Updated on: Nov. 10, 2021

The AMA advocates at the federal and state levels on key health care issues impacting patients and physicians. See updates of our some of our recent efforts.

Subscribe to AMA Advocacy Update

Stay current on the latest on the issues impacting physicians, patients and the health care environment with the AMA’s Advocacy Update Newsletter. 

  • Working at the federal and state levels to advocate for a comprehensive response to the public health emergency (PHE)—including telehealth expansion, financial relief, testing, vaccination and more (read the full COVID-19 Advocacy efforts web page for details—highlights are included below).
  • American Rescue Plan Act included the following provisions: (a) added an additional $8.5 billion to the Provider Relief Fund; (b) directs the utilization of the Defense Production Act to boost domestic production of personal protective equipment (PPE), vaccines, and onshore production of rapid COVID-19 tests; and (c) adds $15 billion in new funding for Targeted Economic Injury Disaster Loan Grants to provide hard-hit, underserved small businesses with increased flexible monetary relief.
  • Biden administration nearly doubled Medicare payment for administration of the COVID-19 vaccine, including administration of vaccines requiring two doses, to $40 per administration.
  • Successfully sought introduction of federal legislation to ensure Provider Relief Fund grants do not count as taxable income.
  • CDC announced new investments and activities aimed at improving health equity in response to the COVID-19 pandemic.
  • Biden administration encouraged states to supply more vaccines to primary care physicians’ offices to address immunization inequities and better reach patients who are hesitant to get vaccinated against COVID-19
  • Maintained enforcement discretion on Health Insurance Portability and Accountability Act (HIPAA) penalties for physicians using telehealth in the event of noncompliance with regulatory requirements
  • Successfully advocated for many services to be added to Medicare Telehealth List during the pandemic and for most to continue being covered through 2023. Obtained improved payment rates for telehealth services during the pandemic, with audio-video and audio-only services being equivalent to in-person office visits.
  • Administration lifted the Title X “gag clause” rule.
  • Administration has started to eliminate Medicaid work requirements.
  • American Rescue Plan Act (ARPA) included provisions to extend postpartum coverage under Medicaid and CHIP, increase premium subsidies for ACA marketplace plans, and invest in trust and treaty obligations to provide essential safety-net programs that serve Native American communities.
  • The American Families Plan announced by the President on April 28 would make ARPA’s ACA subsidy enhancements permanent.
  • An ACA special enrollment period was opened in 2021 to expand access to coverage.
  • Legislation signed into law that prevents a 2 percent sequester payment cut through 2021.
    • Grassroots campaign led by AMA garnered over 133,000 emails to Congress and over 50,000 engagements.
  • Physicians will be held harmless from the up to 9 percent Merit-based Incentive Payment System (MIPS) penalties due to the significant disruptions of the COVID-19 public health emergency on physician practices’ performance in 2020 and 2021. Because of the concerns of the direct and indirect effects of the COVID-19 PHE, CMS will continue to double the complex patient bonus available for the 2021 MIPS performance year/2023 MIPS payment year for physicians that chose to participate in MIPS.
  • One year 3.75 percent increase in Medicare payments(PDF) to offset impact of budget neutrality adjustment.
  • CMS reopened the hardship exception application for group practices, virtual groups, and alternative payment model entities who missed the previous 2020 deadline.
  • Jointly with many specialty societies, made recommendations to CMS (PDF) for improving design and implementation of alternative payment models, which are reflected in new CMS strategy document.
  • Released 2020 prior authorization survey data (PDF) that highlighted the continued negative impact of this onerous process on patients and physicians—even during the height of the COVID-19 pandemic.
    • Survey data also underscore the lack of progress (PDF) by insurers on the prior authorization reforms agreed to three-and-a-half years ago in the Consensus Statement on Improving the Prior Authorization Process.
  • The AMA has strongly advocated for federal and state prior authorization legislation.
    • The AMA successfully pushed for reintroduction of the Improving Seniors’ Timely Access to Care Act, which would require Medicare Advantage plans to follow many of the provisions of the Consensus Statement and sent a letter of support to the lead co-sponsors; this legislation now has bipartisan, majority support in the House and a Senate companion bill has been introduced.
