

Letter to Sen. Tom Coburn supporting the Senate companion bill, S. 972

Letter to Rep. Poe supporting H.R. 1701, April 26, 2013

ICD-10 letter to Congressional Leaders and Chairs & Ranking Members of Relevant Committees, January 17, 2012

Indian Health Service

American Indians and Alaska Natives (AI/AN) suffer disproportionately from a variety of health afflictions, including heart disease, cancer, diabetes, and tuberculosis. Addressing the health disparities experienced in the AI/AN population is made more difficult by both the lack of adequate funding and the delays in such funding.

On October 1, 2013, Rep. Don Young (R-AK-At Large) introduced H.R. 3229, the “Indian Health Service Advance Appropriations Act of 2013.” This legislation would allow the Indian Health Service and the Indian Health Facilities Accounts to receive advance appropriations which would allow tribal health administrators to continue to treat patients without worrying about if or when funding would be available due to underfunding, or delays in the enactment of annual appropriations legislation. Senator Lisa Murkowski (R-AK) introduced S. 1570, the Senate companion bill, on October 10, 2013.

AMA letter to Sen. Lisa Murkowski supporting S. 1570, the “Indian Health Service Advance Appropriations Act of 2013,” September 3, 2014

AMA letter to Rep. Don Young supporting H.R. 3229, the “Indian Health Service Advance Appropriations Act of 2013,” September 3, 2014

Meaningful Use of Electronic Health Records

In a May 17, 2013 letter, the AMA provided feedback on a health information technology (HIT) white paper entitled, “REBOOT: Re-Examining the Strategies Needed to Successfully Adopt Health IT,” which was authored by Senators John Thune (R-SD), Lamar Alexander (R-TN), Pat Roberts (R-KA), Richard Burr (R-NC), Tom Coburn, MD (R-OK), and Mike Enzi (R-WY).

The white paper outlines several concerns with the Meaningful Use (MU) of Electronic Health Records (EHRs) program, focusing extensively on the lack of interoperability of EHRs. The AMA response expresses its continued support for financial incentives to support physician adoption of HIT. However, it also outlines several serious concerns with the way the MU program has been structured, and makes multiple recommendations for improving the program, including modifying the rulemaking for Stage 2 of the MU program to provide physicians with greater flexibility.

On March 21, 2013, Rep. Diane Black (R-TN) introduced H.R. 1331, the “Electronic Health Records Improvement Act,” in an effort to improve the MU program. The AMA expressed its support in a May 30 letter for the “hardship exemptions” from meaningful use financial penalties for solo practitioners and physicians near retirement contained in this legislation. AMA also expressed its belief that the legislation will help make improvements to the program by imposing a one-year limit on the back-dating of program requirements, expanding the options for participation in the incentive program, providing scope of practice exemptions, and establishing a formal penalties appeal process.


Medicaid Payment Parity

The AMA believes that all physicians seeing Medicaid patients should be paid at least the Medicare rate to ensure adequate access.

Research studies have demonstrated that low Medicaid reimbursement rates can significantly affect a physician’s ability to accept new Medicaid patients into his or her practice. Congress has recognized that low provider participation in Medicaid can negatively affect access to health care, and took action to increase Medicaid payments for certain primary care services to be not less than the Medicare payment rates for 2013 and 2014.

On July 30, 2014, Senators Sherrod Brown (D-OH) and Patty Murray (D-WA) introduced S. 2694, the “Ensuring Access to Primary Care for Women and Children Act.” This legislation would extend the application of the Medicare payment rate floor to primary care services provided by primary care physicians under the Medicaid program beyond 2014, when the enhanced payment rate is scheduled to expire under current law. AMA supports this legislation.

Co-sponsorship List

In addition, Rep. Kathy Castor (D-FL) introduced H.R. 5723, the "Ensuring Access to Primary Care for Women and Children Act," on November 17, 2014. This legislation would extend Medicaid payment rates under current law for certain primary care and immunization services to at least the level of Medicare through 2016. AMA supports this legislation.

Medical Liability Reform

The AMA strongly supports comprehensive medical liability reform (MLR), including reasonable limits on non-economic damages similar to successful reforms in California and Texas.

