"They'll tell you talk is cheap, but you tell them silence is unaffordable." That was the message Sekou Andrews, creator of "Poetic Voice" kicked off the 2020 National Advocacy Conference with, reminding physician advocates that "there will always be those who will only wade waist-deep in the waters of change because they are afraid to make waves...today we are going to focus on making waves for the purpose of change." This sentiment echoed through the conference as attendees listened to speakers from the administration and from Congress, getting caught up on the latest issues in health care policy before heading to the Hill to make their voices heard.

In her speech Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma touched on the health care priorities in the president's new budget, including expanding access to care and innovative treatments as well as fixing Medicare's wage index to help save rural hospitals. She also spoke about the burden of prior authorization (PA) being a primary driver of physician burnout saying, "The practice of prior authorization became indefensible years ago."

Rep. Suzan DelBene (D-WA) echoed a similar sentiment on the burden of prior authorization saying, "PA forms are deliberately burdensome—and should not be used as a tool to delay care." She is cosponsor of bipartisan legislation, H.R. 3107, the Improving Seniors' Timely Access to Care Act of 2019, supported by the AMA, which would reduce unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program.

Efforts to ban surprise billing are under consideration in both congressional chambers, and the AMA is pressing lawmakers for a solution that protects patients but does not give insurers unreasonable negotiating power. One of the leading voices in this debate is Sen. Bill Cassidy (R-LA) who gave an update to attendees on this issue and urged them to convey how these legislative proposals would affect their local communities.

Rep. Andy Harris (R-MD), MD, emphasized the need for physicians to be involved in policymaking. He encouraged physicians to tell stories about their patients saying, "I didn't get into medicine to take care of me, I went into medicine to take care of patients—remember that as you go to your legislators and your patients will be behind you." He emphasized the need for more robust research into legitimate indications for medical marijuana and asked for a federal solution to needless prior authorization delays.

ADM Brett P. Giroir, MD, Assistant Secretary for Health, U.S. Department of Health & Human Services (HHS), laid out the plans behind the president's initiative to end HIV in America. The stated goal of the initiative, as modeled through the Centers for Disease Control and Prevention, is to have a 75% reduction in new HIV infections in five years and at least a 90% reduction in 10 years. Currently there are 40,000 new cases of HIV identified in the U.S. every year, despite highly effective treatment being available.

Deputy HHS Secretary Eric Hargan gave an update on the coronavirus saying, "The immediate risk to the American public at this time is low, and we are acting swiftly to keep that risk low." Hargan discussed how hearing a story from a post-surgical patient about being able to receive all their medications before leaving the hospital inspired proposed changes to the Stark law and the anti-kickback statue, part of a larger sprint towards coordinated care. He emphasized a push towards "patient-centered innovation that focuses on quality and outcomes rather than reams of paperwork and volumes of procedures."

The AMA presented its Dr. Nathan Davis Awards for Outstanding Government Service to six honorees, including physicians who have served their patients by working in state houses, governors' mansions, the U.S. House of Representatives, and the National Institutes of Health (NIH), working to move medicine forward on issues like surprise medical bills, malaria research, environmental health, gaps in mental health care and research on addiction

Echoing the sentiment of many of the physician advocates in the room and speaking to the power of organized medicine, Sen. John Barrasso (R-WY) said: "When I talk to the medical students, they say, 'Would you still go into medicine today?' I said, 'Yes.' Would I join the American Medical Association again? Proudly."

Save the date to attend next year: The 2021 National Advocacy Conference will take place in Washington, D.C., Feb. 22-24. Learn where the AMA stands on the most pressing issues of 2020 (PDF).

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