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Among the issues are MACRA reform, Physician Fee Schedule conversion factor and budget neutrality, mental and behavioral health, reduction of administrative burdens

Jan. 27, 2023 (ACP) — Considering the stark political divide on Capitol Hill, 2023 is shaping up to be an especially difficult year for the U.S. Congress to make progress on important health/medical matters. However, the advocacy team of the �ܼ�����ˮ��̳ is continuing to push for policies that benefit both patients and clinicians.

“ACP is encouraging Congress to advance policy solutions that have bipartisan support and are essential to improving health care delivery,” said George Lyons, Jr., Esq., ACP director of legislative affairs.

One of the most pressing issues is the future of MACRA, the Medicare Access and CHIP Reauthorization Act of 2015 — commonly known as the Permanent Doc Fix — which overhauled how the federal government pays physicians. “Congress should reform MACRA to include annual positive inflationary updates for the physician community, make it easier to develop and implement alternative payment models, and provide financial incentives for practices to transition from a fee-for-service to a value-based payment system,” Lyons said.

ACP and the rest of the physician community is also calling on Congress to end the annual cycle of cuts tied to the Medicare Physician Fee Schedule conversion factor and budget neutrality limits that require increased or new expenses to be balanced by cuts, Lyons explained.

In addition, Lyons said, there is legislation that will need to be reintroduced into the 118th Congress that did not get included in the omnibus package last year. “Among those bills is legislation to streamline the prior authorization process for Medicare Advantage plans that received bipartisan support in the last Congress,” he noted.

In regard to the fiscal year 2024 budget, ACP will encourage Congress to maintain or increase appropriations spending levels for public health agencies such as the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention and the National Institutes of Health.

Additionally, “we will ask Congress to pass a comprehensive mental health reform bill that would expand access to behavioral health care for patients who need these services,” Lyons said. “This includes policies that would expand access to tele-mental health services, increase the mental health clinician workforce, advance the integration of behavioral health in physician practices and improve mental health parity to ensure coverage of behavioral health.”

ACP will also continue urging Congress to address the shortage of physicians — particularly in underserved and rural areas. ACP supports increasing the number of federally funded Graduate Medical Education training positions and expanding loan forgiveness opportunities for new physicians practicing in these areas, as well as the reauthorization of the Conrad 30 program to increase the number of international doctors serving in underserved communities.

According to Lyons, the most promising areas for bipartisan progress center around “mental and behavioral health and reducing some of the administrative burdens facing physicians and their patients in the delivery of health care, including prior authorization reform. There are some things that can be done through other avenues, such as the regulatory process and executive action. It is still too early in the cycle to know whether Congress will hold hearings or address our concerns regarding Medicare physician payment reform for 2024, but that is also part of our advocacy efforts.”

In other areas, ACP will continue to support legislation that aligns with its policies addressing telehealth, reproductive health, firearm-related injury and death, pandemic preparedness and the public health emergency response, as well as funding for other health care agencies.

“We will monitor House oversight hearings for purposes of determining whether there is misinformation being disseminated regarding the COVID-19 pandemic, the public health emergency, vaccination mandates, and other health care issues,” Lyons said. “We'll address misinformation as needed.”

Finally, ACP will closely monitor the debt ceiling situation. Without congressional action later this year, a default on the national debt could create economic uncertainty around the world, according to Lyons.

There is currently a stalemate between Republicans — who are demanding cuts in return for lifting the debt ceiling — and Democrats, who want to extend the debt limit without any conditions. The federal government could default on its debt if the ceiling is not raised. “A default on the federal debt has never happened, making the consequences very unpredictable; however, such an event could adversely affect funding for federal entitlement programs, such as Social Security and Medicare,” Lyons said. “A negotiated resolution could also affect funding levels for other health care programs that are included in annual appropriations legislation.”

As always, ACP will be a bold and insistent voice in the nation's capital.

Back to the January 27, 2023 issue of ACP Advocate