The "Patient Protection and Affordable Care Act" (ACA) included multiple provisions concerning the establishment and implementation of national care and practice standards and guidelines for health care providers, with potential for new causes of legal action against physicians. The AMA believes physicians should not have to worry about potential new causes of action or liability exposure in their attempts to develop new ways to improve the quality and efficiencies of care.

On April 10, 2013, Rep. Phil Gingrey (R-GA), who has long been a proponent for MLR, introduced H.R. 1473, the "Standard of Care Protection Act of 2013." The companion bill, S. 1769 was introduced in the Senate by Sen. Pat Toomey (R-PA) on November 21, 2013. The Senate companion bill S. 1769 was introduced by Sen. Pat Toomey (R-PA) on November 21, 2013. This legislation would clarify that the care standards and guidelines specified in the ACA Medicare and Medicaid statutes cannot be used to create new causes of legal action against physicians providing care to patients. In addition, it would preserve state medical liability laws. AMA supports H.R. 1473 and S. 1769. AMA supports H.R. 1473 and S. 1769.

Letter to Sen. Pat Toomey supporting S. 1769, the “Standard of Care Protection Act,” November 27, 2013

Letter to Rep. Phil Gingrey supporting H.R. 1473, the "Standard of Care Protection Act of 2013," April 11, 2013

H.R. 1473 co-sponsorship list

S. 1769 co-sponsorship list

Additionally, the AMA supports H.R. 1733, the "Good Samaritan Health Professionals Act of 2013," which was introduced by Rep. Marsha Blackburn (R-TN) on April 25, 2013. Its Senate companion bill S.2196, the "Good Samaritan Health Professionals Act of 2014" was introduced by Sen. Lisa Murkowski (R-AK) on April 1, 2014. This legislation would help ensure that needed medical volunteers are not turned away due to confusion and uncertainty about the application of Good Samaritan laws, as was the case in the aftermath of hurricanes Katrina and Rita.

Letter to Rep. Marsha Blackburn supporting H.R. 1733, the "Good Samaritan Health Professionals Act of 2013," April 7, 2014

Letter to Sen. Lisa Murkowski supporting S. 2196, the "Good Samaritan Health Professionals Act of 2014," April 7, 2014

H.R. 1733 co-sponsorship list

S. 2196 co-sponsorship list

Liability insurance carriers do not typically provide coverage outside the state where a physician is licensed to practice. This means that physicians or other sports medicine professionals traveling with sports teams may not be covered when they provide care in another state. To remedy this problem, Rep. Tom Latham (R-IA) introduced H.R. 3722 on December 12, 2013, a bill to provide protection for sports medicine professionals, including physicians, who provide certain medical services in a secondary state. Its Senate companion bill was introduced by Senators Amy Klobuchar (D-MN) and John Thune (R-SD) on April 8, 2014. AMA supports this legislation.

Letter to Rep. Tom Latham supporting H.R. 3722, a bill to provide protection for sports medicine professionals, including physicians, April 18, 2014

Letter to Senators Klobuchar and Thune supporting S. 2220, the Senate companion bill to H.R. 3722, April 28, 2014

Medicare Patient Empowerment Act

In the 113th Congress, the "Medicare Patient Empowerment Act" has been introduced by Senator Lisa Murkowski (S.236), and by Representative Tom Price (H.R. 1310). This legislation would establish a Medicare payment option for patients and physicians (and practitioners) to freely contract, without penalty, for Medicare fee-for-service physician and practitioner services, while allowing patients to use their Medicare benefits and physicians to bill the patient for all amounts not covered by Medicare. The AMA strongly supports this legislation.  More information on this issue as well as a petition that physicians are encouraged to sign can be found at www.mymedicare-mychoice.org

AMA Letter of Support for S. 236
S. 236 co-sponsorship list

AMA Letter of Support for H.R. 1310
H.R. 1310 co-sponsorship list

Learn more

Medicare Physician Payment

As the leading force in Washington for Medicare reform, the AMA continues to advocate for replacement of the flawed Medicare physician payment formula. In this effort, the AMA is aggressively working with Congress and federal agencies to improve the Medicare program by repealing the sustainable growth rate (SGR), enacting stable, adequate annual Medicare physician payment updates, and ensuring beneficiaries’ continued access to care. The AMA has recommended to Congress a three-pronged approach to reforming the physician payment system:

  1. repeal the SGR;
  2. implement a five-year period of stable Medicare physician payments; and
  3. transition to an array of new payment models designed to enhance care coordination, quality, appropriateness and costs.

