The House and Senate have approved a Continuing Resolution (CR) to keep the government funded through Dec. 11. The AMA strongly supports provisions in the CR that will offer relief to hard-pressed physician practices. Revisions to the Medicare Accelerated and Advance Payments program (AAP) will help keep doors open during the pandemic and continue to offer patients access.  

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The Centers for Medicare & Medicaid Services (CMS) worked quickly in the spring to provide financial assistance to physicians—a lifeline for many practices. The AMA also appreciated that the CARES Act postponed the start of recoupment for the AAP until 120 days after initial payment and allowed up to 210 days for repayment for physicians. Unfortunately, the terms of the AAP loans were too harsh; physicians would have 100% of their Medicare claims withheld to repay the loans on a short timeline, and after a few months any outstanding balances will be subject to a 10.25% interest rate.  The AMA has heard from physicians around the country expressing significant concerns about their ability to repay this money during the economic uncertainty posed by the pandemic. In the spring, surveys showed that from March to May revenues in physician offices were down at least 50%.   The Continuing Resolution: 

  • Postpones the recoupment of disbursed funds until 365 days after the advance payment has been issued to a physician practice; the balance would be due by Sept. 2022.
  • Reduce the per-claim recoupment amount from 100% to 25% for the first 11 months and then 50% of claims withheld for an additional six months. If not repaid in full, the interest rate kicks in.
  • The interest rate would be lowered from 10.25% to 4%. 

"Members of Congress and the Administration have settled on a bipartisan response to the economic sword hanging over physician practices. This relief will be felt across the country as physicians will be able to continue providing health care during the pandemic," said AMA President Susan R. Bailey, MD.

In response to the Trump Administration's recent Executive Order that would deal a crippling setback to workplace efforts to increase equality and address race and gender disparities, the AMA has issued a statement affirming its dedication to the work of dismantling racist and discriminatory policies in health care, including those proposed by the federal government. The statement is as follows: "In contrast to the position taken in the Administration's Executive Order on Combating Race and Sex Stereotyping, the AMA believes our country benefits from having more tough conversations about race, gender, sexual orientation and the systems, practices and policies that discriminate and oppress people through racism, sexism, and homophobia. AMA will continue to celebrate all of the diverse identities of physicians and the patients they serve, and the employees who work on their behalf. Only by understanding and discussing why we continue to see disparities based on race and sex in health, housing, wealth, employment and education will we be able to correct inequities and become a more perfect nation. To that end, the AMA will continue its work to dismantle racist and discriminatory policies in health care, including those proposed by the federal government, that permit disparate treatment based on race and sex."

The revised framework that lists and describes the 10 Essential Public Health Services is centered on equity and emphasizes a need for partnerships across community sectors to remove structural and systematic barriers to optimum health. The new framework updates the list that was developed in 1994 by the Clinton Administration and has been used for the last 25 years as a tool to explain public health to policymakers, to inform strategic planning, to shape education curricula and to measure the effectiveness of local public health efforts. The revision was facilitated by the Public Health National Center for Innovations (PHNCI) and the de Beaumont Foundation, a Maryland-based public health advocacy and philanthropy organization. It is intended as a transparent, actionable and inclusive document, informed by data and driven by evidence with updated terminology and a forward-looking thrust to keep it relevant for years to come. AMA Chief Health Equity Officer Aletha Maybank, MD, MPH, served on the task force that developed the revision as well as a subcommittee that drafted a statement on the definition of "equity." "Equity is defined as a fair and just opportunity for all to achieve good health and well-being," the definition reads. "This requires removing obstacles to health such as poverty and discrimination and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and healthcare. It also requires attention to health inequities, which are differences in population health status and mortality rates that are systemic, patterned, unjust and actionable, as opposed to random or caused by those who become ill." Dr. Maybank discussed how the 10 Essential Public Health Services are now centered around equity in the Sept. 9 episode of AMA's ongoing COVID-19 update video series which focused on understanding the context of public health to improve equity. "We have to center equity, not only as an outstanding principle and moral and foundation of these services, but it has to be embedded throughout the entire services—all of them," Dr. Maybank said. "I think during this time of COVID, I think it's even more critical to really understand this context of—not just public health as a framework—but public health as an infrastructure and a system—and how critical it is for it to be funded."Read the full story.

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