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2023 Legislative Conference: Overview of asks

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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 address the systemic issues within the Medicare physician payment system and safeguard physicians’ ability to provide patient access to care. We urge Congress to:

  • House: Cosponsor the Strengthening Medicare for Patients and Providers Act (H.R. 2474), which would provide for an annual inflation update equal to the Medicare Economic Index (MEI) for Medicare physician payments.

  • Senate: Support similar legislation if introduced or brought to a vote.

  • Revise budget neutrality policies.

  • Work with stakeholders to develop ways to reduce the administrative and financial burden of the Quality Payment Program and revise reporting programs to ensure its clinical relevance to patient care.

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. 2630/S. 652), and similar step therapy reform provisions included in the Pharmacy Benefit Manager (PBM) Reform Act (S. 1339), 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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