See What the American Academy of Family Physicians Advocacy Team Has Been Working On.
Reintroduction of Legislation to Streamline Prior Authorizations
On June 12, 2024, congressional champions reintroduced the Improving Seniors’ Timely Access to Care Act (H.R. 8702/S. 4518), which would streamline and standardize prior authorization under the Medicare Advantage program and protect patients from unnecessary delays in care. The American Academy of Family Physicians (AAFP) is urging Congress to swiftly pass this bipartisan legislation.
While the Centers for Medicare and Medicaid Services (CMS) recently finalized proposals to reform prior authorization, legislation is still necessary to ensure that these much-needed changes are made permanent.
SCOTUS Preserves Patient-Physician Relationship
The June 13, 2024, U.S. Supreme Court decision in the case of Alliance for Hippocratic Medicine (AHM) v. Food and Drug Administration (FDA) preserves the patient-physician relationship and upholds access to mifepristone, an FDA-approved medication.
The AAFP has long made clear that…
- Patients must be able to depend on their physicians to help them in making critical decisions about their health.
- Physicians must be able to practice medicine that is informed by their years of medical education, training and experience and the available evidence.
Read the AAFP statement on the ruling on AHM v. FDA.
Continued, Timely Access to COVID-19 Vaccines
As we prepare for another COVID-19, flu and RSV season, it’s important that family physicians are able to provide immunizations to patients in a timely manner.
WHAT WE’RE WORKING ON:
- The AAFP joined the COVID-19 Vaccine Education and Equity project and other health organizations in sending a letter to the Centers for Disease Control and Prevention and the U.S. FDA to ensure that the COVID-19 vaccine is available early in the season.
- AAFP President Steven Furr, MD, FAAFP, wrote in MedPage Today that Congress must pass legislation to require Medicare Part B coverage of all recommended vaccines, allowing patients to access vaccines more readily from their usual source of care and improving our nation’s uptake of one of the most cost-effective public health measures.
Inpatient Prospective Payment Systems Proposed Rule
CMS released the Fiscal Year 2025 Hospital Inpatient Prospective Payment Systems (IPPS) proposed rule. The AAFP applauds CMS for continuing to prioritize health equity in the 2024 IPPS proposed rule.
As the largest funder of graduate medical education (GME), Medicare plays a significant role in addressing physician maldistribution and disparate access to care across the nation. If finalized as proposed, this rule would take several important steps to direct GME funding to the areas of greatest need, helping mitigate health access disparities and more effectively addressing physician shortages.
WHAT WE’RE WORKING ON:
- The AAFP and Council of Academic Family Medicine sent a joint letter to CMS offering our support and recommendations for the Fiscal Year 2025 IPPS proposed rule, particularly regarding a forthcoming distribution of GME residency slots and a newly proposed mandatory model, the Transforming Episode Accountability Model (TEAM). This rule proposes several important steps that would direct GME funding to the areas of greatest need, including a proposal to require hospitals that serve areas designated as health professional shortage areas (HPSA) to have at least 50% of residents’ training time occur at training locations within a primary care or mental health–only geographic HPSA in order to be able to apply for new GME slots.
- Additionally, our organizations appreciate CMS’ recognition of the importance of primary care continuity in its proposal to confirm the patient’s primary care physician status during a hospitalization or procedure in the TEAM Mandatory Model. The AAFP supports the role of family physicians in providing continuity of care to their patients in all settings, both directly and by coordinating care with other health care professionals.
- When considering finalizing the TEAM Mandatory Model, the AAFP encourages CMS to consider the impacts of the national physician workforce shortage. Hospitals, depending on their location, might experience challenges when referring patients after discharge. We encourage CMS to implement safeguards within this model that would prevent physicians from being penalized for situations beyond their control.
Guidance to Help Practices Impacted by Cyberattack
The AAFP is pleased that the U.S. Department of Health and Human Services (HHS) has provided updated guidance to make clear that “covered entity” health care institutions affected by the Change cyberattack can contact Change and direct it to notify patients directly that their information was compromised by the breach.
The AAFP had previously asked for more guidance from HHS regarding Health Insurance Portability and Accountability Act (HIPPA)–related reporting requirements in relation to the Change Healthcare attack. The announcement comes on the heels of a joint letter from the AAFP and more than 100 other health care organizations in requesting that HHS’ Office of Civil Rights clarify that Change Healthcare is responsible for notifying impacted patients of the breach and all related reporting requirements, alleviating practices’ legal concerns and allowing them to focus on continuing to recover from the attack.
WHAT WE’RE WORKING ON:
- The AAFP continues to urge Congress to closely examine how unchecked consolidation affects the overall health system from the perspective of patients and the physicians who care for them.
- The cyberattack on Change Healthcare has had far-reaching implications for family physicians and other providers of health care services, affecting their ability to receive payments and perform everyday business functions that are essential to the delivery of patient care. The AAFP recently shared recommendations with the House Energy and Commerce Subcommittee ahead of its hearing “Examining Health Sector Cybersecurity in the Wake of the Change Healthcare Attack.”
For the latest policy updates impacting family medicine, follow the American Academy of Family Physicians Advocacy team at @aafp_advocacy.
Post author: American Academy of Family Physicians (AAFP)
