Federal Advocacy

3 key senators back physician advocacy priorities

Andis Robeznieks , Senior News Writer

A bipartisan trio of senators championing changes that are essential to improving the U.S. health system spoke to hundreds of physicians and medical association staffers gathered at the AMA National Advocacy Conference in Washington, D.C.

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Democratic Sens. Amy Klobuchar, of Minnesota, and Sheldon Whitehouse, of Rhode Island, addressed priorities such as the need to ensure that Medicare physician payment keeps pace with inflation and that financial incentives for alternative payment models continue(PDF).

Klobuchar also highlighted her efforts to mitigate projected physician shortages by expanding the Conrad 30 waiver program.

Senator Sheldon Whitehouse
Sheldon Whitehouse

Kansas Republican Sen. Roger Marshall, MD, an ob-gyn, talked about his Food is Medicine nutrition initiative, preventing fentanyl poisoning deaths, and his work as the Senate sponsor of  the “Improving Seniors’ Timely Access to Care Act” to fix prior-authorization burdens in Medicare Advantage. This important legislation incorporated major developments in the 2018 consensus statement (PDF) on prior-authorization reform developed by the AMA.

Dr. Marshall gave attendees basic tips on how to lobby for his bill, which included: Telling a quick story about a patient whose treatment was delayed by prior authorization; he stressed the importance of building relationships with their lawmakers’ health care staff and urged attendees to contact them regularly to see if there is anything they can do to move the legislation along.

“This is salesman 101,” he said. “Tell a story. Get to know the staff.”

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Along with Wyoming Republican John Barrasso, MD, Senator Whitehouse introduced the bipartisan “Preserving Access to Value Based Care Act,” which the AMA supports, and would extend the incentive payments to physicians for participating in an alternative payment model, or APM (PDF).

Whitehouse discussed his support for value-based care in general and for accountable care organizations (ACOs) in particular, noting that they saved Medicare $1.6 billion in 2021.

Senator Roger Marshall
Roger Marshall, MD

On this issue, Whitehouse said his battle cry has been: “Don't starve the lead dogs. Instead, help them flourish. Help them build a more successful business model."

“We are trying to repair a massive broken, wasteful system,” he explained. “We are trying to do so by galvanizing and rewarding new models of payment and care that hit the triple aim.”

Leading the charge to reform Medicare pay and tackling prior authorization are critical components of the AMA Recovery Plan for America’s Physicians.

After completing residencies in the U.S. on J-1 visas, international medical graduates (IMGs) are required to return to their country of origin for at least two years before applying for a new visa or green card.

Under the Conrad 30 program, doctors can apply for waivers to stay here if they commit to at least three years of service in areas that have been underserved by limited access to health care services.

“The Conrad 30 program is a critical lifeline for people in these communities, and an important tool to bolster our physician workforce,” AMA President Jack Resneck Jr, MD, said at the conference.

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Senator Amy Klobuchar
Amy Klobuchar

The AMA supports the bill sponsored by Klobuchar (PDF), the “Conrad State 30 and Physician Access Reauthorization Act,” which would reauthorize the Conrad 30 waiver policy for another three years, make targeted policy improvements including permitting expansion of the number of waivers granted to each state, and allow a physician working in an underserved area or Veterans Administration facility for a total of five years to gain priority access to the green card system, thereby helping address the current physician green card backlog. The AMA has long-standing policy supporting the program.

“It's been hugely successful,” Klobuchar said. “What we want to do is expand it. We think there's such a need that we should have more doctors in this program.”

The AMA has adopted a wide range of other policies to support IMG physicians, including a set of underlying principles on IMGs.  Learn about the AMA’s advocacy on Conrad 30 and other visa and green-card issues.

Visit AMA Advocacy in Action to learn about other advocacy priorities the AMA is working on.