ACR Leaders & Volunteers Take the Issues to the Decision Makers

On May 11, ACR leaders representing the Board of Directors, Affiliate Society Council, Government Affairs Committee (GAC), Committee on Rheumatologic Care, RheumPAC Committee and Insurance Subcommittee went to Capitol Hill to advocate on behalf of the ACR/ARHP membership and our patients. The group, which represents 27 states and the District of Columbia, conducted meetings in 101 offices of the Senate and House of Representatives, as well as Health and Human Services.

The ACR Executive Committee gathers in the anteroom of the U.S. Senate Dining Room.

In advance of the meetings with government officials, the fly-in participants met together to plan strategy. Chap Sampson, MD, says, “Our GAC meeting centered on how to align the ACR’s priorities with the best ways we can create positive change in D.C. There is so much going on in Washington right now that it was difficult to only focus on a few particular issues, because everything seemed so important. I was proud that the ACR continues to chart a bipartisan course and is concentrating on the issues that directly affect our patients rather than the inherent conflicts of our current political climate.”

Dr. Sampson earned his medical degree and completed his residency at the University of Arkansas for the Medical Sciences. He completed a fellowship at Indiana University School of Medicine and practices at Washington Regional Rheumatology Clinic in Fayetteville, Ark.

AHCA
Regarding the American Health Care Act (AHCA), ACR leaders met with seven of the 13 members of the Senate who have been tasked with the current phase of healthcare reform and shared our policy priorities, centered on access to care, with those offices. You can read the ACR’s letter to the Senate stating these priorities here.

Dr. Sampson says, “The ACHA bill was still very new in everyone’s mind. I did my best to poll the congressional staff members we met with about where the Senate might head, and it sounds as though it will be a slower and more deliberative process compared with the House bill. However, no one would say much beyond that.”

What We’re Asking For
Padmapriya Sivaraman, MD, who participated in the fly-in, says, “As physicians we not only practice the art of treating the disease, but also the patient who has the disease. Being part of the rheumatology Political Action Committee gives us the unique opportunity to encourage this philosophy.” Dr. Sivaraman completed her residency and fellowship at Case Western Reserve University and practices at Rheumatology Associates in Dallas.

During the Hill meetings (see photos here), ACR/ARHP leaders asked that Congress address the growing workforce shortage issue facing medical providers and specifically the rheumatology field, which will need 3,845 more licensed and practicing rheumatologists in 2025 than what is projected in the ACR’s 2015 Workforce Study. To this end, members of the House were asked to co-sponsor H.R.2267, the Resident Physician Shortage Reduction Act of 2017, which would provide for the distribution of additional medical residency positions. Members of the Senate were asked to co-sponsor S.989, the Ensuring Children’s Access to Specialty Care Act, which would make pediatric subspecialties, such as pediatric rheumatologists, eligible for the National Health Service Corps (NHSC). The NHSC provides scholarship and loan repayment to healthcare providers in exchange for service in rural and underserved areas. Lawmakers in both branches were asked to co-sponsor H.R.2141/S.898, the Conrad State 30 & Physician Access Reauthorization Act, which would streamline visa processing for foreign physicians and provide incentives to physicians to practice in rural and medically underserved communities.

“It was my impression,” says Dr. Sampson, “that members of Congress have been hearing about the physician shortages from other physician groups besides the ACR. They were definitely receptive to learning more about the actionable bills currently before Congress that could begin to alleviate the shortages we’re facing in adult and pediatric rheumatology right now.”

Dr. Sivaraman says, “Some of the important areas that need to be addressed include creating a healthy working environment for rheumatologists to practice their art, providing access for patients to obtain healthcare and increased funding for cutting-edge research in the field of rheumatology. These are fundamental for the future of rheumatology and our patients. The uniqueness of the RheumPAC Committee is that it provides us with a platform for our voice to be heard in numbers and also to serve as an advocate for our patients.”

Medical Research Investment
Maintaining America’s investment in medical research was also discussed as ACR/ARHP leadership thanked members of the House of Representatives and the Senate for the $34 billion, a $2 billion funding increase, which they committed to the National Institutes of Health for FY2017 in the budget omnibus.

Dr. Sampson says, “The ACR again pushed hard to help create a line item for a dedicated research program within the U.S. Department of Defense [DOD]. I think members are starting to recognize that because arthritis is the second leading cause of medical discharge from the military, it makes great sense for the DOD to focus research dollars on programs that are more likely to have a direct impact on increasing troop retention and readiness.”

Moving forward, the ACR asked that a $20 million dedicated arthritis research program be designated in the FY2018 Congressionally Directed Medical Research Program at the DOD to better serve veterans living with rheumatic diseases and that Congress support $16 million for the Centers for Disease Control & Prevention Arthritis Program in the FY2018 Labor-HHS Appropriations Bill.

IPAB Repeal
Our leadership also asked Congress to repeal the Independent Payment Advisory Board (IPAB) included in the ACA. This 15-member appointed board would have the power to impose cuts to rheumatology providers that would disproportionately impact small and rural rheumatology practices. IPAB’s statutorily mandated “fast track” legislative procedure would automatically make any IPAB proposal a law and would require three-fifths of the Senate to agree or a separate piece of House legislation to pass in order to modify an IPAB measure. In addition, IPAB recommendations are not subject to executive or judicial branch review. The College is concerned about this level of power and asked members of the Senate to co-sponsor S.251, the Protecting Medicare from Executive Action Act of 2017, legislation that would repeal the IPAB. Both House and Senate members were asked to co-sponsor H.R.849/S.260, the Protecting Seniors’ Access to Medicare Act of 2017, and support H.J.Res.51/S.J.Res. 16, a joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Medicare Advisory Board under section 1899A of the Social Security Act.

Dr. Sampson expresses some encouragement, saying, “From my meetings with congressional staff, it was easy to surmise that there is now some traction in the Senate for repealing IPAB; so that could certainly be a big win for the ACR this year.”

Final Thoughts
“It was great to meet so many new faces at the dinner,” says Dr. Sampson. “Being around so many dedicated rheumatologists can feel like coming back ‘home’; I felt reenergized from all of our discussions. Sen. Roy Blunt gave a great talk and had a great command of the issues involved with pharmaceutical prices and provided some insight into where he thinks the ACHA might head in the Senate.”

Dr. Sivaraman says, “Being part of RheumPAC gives us an opportunity to serve as a strong advocate for our patients by making our voice heard via involvement and education of political leaders—especially, those who make important decisions that affect patient care.”