Amid the ongoing coronavirus pandemic, upcoming expiration of key health extenders, and unfinished fiscal year (FY) 2021 spending bills, the AAMC provided congressional leaders with recommendations for any year-end legislation that would support the efforts of academic medicine and ensure patient access to care.
AAMC Chief Public Policy Officer Karen Fisher, JD, sent a letter on Nov. 18 urging congressional leaders to consider recommendations critical to ensuring that teaching hospitals, academic physicians, and medical schools can continue responding to the COVID-19 pandemic and providing the best care for all patients.
The letter comes in advance of the Dec. 11 expiration of a continuing resolution (CR) that is temporarily funding the government at FY 2020 spending levels and maintaining funding for certain health programs [see Washington Highlights, Oct. 2].
The letter details the AAMC’s recommendations under the following categories:
Containing the COVID-19 Pandemic and Mitigating Its Impact
- Advance a national strategy to address the COVID-19 crisis through support for testing, vaccine distribution, supplies and personal protective equipment, and an approach that promotes health equity.
- Provide emergency supplemental appropriations to the National Institutes of Health (NIH) and other research agencies to support new COVID-19-related research and mitigate the impact of the impact of the public health emergency on pre-pandemic research and the research workforce.
- Allocate additional resources to the Provider Relief Fund to address some of the challenges and financial stress the pandemic has placed on the health care system.
- Extend the 2% Medicare sequester moratorium until at least the end of the public health emergency and provide an additional increase in the Federal Medical Assistance Percentage.
- Make permanent the current telehealth waivers, including the removal of geographic and site of service restrictions, while ensuring reimbursement remains at a level that will support the infrastructure needed to continue to provide telehealth services.
- Provide emergency funds to the National Health Service Corps (NHSC) to support loan forgiveness for health professionals.
Finalizing FY 2021 Appropriations
- Provide at least $2 billion in increased NIH funding over FY 2020 funding levels, in addition to at least $15.5 billion in emergency funding.
- Increase funding for the Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, National Science Foundation, and Department of Veterans Affairs Medical and Prosthetic Research program [see related story].
- Provide $790 million in FY 2021 for the Health Resources and Services Administration Title VII health professions and Title VIII nursing workforce development programs and oppose elimination of the Health Careers Opportunity Program.
Addressing Key Health Extenders and Other Policy Provisions
- Eliminate the remaining $4 billion in FY 2021 Medicaid Disproportionate Share Hospital (DSH) payment cuts that are scheduled to go into effect on Dec. 11.
- Temporarily halt the pending evaluation and management (E/M) services payment cuts authorized in the most recent proposed calendar year 2021 Medicare Physician Fee Schedule rule.
- Reject any surprise medical bill proposals that would set a payment rate in statute and jeopardize access to care for patients by incentivizing insurers to further narrow their networks.
- Address the physician shortage and ease outdated restrictions on Medicare support for graduate medical education.
- Provide five years of increased mandatory funding for the NHSC, Teaching Health Centers Graduate Medical Education, and Community Health Centers.
- Oppose funding cuts to and reduced numbers of military medical billets in the Department of Defense physician workforce.
Lawmakers have begun negotiating top-line numbers for the FY 2021 spending bills, with the hope of concluding negotiations this week and developing an omnibus spending bill to pass by the Dec. 11 CR deadline.
Separately, House and Senate Democrats this week urged congressional Republicans to reengage in COVID-19 relief negotiations. The ongoing barrier in COVID-19 relief talks remains the overall cost of the package, with Democrats preferring a larger, more comprehensive relief package.