How doctors changed the legislative, regulatory landscape in 2014


The collective physician voice carried a lot of weight in 2014—both in the nation’s capital and in the state legislatures. Changes that took place covered a broad range of issues, including better access to care for veterans, increased graduate medical education (GME) funding and important updates to the electronic health record (EHR) meaningful use program.


On Capitol Hill, physicians made a difference on two particularly important issues.

The unified voice of medicine calling for swift action to address veterans’ urgent health care needs helped produce a bipartisan, AMA-backed law that paved the way for veterans to seek medical care outside the U.S. Department of Veterans Affairs health care system if they aren’t receiving timely treatment. The law was passed in August, just weeks after the AMA House of Delegates adopted policy demanding a quick resolution to this access-to-care crisis.

Responding to physicians’ grassroots efforts regarding the broken Medicare physician payment system, there was a remarkable occurrence in Congress: Both chambers and parties collaborated to create legislative policy to repeal the sustainable growth rate (SGR) formula. While the law wasn’t adopted this year, it laid the foundation for potential repeal in 2015.

In the state capitals, physician organizations—led by the AMA, state and specialty medical associations—pushed through more than 65 legislative and regulatory changes that will improve the health care system for physicians and patients. Among those victories are stronger medical liability reforms, $7 million in new funding for GME programs and advances in team-based care.


On the regulatory side, physicians have borne an increasingly heavy load over the last several years. Key changes the AMA secured on physicians’ behalf this year include:

  • Electronic health record (EHR) meaningful use. Stage 2 was extended for a full year, a significant new exemption was added to help physicians avoid financial penalties and physicians were allowed to use new, old or a combination of both versions of certified software to meet requirements in 2014. In addition, physicians got an extra two months to apply for a hardship exemption. Read more about the AMA’s work to improve EHR usability and simplify meaningful use at AMA Wire®.   
  • Physician Payments Sunshine Act. The AMA helped physicians prepare for this data release, educated the public and convinced the Centers for Medicare & Medicaid Services (CMS) to exclude independent continuing medical education from being reported as financial interactions between physicians and manufacturers of medical devices and drugs.   
  • Medicare’s Recovery Audit Contractors (RAC). These “bounty hunters” often cause tremendous costs for physicians, even though many physicians are audited without due cause. RACs no longer can receive their contingency fees during the appeals process, and CMS has increased the due process protections for physicians. The AMA continues to call for additional reforms.
  • Medicare’s new value-based modifier. CMS intended to increase payment penalties under the modifier from 2 percent to 4 percent, beginning in 2017. The AMA strongly objected to this proposal in a formal comment letter, and CMS scaled back the recommendation so that practices with fewer than 10 physicians will not be subject to more than a 2 percent VBM penalty.   
  • Physician Quality Reporting System (PQRS). CMS originally said physicians would be obligated to report on at least two cross-cutting measures, but it chopped that requirement in half after the AMA urged the agency not to create additional mandates that physicians would struggle to meet. The agency also had planned to shorten the period physicians have to review their feedback reports to just 30 days. Following AMA lobbying, CMS decided to leave the review period at 60 days.   
  • ICD-10 implementation. The AMA published updated data revealing a significant increase in estimated costs of adopting ICD-10 for physician practices. Soon thereafter, ICD-10 implementation was delayed another year. In addition, the AMA convinced CMS to conduct end-to-end testing to identify problems before proceeding with implementation. Testing will take place in April. Watch AMA Wire for details about how to participate.

Physicians, residents and fellows, medical students, and patients successfully amplified their voices on key issues:

  • Hundreds of meetings took place with key members of Congress.
  • 1.02 million emails were sent to Congress calling for Medicare reform.
  • The Patients’ Action Network surpassed 1 million members.
  • During “Save GME” Week, more than 3,300 emails and phone calls to Congress were made by medical students and residents.

Learn more about how you can become involved in the coming year.