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2022 Policy background information

Overview of asks


Support physician practices: Ensure Medicare stability for patients and physicians

Medicare physician reimbursement has failed to keep up with inflation, threatening the viability of medical practices. The current payment structure has contributed to consolidation and increased hospital ownership of physician practices, which are more costly, reduce competition, and are less patient centered. Year-over-year cuts to Medicare reimbursement jeopardize physicians’ ability to keep the doors open and care for patients in our communities.

Legislative ask

Take action to prevent Medicare physician payment cuts impacting patients’ access to care and mitigate the financial distress facing dermatology practices. Beginning Jan. 1, 2023, physician practices could see their Medicare reimbursement cut by 8.5% or more.

House and Senate:

Support legislation to:

  • Replace scheduled and anticipated cuts in Medicare physician payments with positive, inflationary-based updates for at least one year.

  • Cosponsor H.R. 8800, Supporting Medicare Providers Act of 2022, and eliminate the nearly 4.5% cut in reimbursement in CMS’s proposed rule for the 2023 Medicare Physician Fee Schedule.

  • Waive the 4% PAYGO sequester necessitated by passage of legislation unrelated to Medicare.

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Remove barriers to treatment and care: Reform step therapy protocols

Step therapy strategies can negatively impact patient outcomes and quality of life by requiring patients to try one or more drugs before coverage is provided for the drug selected by the patient’s physician. It jeopardizes patient health by risking an adverse and potentially severe reaction to an inappropriate drug. Step therapy can ultimately cost more in the long run, through additional trips to the physician’s office or even to the emergency room.

Legislative ask

Take action to ensure that physicians remain the clinical authority over a patient’s care and lessen the burden on patients required to go through step therapy protocols instituted by insurance companies.

House and Senate:

  • Cosponsor and support passage of the Safe Step Act (H.R. 2163/S. 464), which would ensure that step therapy protocols used by group health plans preserve the physician’s right to make treatment decisions in the best interest of the patient.

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Remove barriers to treatment and care: Reduce prior authorization burdens

Prior authorization policies can fundamentally interfere with the patient-physician relationship and are counter to the practice of personalized medicine. Prior authorization processes are time-consuming and siphon resources away from patient care and baselessly questions physicians’ clinical judgement. Furthermore, prior authorization can cause delays in care and negative patient health outcomes.

Legislative ask

Take action to make common sense reforms to how Medicare Advantage (MA) plans use prior authorization protocols. These reforms will help reduce barriers to care, allow physicians to spend more time with patients, and put treatment decisions back where they belong — in the hands of physicians and patients.

House and Senate:

  • Cosponsor and support passage of the Improving Seniors’ Timely Access to Care Act (H.R 3173/H.R. 8487/S. 3018), which would provide oversight, reduce administrative burdens, and improve transparency of the prior authorization process in the MA plans to allow physicians to spend more time with patients.

House only:

  • Cosponsor and support passage of Getting Over Lengthy Delays in Care as Required by Doctors (GOLD CARD) Act of 2022 (H.R. 7995), which would exempt qualifying providers from prior authorization requirements under MA plans.

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