The Centers for Medicare and Medicaid Services (CMS) accepted two recommendationsput forth by the AOA and the American Association of Colleges of Osteopathic Medicine relating to Graduate Medical Education in the Hospital Inpatient Prospective Payment System final rule released August 5. Hospitals receive payment for their indirect medical education costs and direct GME costs based on the number of interns and residents they train. Federal law caps the number of residents a hospital may count for Medicare payment purposes, but allows for special adjustments in specific situations.
Based on the comments it received, CMS adopted a policy that, effective October 1, 2014, a rural hospital that has been re-designated as urban can receive a permanent cap adjustment for a new program if it received a letter of accreditation for the new program, and/or started training residents in the new program, prior to being re-designated as urban. The AOA and AACOM recommended this letter of accr editation, when CMS originally proposed that the teaching hospital must be actively training residents in the new program while still rural in order for the hospital to continue receiving a cap adjustment for the new program.
CMS is also simplifying and streamlining the timing of its policies by making the FTE resident caps, rolling average, and IRB ratio cap effective simultaneously. In response to public comment, CMS finalized a modification of its original proposal so that its policies will be effective beginning with the applicable hospital’s cost reporting period that coincides with or follows the start of the 6th program year of the first new program started. Under that proposed policy, the FTE resident caps wou ld have taken effect at the beginning of the fiscal year that precedes the sixth program year.
Carol Monaco, Director of Federal Affairs (firstname.lastname@example.org)
On Friday, August 15, the AOA participated in a White House Joining Forces convening on how to improve mental health services for military service members, veterans, and their families. Accompanied by AOA Department of Government Relations staff, Rear Admiral Joyce Johnson, DO, MA USPHS (ret) represented the osteopathic profession in the discussions on how to better align care in the community, as well as in the Veterans and Department of Defense healthcare systems.
The Joining Forces initiative was started in 2011 by First Lady Michelle Obama and Dr. Jill Biden in order to engage all sectors of society in giving service members and their families opportunities and support through national initiatives in employment, education, and wellness. The AOA has been a partner in the initiative since its first year, and as part of its commitment has distributed pocket cards to members on key questions to ask in a military health history, and raised awareness among osteopathic colleges of medicine on the unique needs of veterans and serv ice members.
Friday’s convening was attended by a range of healthcare stakeholders including private payers, pharmaceutical manufacturers, and representatives from the military and the Veterans’ Administration (VA). Other provider groups were also in attendance including the American Academy of Family Physicians, the American Association of Nurse Practitioners, the American Nursing Association, and the Association of American of Medical Colleges. Much of the discussion centered on improving the military cultural competence of providers as veterans’ care is increasingly shifted into the community and private practices. As well, the need for military experience to be flagged in medical chart was emphasized, and possible strategies such as a new CPT code or integration into the electronic health record to increase it. The VA is also looking to increase t he number of providers and resources it lists in its National Resources Directory. The AOA will continue to collaborate with Joining Forces as it works to achieve these goals.
Laura C. Wooster, Associate Vice President, Public Policy (email@example.com)
DOs can join the national health care conversation and become grassroots advocates by using online AOA advocacy tools. Attend Town Hall meetings with legislators in your area during the August recess and take advantage of this opportunity to deliver messages on key issues like Medicare payment reform and extending the Medicaid Primary Care payment bump. Identify your U.S. Senators and House Representative using our online tool. Then, use this chart to see if a Town Hall meeting is being scheduled in your area. (Learn more about participating in Town Halls.) If you are unable to attend a Town Hall and would still like to show your support, send a letter to your Members of Congress about our most critical issues. Subscribe to the Grassroots Osteopathic Advocacy Link (GOAL) to stay informed about upcoming engagement opportunities.
Jordan Abushawish, Director of Advocacy (firstname.lastname@example.org)
Unless Congress acts, the Medicaid primary care incentive that pays physicians at Medicare rates for providing primary care to Medicaid patients will expire in December. Tell your Senators to co-sponsor a bill that will extend it for two more years!
Congress passed legislation in 2010 that called for physicians to be paid at Medicare rates or above for providing primary care services to Medicaid patients in 2013 and 2014. Unless Congress acts again, this valuable program will expire at the end of this year -- just as more patients are entering the Medicaid system, and physicians like you are struggling to provide them with the access to care that they need. While the payment incentive was to go into effect at the start of 2013, many states were only just able to implement the payment bump earlier this year, mere months before the program expires at the end of this December.
Introduced today, S. 2694, or the “Ensuring Access to Primary Care for Women & Children Act,” will extend the Medicaid Primary Care payment incentive for an additional two years through 2016, giving the program time to prove its benefits and helping to ensure that Medicaid patients will have access to a primary care physician.
But in order to pass, the bill needs support—ask your Senators to sign on as co-sponsors. Don’t let this valuable payment expire!
Please see this important message from GL Advisors, one of ACOEP's valued partners.