    • Legislation to reform the prior authorization process, and based on AMA model bill, enacted in Georgia, Illinois and being debated in MI, PA and other states.
    • TX enacted legislation requiring state-regulated plans to offer prior authorization gold-cards to physicians with 90% prior authorization approval ratings for a particular service under that plan. AMA sought media promotion of the passage of this legislation resulting in interest from policymakers across the country in similar legislation to reduce the volume of prior authorizations.
  • Facilitated a Federation sign-on letter (PDF) asking the Biden administration to ensure that physicians have options to receive fee-free electronic funds transfer (EFT) payments and enforce regulations against payers not providing such options.
  • Continuing to build AMA’s grassroots advocacy campaign with a dedicated FixPriorAuth website and associated social media presence
    • One of the newer features to the website is an employer-oriented track, which seeks to educate and engage this new and important audience and offers a toolkit for employers to leverage in health plan negotiations.
  • AMA joined All Copays Count Coalition and signed onto model legislation to prohibit insurers’ copay accumulator programs. More than a dozen bills based on Coalition’s model introduced in the states, with Ark, CT, LA, NC, KY and OK, enacting new laws.
  • AMA successfully advocated for OptumPay to continue providing valuable revenue cycle functionalities for free vs. assessing a percentage-based fee, as originally proposed.
  • In response to AMA advocacy, UnitedHealthcare rescinded a policy that would have prohibited “incident-to billing” and financially harmed many physician practices.
  • Administration adopted policies to address overdose and substance use disorder in ways that will reduce stigma, more effectively prevent overdose deaths, and remove barriers to treatment—and in ways that are consistent with AMA policy recommendations.
  • Administration is waiving burdensome administrative requirements so that all physicians will be able to prescribe buprenorphine for their patients with opioid use disorder; the SAMHSA Administrator said on a recent HHS call that more than 5,000 physicians and other health care professionals have obtained the new 30-patient waiver.
  • Using national principals and working with coalition partners, supported new laws in Virginia and Kentucky directing opioid litigation funds to be earmarked for public health uses; influenced national policy and legislative model from a multi-stakeholder coalition led by the Johns Hopkins School of Public Health and Legislative Analysis and Public Policy Association, respectively.
  • As part of a national coalition, helped support six new state mental health and substance use disorder parity laws that will help enhance oversight and enforcement to protect patients.
  • Released the 2021 Overdose Epidemic Report (PDF), highlighting the worsening epidemic (due primarily to illicit fentanyl, methamphetamine and cocaine as well as polysubstance use of prescription opioids and heroin). Report also shows physicians’ efforts to reduce opioid prescribing by 44.4 percent; use of PDMPs more than 900,000 times, increased education and prescribing of naloxone.
  • Launched the AMA Substance Use and Pain Care Task Force to combine efforts and expertise from the Opioid and Pain Care task forces. New task force and its 25+ organizations released updated recommendations to address the worsening epidemic.
  • Developed a new issue brief focused on actions employers can take (PDF) to help improve access to evidence-based care for opioid use disorder and pain, as well as to support harm reduction efforts
    • Presented the issue brief at multiple DEA-sponsored forums around the country organized by the Milken Institute.
  • Held a national webinar with Manatt Health featuring medical, legal and public health experts identifying ways to remove barriers to evidence-based treatment for opioid use disorder in justice-involved settings; other AMA-Manatt Health webinars focused on harm reduction and addiction medicine training in medical schools.
  • Highlighting physician advocacy efforts to help their patients with a substance use disorder or chronic pain.
  • AMA President Susan R. Bailey, MD, provided a keynote address at the National Rx Drug Abuse and Heroin Summit.
  • The implementation of a problematic Department of Homeland Security (DHS) final rule regarding cap-subject H-1B visa petitioners was delayed. However, the Administration is now urging a D.C. Federal Judge to uphold the rule, which would prioritize H-1B specialty occupation visas by salary, saying that they believe that the rule is valid.
  • The Administration continued policy to defer the removal of certain undocumented immigrants who were brought to the United States as children, have obeyed the law and stayed in school or enlisted in the military (DACA). In an effort of buttress the program, the Administration is currently going through the rulemaking process to increase the stability of the program and the AMA is drafting comments. However, there are still a number of court cases actively opposing this rule. Moreover, with DACA failing to be accepted into any of the Congressional packages this year, the long-term viability of the program is still in question.
