For physicians following federal policy issues, the closing days of 2021 were extraordinarily busy. Following a robust grassroots advocacy campaign that engaged patients and physicians, the AMA and its Federation partners were able to mitigate significant Medicare physician payment cuts that had been scheduled to take effect on Jan. 1. Must-pass bills to raise the nation’s debt limit and continue funding the federal government passed after much debate, yet an enormous legislative package containing major features of President Biden’s health and social policy agenda remains stalled. New rules are taking effect to protect privately insured patients from surprise medical bills but disagreements over key features of the independent dispute resolution process are being challenged in court by the AMA and others. Then, of course, there was COVID-19.
As 2022 begins, sharp partisan divisions will continue to influence what federal policymakers can accomplish, amplified by the upcoming midterm elections and a potential change in party control in both the House and Senate. As a result, prospects for passage of sweeping or controversial legislation are slim. Yet, organized medicine laid strong groundwork last year for action in 2022 on legislative proposals that would have a significant and positive impact on patients and their physicians.
For example, a positive outcome of the extraordinary grassroots advocacy on Medicare issues is that policymakers have become more attuned to some of the fundamental flaws of the current physician payment system. Key legislators have been seeking additional information and are interested in working on more long-lasting solutions that will stabilize the system. The AMA and Federation groups initiated a close examination of problems with the law and will be working with these and other legislators to fully examine medicine’s concerns and develop solutions over the course of the year.
The public health emergency declared due to COVID-19 was accompanied by eased geographic and site restrictions on the use of telemedicine under Medicare to help curtail spread of the disease while improving access to care. When the public health emergency ends, the restrictions on the use of telemedicine will be reimposed unless Congress passes legislation to expand eligibility for these services. Fortunately, there is overwhelming bipartisan support on Capitol Hill to allow Medicare patients to maintain this benefit, although the potentially significant budget impact of the policy change is raising concerns. Nevertheless, prospects are good for positive action on at least a temporary extension of the expanded benefit this year.
Similarly, medicine has been successful in persuading members of Congress about the adverse impact of increasingly onerous prior authorization rules that impede timely access to care. Several bills have been introduced with broad bipartisan support that would streamline, modernize and simplify prior authorization programs in Medicare Advantage plans.
Other issues that may be poised for legislative action in the coming year include health care workforce initiatives such as improvements to the Conrad 30 waiver program, as well expanding medical marijuana research.
These and other issues will be featured and discussed during the upcoming AMA National Advocacy Conference on Feb. 14-16, 2022, which will be held in person in Washington, D.C. Register to join us. AMA Senior Vice President of Advocacy Todd Askew also recently discussed these issues in the AMA’s Moving Medicine video series.
Physician advocates can stay engaged and move medicine’s agenda forward by joining and participating in the AMA’s grassroots programs.