Jan. 27, 2023: National Advocacy Update

The AMA, alongside more than 100 physician and non-physician organizations representing more than one million clinicians and their patients, signed on to a letter (PDF) welcoming the 118th Congress and urging them to begin holding Congressional hearings as soon as possible to explore solutions to the Medicare physician payment system.

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According to the letter, reforming the Medicare physician payment system is crucial to ensure that America’s seniors have continued access to high-quality health care.  

“While Congress has taken action to address some of these fiscal challenges by mitigating some of the recent Medicare Physician Fee Schedule (MPFS) cuts, payment continues to decline. According to an American Medical Association analysis of Medicare Trustees data, when adjusted for inflation, Medicare payments to clinicians have declined by 22% from 2001–2021,” says the letter.

With the MPFS lacking an inflationary update and statutory budget neutrality requirements, there will continue to be significant instability for health care professionals that will threaten patient access to care.

On Jan. 12, the AMA released a statement commending the Medicare Payment Advisory Commission (MedPAC) for recommending Congress increase 2024 Medicare physician payments above current law by adding a payment update tied to the Medicare Economic Index (MEI). As part of a comprehensive strategy to strengthen Medicare physician payments, the AMA has long called for an annual inflation-based update to the Medicare Physician Fee Schedule.  

However, the statement also noted that an update tied to just 50% of MEI does not go far enough and pointed out the disproportionate impact that increasingly thin operating margins have on small, independent and rural physician practices, as well as those treating low-income or other historically minoritized or marginalized patient communities.  

Ultimately, the statement calls on Congress to adopt a 2024 Medicare payment update that recognizes the full inflationary growth in health care costs. MedPAC is an advisory body to Congress; their recommendations do not carry force of law. In order for an inflation-based Medicare payment update to be implemented, Congress would need to pass authorizing legislation. 

Register now to secure your spot for the AMA National Advocacy Conference—Feb. 13-15 at the Grand Hyatt in Washington, D.C.  

New speakers have just been announced, with more to come. Don’t miss:  

• The Honorable Roger Marshall, MD, United States Senator (R-KS) 
• The Honorable Sheldon Whitehouse, United States Senator (D-RI) 
• The Honorable Rahul Gupta, MD, MPH, FACP, MBA, director, National Drug Control Policy 
• David M. Lusk, founder, Key Advocacy  

Previously announced featured speakers include: 

• Michael Beschloss, presidential historian and bestselling author  
• April Ryan, White House reporter and political analyst  
• Bill Whitaker, CBS News correspondent on 60 Minutes  

ICYMI: View this short video from AMA President Jack Resneck Jr., MD, on the top reasons to attend. Find more details in the agenda.   

Register now. 

The Centers for Medicare & Medicaid Services (CMS) announced the distribution of the first 200 GME slots, out of the additional 1,000 slots, that were created as part of the Consolidated Appropriations Act, 2021 (CAA). The slots were adamantly supported by the AMA and will be effective July 1, 2023. In this first distribution of slots, 100 teaching hospitals in 30 states, the District of Columbia and Puerto Rico received awards. The application cycle for the 200 FY 2024 slots is currently open and will remain open until March 31, 2023.  

In order to be eligible for these additional FTE resident cap slots, a hospital must qualify in at least one of the following four categories:  

1. Hospitals in rural areas (or treated as being located in a rural area under the law) 
2. Hospitals training a number of residents in excess of their GME cap 
3. Hospitals in states with new medical schools or branch campuses 
4. Hospitals that serve areas designated as health professional shortage areas (HPSAs) 

Additionally, no hospital can receive more than 25 FTE resident cap slots. Find answers to questions (PDF) concerning the Section 126 application process for additional slots. Find more on the application for additional slots on the CMS site.

On Jan. 23, the AMA sent a letter (PDF) to the Departments of Health and Human Services, Labor, and Treasury (“the Departments”) regarding ongoing implementation of the No Surprises Act. In the letter, the AMA offers concrete recommendations to improve the federal Independent Dispute Resolution (IDR) process and reduce the current claims backlog.

The letter calls for increased flexibility in the batching of claims, enhanced transparency into qualifying payment amount (QPA) calculations, improved oversight of payer compliance with IDR requirements and called on the Departments to reverse significantly hiked IDR fees, which would disproportionately impact small, rural and safety-net practices and their patients. 

On Jan. 11, the Department of Health and Human Services (HHS) announced through the Centers for Medicare & Medicaid Services (CMS) key dates for the implementation of the Medicare Drug Price Negotiation Program. The program was created through passage of the Inflation Reduction Act (IRA) in 2022 and aims at identifying a number of both Part D and Part B drugs for which the Medicare program will begin negotiating pricing.