  • Consistent with AMA advocacy, the Biden administration lifted the immigration ban on Muslim countries and rescinded rules that would deem immigrants inadmissible on public charge grounds. In October 2021, in response to a Request for Information, the AMA submitted comments (PDF) on the public charge grounds for inadmissibility.
  • The AMA is currently advocating for a broad range of immigration and border security policy changes, including those that would ease visa restrictions for foreign-born physicians seeking to train or practice in the U.S.
  • Administration issued rules to require background checks for “ghost guns”
  • House passed two bills supported by AMA that would:
    • Close the so-called “Charleston Loophole” by extending the time period the FBI has to determine whether a buyer is qualified to purchase a gun
    • Expand the existing background check system to cover all firearm sales, while providing exceptions for law enforcement and family and friend transfers
  • Helped to successfully secure FY 2021 federal appropriations of $25 million for the National Institutes of Health and $25 million for the Centers for Disease Control and Prevention for research on gun violence
  • Applauded the CDC for recognizing racism as a serious public health threat
  • Supported Asian American and Pacific Islander hate crime legislation, which was signed into law May 20.
  • Successfully opposed state legislation that would have barred state-funded entities from conducting trainings on diversity and inclusion.
  • Responded to numerous requests for information from the federal government related to racism and bias in health care algorithms, recommending that clinicians and researchers focus on genetics and biology, structural racism, and other structural determinants; and collect, report, and use race data as a proxy for structural racism and not ancestry, when describing risk factors for disease and outcomes.
  • Advocated to various stakeholders that more must be done to address why care experiences and clinical outcomes vary by race/ethnicity and encourage additional efforts to improve outcomes and satisfaction for historically minoritized patients seen by non-racially concordant doctors.
  • Engaging in a workgroup at the National Association of Insurance Commissioners (NAIC) addressing race and ethnicity data in provider directories and network adequacy, urging careful consideration of implications and the use of appropriate safeguards and guardrails when data is collected and potentially published.
  • Supported H.R. 5, the Equality Act, passed by the House, which prohibits discrimination based on sex, sexual orientation, and gender identity in areas including public accommodations and facilities, education, federal funding, employment, housing, credit and the jury system.
  • Biden Administration withdrew a Trump Administration proposal restricting transgender people in homeless shelters.
    • AMA strongly opposed the proposal and urged the Trump and Biden administrations to withdraw it.
  • Biden Administration announced it would provide protections against discrimination in health care based on gender identity and sexual orientation, reversing a rule issued by the Trump administration that allowed discrimination against transgender individuals
    • AMA strongly opposed the previous policy and had urged the Biden administration to reverse it.
  • Biden administration withdrew the previous administration’s proposed rule that would have weakened the Equal Access Rule; this Rule ensures that all individuals—regardless of sexual orientation or gender identity—have equal access to the Office of Community Planning and Development programs, shelters, other buildings and facilities, benefits, services, and accommodations.
  • Successfully defeated harmful anti-transgender legislation in over a dozen states that would have criminalized the provision of medically necessary gender-affirming care to minor patients.
    • Work continues in other states.
  • In a letter to the National Governors Association, AMA urged the nation’s governors to reject legislation that would discriminate against transgender individuals.
  • Submitted an extensive statement for the record to the U.S. House of Representatives Committee on Oversight and Reform as part of the hearing entitled, “Birthing While Black: Examining America’s Black Maternal Health Crisis.”
  • HHS approved a postpartum Medicaid expansion for Georgia, Illinois, Indiana, Missouri and New Jersey.
    • Several state legislatures have also authorized coverage expansions for postpartum women
  • Successfully sought introduction of the “Mothers and Offspring Mortality and Morbidity Awareness Act,” also known as the MOMMA Act.
    • Would extend coverage for postpartum care from the existing 60 days to an expanded 12 months under Medicaid and CHIP.
    • Would also support training clinicians on implicit bias and health equity issues.
  • AMA also supports the “Connected Maternal Online Monitoring (MOM) Act.”