Recent Congressional testimony and correspondence

AMA letter to entire Senate urging “No” vote on H.R. 4302, March 28, 2014

Sign-on letter to House Leadership and all U.S. Reps. Opposing H.R. 4302, March 26, 2014

Letter to Senate leadership urging bipartisan passage of SGR repeal legislation

Letter to House leadership expressing disappointment that partisanship threatens to derail SGR repeal legislation

Sign-on letter to all Congress supporting H.R.4015/S.2000

Letter from the AMA and 111 state and specialty medical societies sent to House and Senate leadership in opposition to the continued cycle of short-term SGR patches

AMA letter to Rep. Burgess supporting H.R. 4015/S 2000, the "SGR Repeal and Medicare Providor Payment Mondernization Act of 2014"

Comparison of House W&M and Senate Finance's revised SGR discussion draft (Dec. 2013) to AMA suggestions made Nov. 11, 2013

AMA Letter to House W&M Committee urging support of bipartisan SGR Repeal Proposal, December 11, 2013

AMA letter to Senate Finance Committee on SGR Proposal, December 10, 2013

AMA comments on SGR proposal to House W&M and Senate Finance, November 11, 2013

SGR Repeal/Budget Neutrality letter to House Energy and Commerce, July 30, 2013

SGR Budget-Neutrality Markup sign-on letter to House Energy and Commerce, July 25, 2013

AMA comments in response to Energy & Commerce June 28, 2013 draft SGR repeal and replace legislation, July 11, 2013

AMA comments to House Energy and Commerce in response to questions on the Sustainable Growth Rate, June 10, 2013

AMA response to Senate Finance Committee request for input - new Medicare physician payment & delivery reforms, May 31, 2013

AMA comments on E&C and W&M majority "Overview of SGR Repeal and Reform proposal: Second Iteration," April 16, 2013

AMA comments on jointly released E&C and W&M majority “Overview of SGR Repeal and Reform Proposal,” March 4, 2013

AMA Statement for the Record to House Energy and Commerce Subcommittee on Health “SGR: Data, Measures and Models; Building a Future Medicare Physician Payment System,” February 14, 2013

Senate Sequestration sign-on letter, December 21, 2012

House Sequestration sign-on letter, December 21, 2012

AAFP-generated sign-on letter to entire Congress opposing proposal to eliminate the new Medicaid primary care payment increase to fund temporary SGR patch, December 5, 2012

SGR Transition Principles sign-on letter sent to the Chairs and Ranking Members of Senate Finance, House Ways & Means, and House Energy and Commerce Committees, October 15, 2012

Senate SGR Sequestration sign-on letter, September 12, 2012

House SGR Sequestration sign-on letter, September 12, 2012

Comments to Senate Finance Committee Chair and Ranking Member – Medicare Physician Payment Reform Roundtables, August 30, 2012

AMA Statement to Senate Finance Committee re: Medicare Physician Payment Policy: Perspectives from Physicians, July 11, 2012

AMA response to Ways & Means' request for comments on Alternative Medicare Payment Models, May 25, 2012

Letter sent to Rep. Schwartz and Rep. Heck regarding their bipartisan legislation “Medicare Physician Payment Innovation Act of 2012,” May 9, 2012

Sign-on letter to Conferees re: SGR Repeal, January 23, 2012

Letter to Physician Members of the Doctors Caucus urging SGR Repeal, November 17, 2011

Sign-on letter to Deficit Reduction Committee urging repeal of the SGR, November 10, 2011

Beneficiary-Provider letter to Congress, October 20, 2011

Sign-on Letter to MedPAC on SGR, October 3, 2011

W&M Testimony, "Expiring Medicare Provider Payment Policies," September 21, 2011

Sign-on letter to Sen. Murray, Joint Select Committee on Deficit Reduction, September 20, 2011

Sign-on letter to Rep. Hensarling, Joint Select Committee on Deficit Reduction, September 20, 2011

Sign-on letter to President Obama to repeal the Medicare Sustainable Growth Rate, June 27, 2011

E&C Testimony, "The Need to Move Beyond the SGR," May 5, 2011

Letter to E&C Committee re: pathway to reforming the Medicare physician payment system, April 26, 2011

Letter to the Senate urging elimination of the SGR, March 10, 2011

Letter to the House urging elimination of the SGR, March 10, 2011

Strategies to Reform Medicare

Learn more

Mental Health Reform

In a September 30, 2013 letter to Senators Baucus and Hatch, the AMA provided input on how to improve the mental health system under the Medicare and Medicaid programs.