HHS aims to begin to propose its manufacturer data collection process starting in winter 2023 and will begin to issue guidance for the negotiation process through the spring of 2023. The first 10 Part D drugs selected for negotiation will be published in the second half of 2023, with the negotiation process beginning in earnest in 2024. The maximum fair prices (negotiated prices) for those 10 drugs will take effect on Jan. 1, 2026. The negotiation program will be phased in through 2029 and will begin to include additional drugs paid under both Parts D and B.

Also expected soon is a highly anticipated report on value-based payment models for prescription drugs. The report, required by a 2022 Executive Order, is expected to outline proposed payment models. The Executive Order had required the report to be submitted by Jan. 12, 2023; however, it has not yet been made public. 

Leading up to the AMA National Advocacy Conference, register now for an AMA Advocacy Insights webinar hosted by Sandra Adamson Fryhofer, MD, chair of the AMA Board of Trustees, on Feb. 7 at 11:00 a.m., Central, about the AMA’s advocacy on Capitol Hill and how you can get involved. Hear from: 

• Jack Resneck Jr., MD, president, AMA, about his experience being a physician leader pushing for change
• Rob Jordan, director, Political and Legislative Grassroots, AMA, about joining the AMA Physicians Grassroots Network and grassroots best practices 
• Jason Marino, director, Congressional Affairs, AMA, about the power of physician voices at the AMA National Advocacy Conference 

Attendees will also get a sneak peek of some of the issues that will be covered at the AMA National Advocacy Conference. Register now. 

Additionally, a recording of the January Advocacy Insights webinar—“2023 AMA advocacy agenda: Full steam ahead”—is now available.  

Ever wonder how doctors get elected to Congress or your state legislature? Considering a run for office for yourself? The AMPAC Candidate Workshop will teach you how to run a winning political campaign, just like many of your AMA colleagues have been taught over the years. 

After two years of hosting the program virtually due to the COVID-19 pandemic, the AMPAC Candidate Workshop is returning in-person March 31-April 2 at the AMA offices in Washington, D.C.—registration now open. 

The candidate workshop is designed to help you make the leap from the exam room to the campaign trail and give you the skills and strategic approach you will need to make a run for public office. 

At the candidate workshop, Republican and Democratic political veterans work together to give you expert advice about being a successful candidate and how to run a winning campaign. You will learn:  

• The importance of a disciplined campaign plan and message 
• The secrets of effective fundraising 
• What kinds of advertising may be right for your campaign; how to work with the media 
• How to build your campaign team and a successful grassroots organization 

Please note the following: 

• The Candidate Workshop is open to AMA physician members, member spouses, residents, medical students and state medical society staff.  
• Registration fee is $250 for AMA Member/$1000 for non-AMA members. This fee is waived for AMA residents and students; however, space is limited and the AMPAC Board will review and select four participants from the pool of qualified resident and student applicants. 
• Faculty, materials and all meals during the meeting are covered by the AMA. Participants are responsible for their registration fee, travel to/from Washington, D.C. and hotel accommodations (AMA will provide you with a list of nearby hotels within walking distance of the AMA offices). 
• Participants will be required to bring a laptop or Wi-Fi-enabled tablet with them. 
• All participants will be required to attest to being fully vaccinated with at least one booster for the COVID-19 virus. 

Registration for the 2023 AMPAC Candidate Workshop is now open. Space is limited and the deadline to register is March 17, 2023.  

For more information please contact: [email protected]. 

When Republicans won a House majority for the 118th Congress in November, it followed historical trends for midterm elections (namely, that the party not in control of the White House gains seats during such elections). Many individual races, however, particularly in the Senate, bucked these historical tendencies. 

This new House majority will be slim for the Republicans, while in the Senate Democrats will enjoy their first outright majority in eight years. Coupled with yet another "change election" in 2022, the selection of Kevin McCarthy (R-CA-20) as House Speaker and Hakeem Jeffries (D-NY-8) as House Minority Leader should result in additional changes in the power dynamics on Capitol Hill. 

Which lawmakers could gain influence with the narrow House and Senate majorities? What legislators might not have the sway they once enjoyed? What developments have occurred with such narrow majorities in the past? And most importantly, what might this all mean for the AMA’s policy priorities? 

Advocacy expert David Lusk of Key Advocacy will join AMA staff to tackle these questions and discuss the changing landscape of Congress and what the near-term impacts might be for health care policy. Register now to get access to this exclusive webinar on Feb. 1 at 7:00 p.m. Central.  

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