    • Would require CMS to identify barriers to coverage of remote physiologic devices under state Medicaid programs to improve maternal and child health outcomes for pregnant and postpartum women.
  • AMA supports the “Maternal Health Quality Improvement Act.”
    • Would provide grants to identify, develop and disseminate best practices to improve maternal health care quality and outcomes; promote collaboration with state maternal mortality review committees to identify ways to reduce preventable maternal mortality and severe maternal morbidity; promote perinatal collaboration on quality; and implement integrated health care services for pregnant and postpartum women.
  • AMA joined a second sign-on letter urging Congress to direct $20M to the CDC Hospitals Promoting the Breastfeeding line item in the fiscal year 2022 Labor, Health and Human Services, and Related Agencies appropriations bill, an increase of $10.5M above the president’s budget level.
  • AMA supported a provision in the American Rescue Plan Act of 2021 that established a temporary, optional provision to assist states in expanding Medicaid and CHIP coverage opportunities to one year postpartum. The new option can take effect starting April 1, 2022 and would be available to states for five years.
  • Federal Trade Commission (FTC) announced a new policy, Statement on Breaches by Health Apps and Other Connected Devices to clarify that the scope of its Health Breach Notification (HBN) rule includes “health apps and connected devices that collect or use consumers’ health information”
    • The AMA asked that the FTC “expand the HBN Rule’s coverage to specifically include direct-to-consumer technologies and services such as mobile health apps, virtual assistants and platforms’ health tools.”
  • Developed guidance to health app developers to help implement the AMA’s Privacy Principles.
  • Advocated to ONC and the National Governors Association to develop, publicize and enforce comprehensive guidelines related to the use of digital vaccine credential services.
  • Encouraged NIST to provide guidance to physicians on which cybersecurity practices will be recognized by HHS during OCR HIPAA investigations.
  • Urged CDC and OCR to enforce their guidance prohibiting the use of patient/customer information collected by retail pharmacies for COVID-19 vaccination scheduling and/or the vaccine administration process for commercial marketing or future patient recruiting purposes, especially any targeting based on medical history or conditions.
  • Recommended that OCR establish a one-year glide path to HIPAA compliance for telemedicine technologies, during which physicians and other affected parties shall not be subject to HIPAA audits and other HIPAA enforcement activity related to telemedicine.
  • The Consolidated Appropriations Act signed into law on Dec. 27, 2020, included “No Surprises Act” provisions that allow for price transparency, more accurate provider directories, and patient financial protections against “surprise medical bills” or unexpected gaps in health insurance coverage
    • The final provisions reflect significant advocacy by the AMA and Federation groups, including an independent dispute resolution.
  • Released the National Managed Care Legal Database, which pulls in over 1,000 patient and physician protections passed at the state and federal levels and seeks to empower physicians, patients and their advocates in their dealings with health insurers and to inform policymakers, legislators and regulators about key issues—e.g., surprise billing—involving health insurers, physicians and patients.
  • Leading an effort with national specialties and state medical associations to build consensus and impact the No Surprises regulations, including developing common strategies and recommended revisions to eliminate increased leverage they provide for insurance companies. Submitted numerous comment letters to the Departments on various components of the law reflecting consensus among these groups. Worked with members of Congress to reemphasize their intent in drafting statutory provisions pertaining to the independent dispute resolution system.
  • Working with Federation members and outside stakeholders to address operationalization of the No Surprises Act requirements (e.g., good faith estimates) and provide feedback to state and federal regulators.
  • Successfully thwarted several attempts by the pharmacy community to advance legislation that would have recognized pharmacists as physicians in the Medicare program and allowed them to provide acute and chronic care.
  • Launched new scope microsite providing an easier way for Federation colleagues and physician leaders to access AMA’s scope materials, including geomaps, education and training modules, issue briefs, social media graphics, etc.
  • Created 2020 set of geomaps, expanding our growing set of geomaps to 4,500 giving us key data to refute claims by nurse practitioners and others that scope expansions are necessary to increase access to care.
    • Despite the promises nurse practitioners and others are not providing care in rural and other underserved areas.