Key to improving the mental health system is the better integration of psychiatric and medical care. Not only would better integration improve quality of care and population health and reduce morbidity and mortality among patients with psychiatric and substance abuse disorders, but it would also reduce overall health care costs. Primary care physicians are often the initial point of contact for screening, assessing, and treating mental health issues, whether during annual physicals or other scheduled appointments. However, Medicare’s traditional fee-for-service (FFS) system is a barrier to allowing psychiatrists to assist primary care physicians manage patients with depression and other mental health issues. Current Medicare policy that will not pay for consultations or team meetings imposes a barrier to the communication that is necessary among treating clinicians for effective integrated care. One way to begin to address these problems would be to start paying for non-face-to-face and care coordination services. The adoption of such a policy is one way that Medicare could begin to promote care improvements and reduce spending that physicians can achieve through participation in alternative payment models (APMs).

Physician Workforce

The AMA continues with efforts to address physician workforce shortages, including strongly supporting stable, adequate funding for graduate medical education (GME) training positions.

Letter to Rep. Kathy Castor supporting H.R. 4282, the "Creating Access to Residency Education Act of 2014 (CARE Act)," July 17, 2014

Letter to Rep. Issa supporting H.R. 2131, the “SKILLS Visa Act,” June 7, 2013

Letter to Senator Klobuchar supporting S. 616, the “Conrad State 30 and Physician Access Act,” March 22, 2013

AMA letter of support for S. 577, the "Resident Physician Shortage Reduction Act of 2013," March 19, 2013

AMA letter of support for H.R. 1180, "Resident Physician Shortage Reduction Act of 2013," March 19,2013

Letter to Rep. Joseph Pitts supporting H.R. 297, the "Children's Hospital GME Support Reauthorization Act of 2013," Jan. 29, 2013

AMA Testimony to the Institute of Medicine Committee on the Gonvernance and Financing of Graduate Medical Education, December 19, 2012

Letter to Rep. Crowley supporting H.R. 6562, the "Resident Physician Shortage Reduction Act of 2012," October 15, 2012

Letter to Rep. Sarbanes supporting H.R. 5888, the "Physician Rentry Demonstration Program Act," June 26, 2012

Letter to Sen. Conrad supporting S. 1979, the "Conrad State 30 Improvement Act," January 3, 2012

AMA letter to Sen. Nelson supporting S. 1627, the "Resident Physician Shortage Reduction Act of 2011," October 3, 2011

AAMC sign-on letter to Super Committee regarding potential GME cuts, October 3, 2011

Letter to Senate HELP Committee re: S. 958, Senate Companion Bill to H. R. 1852, July 27, 2011

Letter supporting H.R. 1852, the "Children's Hospital GME Support Reauthorization Act of 2011," July 11, 2011

Program Integrity

Initiatives to fight health care fraud, or to identify areas of waste, have a tangible impact on physician practices. To comply with anti-fraud rules and regulations, physicians proactively conduct internal audits and adopt compliance programs at their own cost. Broad-brush regulations that impose burdens on all providers, rather than focusing on those providers who have demonstrated a propensity to commit fraud or abuse, inequitably affect physicians who are good actors, and result in unnecessary costs to the health care system.

On June 29, 2012, the AMA responded to a request from the Senate Committee on Finance for input on waste, fraud, and abuse (or "program integrity") reforms. The AMA submitted a white paper that outlined the recommendations of the AMA for greater value and efficiency in program integrity efforts.

AMA Statement to House Energy & Commerce Subcommittee on Health re: Examining Options to Combat Health Care Waste, Fraud and Abuse, November 28, 2012

AMA Statement to House Energy & Commerce Committee on Medicare Contractors' Efforts to Fight Fraud, June 8, 2012

AMA Statement to House Committee on Oversight & Government Reform on Accessing Medicare and Medicaid Program Integrity, June 7, 2012

Quality Improvement Organizations (QIOs)

On February 25, 2013, Rep. Tom Price re-introduced H.R. 805, the "Quality Improvement Organization Program Restoration Act." This bill would restore and maintain local physician involvement in Quality Improvement Organizations (QIOs) and keep the program state-based. The bill would also support local physician involvement in peer review.

