What is AAFP’s Federal Advocacy Team Working on?

CMS Releases 2023 Medicare Physician Fee Schedule

Why it matters:

This month, the Centers for Medicare and Medicaid Services (CMS) released the 2023 Medicare physician fee schedule (MPFS) and Quality Payment Program (QPP) proposed rule. It includes an estimated 4.5% reduction in the Medicare conversion factor. The AAFP fears this may result in untenable Medicare payment cuts for family physicians in 2023 and jeopardize patients' timely access to essential primary care.

The AAFP is pleased that CMS has proposed several changes to Medicare supervision and billing rules for certain behavioral health clinicians that will enable them to help manage patients' behavioral health needs as part of the primary care team. The rule also includes several proposals to modify the Medicare ACO program, which may help more family medicine practices transition into ACOs. While these proposals are positive for family medicine, more comprehensive Medicare physician payment reform is needed to protect patients' access to high-quality primary care.

What the AAFP is working on:

  • Calling on Congress to avert Medicare Part B payment cuts set to go into effect in 2023.
  • Urging Congress to enact positive annual updates for Medicare physician payments to account for increasing practice costs and address the limitations of Medicare budget-neutrality requirements.
  • Supporting legislation to extend the alternative payment model bonus for another five years and to reform the qualifying criteria so that more clinicians can transition into alternative payment models.
  • Advocating for greater financial support to stand up and sustain integrated behavioral health models.

Bipartisan Safer Communities Act Becomes Law

Why it matters:

The AAFP applauded Congress for passing the Bipartisan Safer Communities Act. Gun violence is an urgent national public health epidemic, and the AAFP commends this legislation as an important step toward curbing injuries and death caused by firearms.

What the AAFP is working on:

The AAFP is pleased that the below provisions, for which we have specifically advocated, were included in the Bipartisan Safer Communities Act.

  • $60 million for training in mental health for primary care clinicians who treat children and youth through HRSA's Primary Care Training and Enhancement Program (PCTE). PCTE funded programs provide impactful training to family physicians, and we have long advocated for additional funding to support the integration of behavioral health and primary care.
  • $80 million and reauthorization of the Pediatric Mental Health Care Access program. The AAFP has repeatedly called on Congress to reauthorize and expand this HRSA program to help promote behavioral health integration in pediatric primary care.
  • Preserves and expands access to telehealth for Medicaid and CHIP beneficiaries, which the AAFP has called for as a means of expanding timely access to primary and behavioral health care.
  • Includes strategies to address equity and bridge the digital divide for telehealth access in the Medicaid program.
  • $250 million for the Community Mental Health Services Block Grant. The AAFP requested robust funding for these block grants, which improve access to community mental health care and SUD treatment.

Supreme Court Decision Striking Down Roe v. Wade Threatens Patient-Physician Relationship

Why it matters:  The AAFP is disappointed and gravely concerned by the Supreme Court's decision to strike down longstanding protections afforded by Roe v. Wade and Planned Parenthood v. Casey. This decision negatively impacts clinicians and patients by undermining the patient-physician relationship and allowing states to criminalize or penalize evidence-based medical care.

What the AAFP is working on:  

  • Following the Supreme Court's decision, the AAFP wrote to Health and Human Services Secretary Becerra to urge HHS to utilize its federal authority to immediately protect patient safety, support family physicians and other clinicians, and strengthen timely access to reproductive health care. We also submitted testimony to the Senate HELP Committee on how the decision threatens access to reproductive health care.
  • On July 7, the AAFP joined the American Medical Association and the American College of Obstetricians and Gynecologists, along with 75 other health care organizations, in releasing a statement opposing legislative interference in health care in the wake of the Supreme Court decision.
  • We will continue to advocate for everyone's right to health care and to protect family physicians and their patients. This is in keeping with our longstanding policies opposing any governmental interference in the confidential relationship between patient and physician.

Extending and Transitioning Out of the Public Health Emergency

Why it matters: The AAFP delivered urgent new guidance to federal regulators and called for the PHE to continue through at least December 31, 2022. The PHE's waivers, flexibilities, coverage policies, and other actions provided family physicians with critical resources to care for patients and keep their practices open during the pandemic.

Given that many of these policy changes have significantly altered the health care coverage and delivery landscape, transitioning away from the federal PHE could cause considerable disruptions to physicians and their patients. The AAFP strongly urged HHS to publish a plan outlining how it will minimize these disruptions.

What the AAFP is working on:

  • Prioritizing primary care practices in vaccine distribution and advocating for HHS to permanently cover and pay for vaccine counseling when it is provided separately from vaccine administration, including via audio-only and audio/video telehealth.
  • Ensuring Medicare, Medicare Advantage, Medicaid, and CHIP continue providing comprehensive coverage and payment for COVID-19 vaccines, therapeutics, and testing after the end of the PHE.
  • Urging Congress to strengthen Medicaid coverage for those who are eligible, maintain federal support for marketplace coverage by making permanent the enhanced ACA premium tax credits, and closing the Medicaid coverage gap to expand coverage options for those who are uninsured.
  • Preserving appropriate telehealth flexibilities and ensuring adequate and stable payment for telehealth services and standardized coverage of telehealth services across payers so patients can continue to use telehealth with their primary care physicians.
  • Urging Congress to pass supplemental funding legislation to provide urgently needed support for federal COVID-19 response efforts, including vaccination campaigns as well as the development of new vaccines and therapeutics.

CMS Delays Penalty Phase for Appropriate Use Criteria Program

Why it matters: CMS is delaying the penalty phase for the Appropriate Use Criteria (AUC) Program until further notice. The AAFP advocated for delays due to concerns about AUC's burden on family physicians.

What the AAFP working on:

New Medicare payment and delivery models that address quality and patient outcomes make the AUC Program outdated and unnecessary. That's why we are urging Congress to repeal the AUC program and allow CMS to rely on existing models to improve care quality.