  • Worked with 35 state medical associations on scope of practice legislation, resulting in key victories in AK (naturopath), AL (optometrist, psychology), CO (PAs), FL (optometrist), FL (APRN), FL (PAs), KS, (APRN), Louisiana (APRN), Maine (APRN), MD (podiatrist "physician" bill), MS (APRN), SD (PAs), TN (APRN), TX (APRN, optometrist, PA, and psychologist) to name a few.
  • AMA President Susan R. Bailey, MD, testified before the House Health & Human Services Committee in South Dakota on H.B. 1163 which would have expanded the scope of practice of physician assistants.
    • The Committee voted against the bill.
  • Sent 22 letters to lawmakers in 10 states expressing AMA’s opposition to various scope of practice bills (Alaska, Colorado, Delaware, Kansas, Louisiana, Maryland, Maine, Mississippi, South Dakota, Wisconsin).
  • The Scope of Practice Partnership Steering Committee has approved 9 grants so far in 2021 and welcomed AAO-HNS to the SOPP, as well as ACEP and ACR to the SOPP Steering Committee.
  • AMA & ASA co-hosted a Medical Title Misappropriation Summit with around 60 attendees representing the AMA, AOA, 11 national specialty societies, 7 state medical associations, the American Board of Medical Specialties, AMA’s Council on Legislation, AMA’s Council on Medical Education, AMA’s Academic Physicians Section and AMA’s Resident and Fellows Section.
  • Conducted survey of U.S. voters’ sentiment on scope of practice and created toolkit based on findings.
  • Organized a letter with 102 national specialty and state medical associations to the Veterans Administration (VA) expressing strong concern with the VA Supremacy Project.
  • Leading an effort to engage the VA, veterans groups and the Hill to raise awareness and impact the VA Supremacy Project.
  • Successfully sought introduction of the Dr. Lorna Breen Health Care Provider Protection Act to help reduce and prevent physician mental and behavioral health conditions, suicide and burnout, elements of which were included in the American Rescue Plan Act.
  • Collaborated to ensure enactment of new laws in Indiana and South Dakota to provide for confidentiality of physicians who seek care for wellness and related mental health concerns; AMA advocacy helped contribute to changes in medical licensing applications in Alaska, Minnesota and Ohio to remove inappropriate questions related to past diagnosis rather than potential current impairment.
  • Published an issue brief, “Confidential care to support physician health and wellness,” that highlights several different options for physicians seeking care and provides tangible legislative, regulatory and other options for medical societies and other stakeholders to support those efforts. It seeks to further the goals of balancing privacy and confidentiality while also reducing stigma and protecting public health.
  • Planned an entire day at the annual American Bar Association Physician Legal Issues Conference dedicated to physician wellness. Speakers that day included leadership of the Dr. Lorna Breen Foundation, the AMA IPPS Section, and the AMA Advocacy Resource Center (who discussed and promoted the AMA’s advocacy in this area).
  • AMA advocacy also has included presentations to the Federation of State Physician Health Programs and Rush University.
  • Published the 2021 update to Medical Liability Reform NOW! (PDF).
  • Assisted the New Mexico Medical Society in successfully mitigating a plaintiffs’ trial bar bill that otherwise would have become law and have dire negative effects on both physicians and hospitals.
    • This bill was the first major amendment to the 1976 New Mexico Malpractice Act and had widespread support in the New Mexico legislature.
  • When Optum proposed to acquire Change HealthCare, AMA presented to the Department of Justice (DOJ) a thorough written examination of significant competitive concerns that require DOJ’s investigation.
  • Published the 20th edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets which demonstrated that more than 70% of health insurance markets continue to be highly concentrated.
  • Led effort with the Federation to push back on federal information blocking requirements that force physicians to release medical information that can emotionally and mentally harm patients or their caregivers.
  • Successfully removed burdensome CMS requirements that would have required physicians to maintain the availability of electronic medical records indefinitely.
  • Successfully added MIPS exceptions for physicians who do not have EHRs certified to technical requirements needed to electronically report cases to their local public health departments.
  • Successfully removed burdensome MIPS reporting requirements which could have complicated physicians’ compliance with ONC’s information blocking regulations.

Published five AMA Policy Research Perspectives:

Static Up
134
Featured Stories