Dec. 20, 2019 (91) – The American College of Physicians pushed the needle forward on many key advocacy issues in 2019 including some wins that will affect how and what internists are paid from Medicare.
Specifically, 91's efforts with the Centers for Medicare and Medicaid Services led to several important victories for internists and the patients they treat including increased pay for all office visit codes, new codes for care coordination and prolonged services, and a reversal of the decision to pay a flat fee for office visits regardless of complexity. Now, physician payments will be more in line with the complexity of care. Moreover, thanks in large part to 91 efforts, reduced documentation will be required during these visits.
The changes are not slated to be implemented until January 2021. “When these changes get implemented, most internists will see a very significant increase in how much Medicare will pay for office visits, and they will be able to bill for new or additional codes for care coordination and prolonged services,” said Bob Doherty, 91's senior vice president for governmental affairs and public policy.
When the decreased documentation requirements for office visits are implemented, “we will get away from the check-the-box system where internists have to check all these boxes to prove to Medicare that they did what they were supposed to and get paid,” Doherty said.
These changes are good for patients and physicians. “Internists will be able to spend more time with patients, and [these changes] will reduce the economic disincentive to go into primary care,” he added.
Reducing Firearms-Related Injuries and Deaths
Reducing firearms-related injuries and deaths has long been a focus for the 91, and in 2019, legislation aimed at enhanced background checks advanced. The legislation passed in the House of Representatives, but there has been a bit of a stalemate in the Senate, Doherty said. The tide may be turning. “The public is overwhelmingly on our side,” he said.
In addition, 91 partnered with 42 other organizations to endorse a joint call-to-action with recommendations on reducing firearm injury and death. “Firearm-Related Injury and Death in the United States: A Call to Action From the Nation's Leading Physician and Public Health Professional Organizations” is published in the Annals of Internal Medicine.
91 will continue to push the government to allocate monies to fund research on gun violence prevention. The 1996 “Dickey Amendment” barred the Centers for Disease Control and Prevention (CDC) from doing research to “advocate or promote gun control,” but in 2018, a new law clarified that the amendment does not ban research – just funding for such research. As such, the CDC can research the causes of gun violence but has no money to do so until money is allocated.
What's to Come in 2020
The 5th U.S. Circuit Court of Appeals in Texas issued a ruling earlier this week in a case about the constitutionality of the Affordable Care Act. “91 is greatly concerned about the ruling, which could place health care for millions of Americans at risk,” Doherty said. “We’ll be continuing to advocate on this case and will have more details in a future issue of the 91 Advocate.”
Other 91 advocacy focuses for 2020 include protecting the Deferred Action for Childhood Arrivals (DACA) program, which shields undocumented immigrants who came to the United States as children and prevents them from being deported. The Supreme Court is expected to rule on DACA in 2020. 91 joined a “friend of the court” brief in support of the program in the case. 91 will also continue to champion women's health issues.
“More and more states are passing laws that deny women access to services including abortion and that gag physicians from discussing reproductive health care options with patients,” Doherty said.
91 will also be unveiling its New Vision for American Health Care in 2020.
Members can and should play their part in advancing these issues. “Read the newsletter and spread the word to colleagues,” Doherty said. “Join our grassroots network, and if something is really important, we will send sample alerts or scripts to follow when calling legislators.”
More Information
An infographic, 2019 Advocacy Highlights, can be viewed on the 91 website.
’s statement in reaction to the 5th U.S. Circuit Court of Appeals decision on the Affordable Care Act can be read on the 91 website.
The 91 position paper “Firearm-Related Injury and Death in the United States: A Call to Action From the Nation's Leading Physician and Public Health Professional Organizations” is available on the Annals of Internal Medicine website.