Letter to Rep. Tom Price supporting H.R. 805, the “Quality Improvement Organization Program Restoration Act,” March 4, 2013

H.R. 805 co-sponsorship list

Sunshine Act

The Physician Payments Sunshine Act (Sunshine Act) was not passed to limit or construct additional barriers to the dissemination of new medical knowledge that improves patient health outcomes. The Sunshine Act was designed to promote transparency with regard to payments and other financial transfers of value between physicians and the medical product industry. However, as a result of the Sunshine Act, onerous and burdensome reporting obligations are being imposed by the Centers for Medicare and Medicaid Services (CMS) that have already chilled the dissemination of medical textbooks, peer-reviewed medical reprints and journals.

On September 18, 2014, Rep. Michael Burgess (R-TX) introduced H.R. 5539, a bill which would clarify that certain applicable manufacturer transfers of value to support independent medical educational programs, reprints, and medical textbooks are exempt from reporting under the Sunshine Act. The AMA and physician organizations representing both national medical specialty societies and state medical societies strongly support this legislation. Passage of this bill is urgently needed to remedy the unintended consequences that have chilled the exchange of timely independent medical information that benefits patients through improved clinical decision-making.

Truth in Advertising

The AMA strongly supports H.R. 1427, the "Truth in Healthcare Marketing Act of 2013." This legislation was introduced by Rep. Larry Bucshon (R-IN) and Rep. David Scott (D-GA) on April 9, 2013, and would help patients make informed decisions about their health care by ensuring that they have accurate information regarding the education, training, and qualifications of individuals providing their health care services. In addition, H.R. 1427 would require disclosure of health care providers' licensure in advertisements for health care services, and provide vital resources to address patient confusion in the health care marketplace.

Letter to Reps. Bucshon and Scott supporting H.R. 1427, May 1, 2013

H.R. 1427 co-sponsorship list

Veterans' Health

The AMA, at its 2014 Annual Meeting, resoundingly adopted new policy that supports the provision of full health benefits to eligible veterans to ensure that they can access the medical care they need outside the Department of Veterans Affairs' (VA) medical centers and other facilities.  This action was in response to recent disturbing reports of unconscionably long wait times and of the unacceptable, unworkable VA appointment scheduling system.

On June 9, 2014, Rep. Jeff Miller (R-FL) introduced H.R. 4810, "The Veteran Access to Care Act of 2014," which passed the House on June 10, 2014.  On June 11, Sen. Bernie Sanders (I-VT) introduced S. 2450, "The Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014," which passed the Senate as H.R. 3230, also on June 11.  Congress will now work to reconcile the differences between these bi-partisan bills.

The AMA strongly advocates that Congress act to rapidly enact a bi-partisan long-term solution for timely access to entitled care for eligible veterans.

Letter to Sens. Sanders and Burr supporting S. 2450, "The Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014," June 19, 2014

Letter to Reps. Miller and Michaud supporting H.R. 4810, "The Veteran Access to Care Act of 2014," June 19, 2014

Archives - 112th Congress

Form 1099 Information Reporting

After House and Senate passage, H.R. 4 was signed into law April 14, 2011. The law repealed an IRS 1099 reporting requirement for businesses that was included in the Affordable Care Act. The provision required businesses, including physician offices, to file a 1099 form with the IRS if the total amount of payments made to another business in exchange for goods and services was $600 or more in a year. The AMA strongly advocated for the repeal of this requirement since the stricter requirements in the provision would have created an expensive reporting burden which would have negatively impacted the operation of businesses, including physician practices.

Comment letter to IRS Commissioner Shulman regarding 1099 Reporting, September 29, 2010

Letter to Rep. Lungren supporting H.R. 4, the "Small Business Paperwork Mandate Elimination Act of 2011," February 15, 2011


On April 20, 2011, AMA sent a letter to Chairman Rehberg of the House Approps. Subcommittee on Labor-HHS, Education and Related Agencies sharing its views on funding priorities for various health programs under the subcommittee's jurisdiction, including those that are crucial to ensuring an adequate supply and distribution of physicians.