GL Advisor has been carefully reviewing the details of the budget proposal recently released by the Obama Administration. The potential changes to existing student loan repayment and forgiveness programs could adversely impact thousands of borrowers, especially young graduate professionals working in the public sector. Our presentation highlights the proposed changes and provides real-world case studies of the possible impact on young medical professionals.
Super Tuesday has come and gone and primaries throughout the country. It is important to know who our leaders are, so stay informed! Here are some helpful links!
The Cook Political Report
Take a moment to familiarize yourself with Sylvia Mathews Burwell, President Obama's nominee for Health and Human Services Secretary.
The Wall Street Journal: Sylvia Burwell, HHS Nominee, Answers Senators' Questions
The cost to permanently repeal the Medicare Sustainable Growth Rate (SGR) has gone up by almost twenty percent, only weeks after Congress passed a one-year patch derailing the unprecedented progress made to date on permanent physician payment reform. One of the reasons that progress was even put in motion was because the cost estimate to repeal the SGR had been drastically lowered in 2013 by the Congressional Budget Office (CBO). But by approving the 17th temporary SGR patch in 11 years last month, Congress chose a fiscally irresponsible path that delayed permanent reform long enough that the price has now gone up, making permanent reform even more urgent before future generations of seniors are put at risk.
Ensure physician voices are heard - write your senators and tell them to vote YES.
The "SGR Repeal and Medicare Provider Payment Modernization Act" (H.R. 4015/S. 2110) was introduced last month in both the House and Senate, and is the first bipartisan, bicameral legislation to replace the flawed Medicare physician payment formula. The legislation will:
• Permanently repeal the SGR;
• Establish a new payment system with positive updates for all physicians for five years;
• Provide payment incentives for transitioning to alternative payment models like the Patient-Centered Medical Home;
• Combine and streamline the current quality reporting programs; and
• Support high-quality patient care
More than 1,200 DOs and osteopathic medical students participated in DO Day on Capitol Hill, the AOA’s premier lobbying event of the year. Wearing white coats and DO pins, participants met face-to-face with U.S. representatives to deliver key lobbying points and tell their own personal stories related to topics like payment reform and physician workforce.
Congress has not heard from physicians that Medicare physician payment reform is a priority. Only 2.4% of DOs emailed letters to Congress last week. Your engagement with Congress in the coming weeks is imperative to end the constant struggle to reform the physician payment system, currently hindered by the sustainable growth rate (SGR) formula, once and for all. If you have sent a letter in the past, please send another today.
The "SGR Repeal and Medicare Provider Payment Modernization Act" will only move to a vote by the full House and Senate if Congress hears from the entire osteopathic family. Don't allow Congress to avoid physician payment reform. Send a letter to your Members of Congress today asking them to co-sponsor the legislation and help advance the bill for a vote. We need your help during this pivotal time!
Take two minutes to send your letter today.
Your experience, insight and voice are all vital components of enacting change in the current political and medical landscape. Do you want to get involved but aren't sure how? Here are some great resources!
Click here to download the minutes from the AOA Legislative and Regulatory Agenda, 113th Congress-2nd Session.
Click here to download notes from the AOA Bureau on Federal Health Programs.
Healthcare Law Roll Out Timeline
The Wall Street Journal has published a timeline of the roll out of the Affordable Care Act.
CVS to Stop Selling Cigarettes
What do you think of CVS's controversial decision to stop selling cigarettes in their locations? Strong move toward a healthier nation or publicity stunt while they still sell unhealthy food options?
Latest Health Care Flap Shows Media at Its Most Boring
An interesting perspective on the way that the Health Care Law is covered in American media.
2014 Cook Political Report
The 2014 Cook Political Report has been published and offers an interesting and in-depth look ahead at the 2014 midterm elections.
If you are interested in advocating on behalf of your fellow physicians as well as the patients you serve but are unsure where to begin, the AOA's D.O. Advocacy Handbook is an excellent tool. Click the link above to download the pdf.
GOAL is an AOA initiative aimed at garnering support from elected officials on topics important to osteopathic physicians and those they treat. They offer tools and information on how to best get involved and make the use of your unique experience.
EveryPatientCounts.org is a one stop website for physicians, future physicians, patients and policy makers who are concerned about the cuts to physician pay form Medicare and Medicaid. It is a place where you can share your story, find information on writing to your elected officials, and understand the important details behind proposed legislation.
An interesting blog article from Sarah Kliff of the Washington Post who runs the paper's Health Reform Act, a regular look at how the Affordable Care Act is shaping the American health-care system.
John Farmer of the the Star Ledger looks at how the Affordable Care Act is likely to affect the midterm elections.
On Sept. 20, 2013, the American Osteopathic Association (AOA) hosted the third annual Health Policy Forum in Washington, D.C. The event featured presentations from the nation's leading experts on various issues impacting physicians and our health care system.
To review key points of the meeting: Click Here (PDF)