Advocacy Update

May 4, 2017: National Advocacy Update


The House of Representatives today voted along party lines, 217–213, for H.R. 1628, the American Health Care Act (AHCA), which would result in millions of Americans losing health insurance coverage. Recent changes to the bill, allowing states to apply for waivers from critical consumer protections provided by the Affordable Care Act (ACA) and additional funding for high-risk pools tinker at the edges without remedying the fundamental failings of the bill.

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The history of high-risk pools demonstrates that Americans with pre-existing conditions will be stuck in second-class coverage if they are able to attain coverage at all. Independent experts have stated that funds available for high risk pools in the AHCA are woefully inadequate. Claims that current pre-existing condition protections would be maintained are illusory.

The timing and process for Senate action on legislation to repeal and replace the ACA using the reconciliation process has yet to be determined. There is a broad consensus that the House bill will be substantially altered in the Senate. In particular, several Republican senators have expressed concerns about the size and timetable for Medicaid cuts in the House bill. Additional concerns have been voiced about Congressional Budget Office projections that 14 million Americans would lose coverage in 2018, growing to 24 million in 2026.

As the debate shifts to the Senate, the AMA has urged congressional leaders and the administration to pursue a bipartisan dialogue on alternative policies that provide patients with access to high-quality, affordable care and coverage while preserving the safety net for vulnerable populations and for people with pre-existing conditions.

Read more at AMA Wire®.

Congressional appropriators have reached an agreement on the fiscal year (FY) 2017 omnibus appropriations bill to fund government operations until Oct. 1. The budget for the U.S. Department of Health and Human Services would be increased $2.8 billion above last year's enacted level, including a $2 billion increase for the National Institutes of Health. In total, efforts to combat opioid abuse within the HHS budget would receive $801 million, including $500 million from the 21st Century Cures Act. The House of Representatives and Senate are expected to pass the appropriations package by May 5. 

The Centers for Medicare & Medicaid Services (CMS) has released guidance on 2017 MIPS Data Validation and Auditing (this link will download a .zip file). The fact sheet provides a high-level overview of the Merit-based Incentive Payment System (MIPS) performance categories for the transition year. Accompanying the fact sheet is a spreadsheet listing validation criteria and suggested documentation for improvement activities.

The suggested documentation is not prescriptive. It provides an opportunity for practices to perform improvement activities in a way that works best for their workflows, patient populations and specialties. The AMA continues to work with CMS on reducing physician burden by promoting the need for flexibility in implementation of the Quality Payment Program.