Letter to Labor-HHS Approps. Subcommittee, April 20, 2011

PDUFA/Drug Shortages/Generic Antibiotic Incentives

On June 20, the House passed S. 3187, the "Food & Drug Administration Safety and Innovation Act," by voice vote. The Senate adopted the measure on June 26 by a vote of 92-4, and the President is expected to sign it into law shortly.

The final version of S. 3187, which is the result of a bipartisan compromise between the House and the Senate, would reauthorize the Prescription Drug User Fee Act and the Medical Device User Fee Act, and newly authorize user fees for generic drugs and biosimilars.  It includes several provisions that the AMA supports and worked to improve throughout the legislative process.  These provisions would address the drug shortage crisis, incentivize the development of new antibiotics, place various chemical substances known as "bath salts" in schedule I of the Controlled Substances Act, and require the Comptroller General to prepare a report on issues posed by rogue online pharmacies.  Additionally, the bill omits a provision that was of significant concern to the AMA, which would have reclassified combination products containing hydrocodone from Schedule III to Schedule II of the Controlled Substances Act.  While the AMA supports efforts to prevent the abuse of such products, this approach could have unintentionally limited patient access to legitimately needed pain treatment.  The final bill requires the Secretary of Health and Human Services to hold a public meeting to solicit recommendations regarding drugs containing hydrocodone.

AMA letter to Chairs and Ranking Members of Senate HELP Committee supporting PDUFA Reauthorization Bill (S. 3187), June 20, 2012

AMA comments to PDUFA Reauthorization Conferees, June 7, 2012

Drug Shortages legislation 2nd draft comments to Senate HELP Committee Chair and Ranking Member, April 24, 2012

AMA letter suggesting changes to next generation antibiotic incentives proposal in draft PDUFA reauthorization legislation, April 19, 2012

Drug Shortages letter to E & C Chair and Ranking Member, April 6, 2012

Senate HELP bipartisan working group's discussion draft on drug shortages – AMA comments, April 6, 2012

Drug Shortages ASHP-generated sign-on letter to E&C and Senate HELP, March 16, 2012

Letter to Reps. DeGette and Rooney supporting H.R. 2245, the "Preserving Access to Life-Saving Medications Act," October 6, 2011

Letter to Sen. Amy Klobuchar supporting S. 296, the "Preserving Access to Life-Saving Medications Act," November 28, 2011

H.R. 2245 Co-sponsorship List

S. 296 Co-sponsorship List

Physician Licensure

The AMA believes that conditioning physician licensure on participation in any public or private insurance plans unduly restricts a physician's freedom to practice. The AMA is actively supporting H.R. 969, the "Medical Practice Freedom Act of 2011," introduced by Representative Tom Price (R - GA), which would ensure that physicians are not required to participate in any health plan as a condition of licensure in any state.

Letter to Rep. Price supporting H.R. 969, the "Medical Practice Freedom Act of 2011," March 14, 2011

H.R. 969 Co-sponsorship List

3% Withhold

The AMA is a strong opponent of section 511 of the Tax Prevention and Reconciliation Act of 2005 (TIPRA). Under this provision, federal, state and local government entities are required to withhold 3 percent of all payments made for services or property after December 31, 2011, including payments under the Medicare program. The AMA strongly opposes section 511 and we support repeal of this provision.

On October 27, 2011, the U.S. House of Representatives passed H.R. 674, AMA-supported legislation that prevents a planned 3% tax-withhold for many Medicare payments, by a vote of 405-16. The Senate passed this legislation on November 10 by a vote of 95 to 0.

The legislation was signed into law by President Obama on November 21, 2011 and completely repeals this provision of law and eliminates the planned withholding. The cost of this repeal was offset by a change in the definition of Medicare Adjusted Gross Income for the calculation of eligibility for Medicaid or insurance subsidies under the Affordable Care Act. This modification was supported by a majority in Congress and the White House.

This represents a significant victory for physicians and a step forward in stabilizing the Medicare system. The additional burden of a 3% tax-withhold would have been untenable in the current Medicare payment environment.

Letter to Ways and Means Chairman Camp in support of H.R. 674, October 12, 2011

Government Withholding Relief Coalition Letter to the U.S. Senate, June 9, 2011

AMA Statement to House Small Business Committee, re: Repeal of the 3% Whithhold Provision, May 26, 2011

H.R. 674 Co-sponsorship list