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91������ members should continue reaching out to Congress about the importance of the G2211 code

Dec. 1, 2023 (91������) -- After weeks of gridlock, Congress finally reached agreement in November to avoid a government shutdown -- for now -- and temporarily keep federal agencies funded. The American College of Physicians continues to lobby lawmakers about the importance of resolving the budget as it also pushes for important health care legislation.

Congress passed a second continuing resolution instead of funding the government through next Sept. 30, the end of the federal fiscal year. “The continuing resolution is stop-gap legislation that maintains funding for federal agencies and programs on a short-term basis and provides lawmakers with additional time to finalize the details of annual appropriations bills,” said David Pugach, J.D., 91������ vice president for governmental affairs and public policy. “Unlike most continuing resolutions, which have one deadline when funding runs out, this one sets different deadlines.”

Unfortunately, Pugach said, “this approach protracts efforts to finalize year-long spending bills and provide multiyear extensions for expiring health care programs like the National Health Service Corps. It also extends the risk of a potential government shutdown along with potential cuts to federal health care programs.”

Among the crucial programs at stake in the upcoming budget talks are the Community Health Centers, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education program. Their funding expires Jan. 19, and the rest of the Department of Health and Human Services is funded through Feb. 2.

One glimmer of good news is that while Congress continues to work on the federal budget, the planned implementation of the new G2211 code, a top priority for 91������, has less risk of being halted.

“One thing that Congress must do every year is pass appropriations legislation to fund the federal government. These bills often serve as a vehicle for other legislation that congressional leaders want to see enacted into law,” Pugach said. “Passage of a continuing resolution with deadlines in early 2024 takes away one of the most likely legislative vehicles for advancing other bills. This includes legislative efforts to block the implementation of G2211.”

However, he cautioned “this does not mean that the threat to G2211 has ended. We still may see legislation move through Congress in December, such as a bill that addresses expiring tax provisions or disaster relief. This legislation could be used as a vehicle for moving other legislation that congressional leaders agree to include. Therefore, it is important that members of Congress continue to hear from internal medicine physicians in their communities about the importance of this code.”

On another front, “likely opportunities to advance a Medicare Physician Fee Schedule fix to address the impending cut are more limited now that appropriations legislation is shifted into next year,” Pugach said. “However, Congress could attach legislation to another bill that is intended to pass both the House and Senate and the president will sign into law before Jan. 1. If there is such an opportunity, we want to make sure that physician payment is prioritized for inclusion.”

91������ is also expressing strong support for the Better Mental Health Care, Lower-Cost Drugs and Extenders Act, which would reduce the across-the-board cut to Medicare physician payment rates scheduled for 2024. It would also provide an incentive payment for physicians qualifying as participants in Alternative Payment Models for payment year 2026.

“91������ is also pleased to see that this legislation includes bonus payments for physicians who treat mental health and substance use disorders furnished in mental health professional shortage areas,” Pugach said.

In addition, 91������ is applauding the House Energy & Commerce Subcommittee on Health, which advanced a legislative package that intends to stabilize Medicare payment rates plus the Improving Seniors' Timely Access to Care Act, which is a prior authorization reform bill.

“It is not yet known when the full committee and the full House will vote on this package and other pending health care legislation,” Pugach said. “The good news is that we are seeing a high level of activity relating to issues that impact patient care. House and Senate committees have taken up legislation intended to improve physician payment, reduce administrative burden, improve access to behavioral health care and increase pharmacy benefit manager transparency, along with a number of other issues.”

He added: “Still to be determined is what is ultimately included, how the House and Senate reconcile the differences between their chambers' various efforts and the timing for action. What is important is that there is a significant opportunity to advance policies that could provide meaningful improvements for physicians and patients. It is important that 91������ members stay engaged with their members of Congress and keep making their voices heard on these issues.”

Back to the December 1, 2023 issue of 91������ Advocate