Shake-up in Washington. What’s in Store for Health Policy in the 112th?

Congress returns to Washington this month, and there will be many new faces on Capitol Hill. The recent midterm election will bring significant changes to the 112th Congress, leaving many to wonder what this new dynamic means for health policy.

Many Republicans ran on a platform of repealing the healthcare law; however, with Democrats still holding the majority in the Senate and a lack of votes to override a veto from President Barack Obama, repealing the healthcare law is highly improbable. With that option off the table, Republicans have two choices: Deny funding for new programs and delay implementation of the law, or take a piecemeal approach to modifying the law. Delaying implementation of the law through the appropriations process will be cumbersome at best, so the most viable option is to revise the law section by section. The ACR will work diligently to educate lawmakers about our priorities for reforming the healthcare reform law, which are:

112th Congress Now In Session

• Pediatric Subspecialty Loan Repayment Program: The healthcare law authorizes the creation of a pediatric subspecialty loan repayment program for pediatric subspecialists who work in underserved areas. Rep. Rosa DeLauro (D-CT) and Sen. Sherrod Brown (D-OH) have requested $5 million in funding for the program for fiscal year 2011. The ACR will continue to work with other specialty societies to secure funding for this vital program.
• Increased Reimbursement for DEXA Scans: Reimbursement for dual energy X-ray absorptiometry (DEXA) scans has increased to 70% of 2006 levels for 2011; however, reimbursements are scheduled to drastically decrease in 2012. The ACR will work with Rep. Shelley Berkley (D-NV) and Rep. Michael Burgess, MD (R-TX) to reintroduce the Medicare Fracture Prevention and Osteoporosis Testing Act, which would permanently restore payments for DEXA screenings to the 2006 rate.
• Independent Payment Advisory Board: In 2014, the law establishes a 15-member Independent Payment Advisory Board charged with recommending reductions in Medicare spending if spending exceeds a target growth rate. The ACR is opposed to any provisions that would empower an independent commission to mandate payment cuts for physicians and any other payment reductions under the Medicare physician payment system.
• PQRI Penalties: Penalties for nonparticipation in the Physician Quality Reporting Initiative (PQRI) will begin in 2015. The capacity to participate in PQRI proves difficult for many rheumatology professionals, especially those not using electronic medical records. It also adds additional paperwork for physicians and health professionals already overloaded with paperwork. The ACR supports the creation and reporting of quality measures but is opposed to penalizing providers for not participating in PQRI.
• Form 1099 Reporting: As of 2012, businesses will be required to report all payments over $600 for services or merchandise to the IRS on a Form 1099. The additional paperwork will add unnecessary costs to small and solo physician practices.

In addition to working with the new Congress to improve the healthcare law, the ACR will continue to pursue our legislative priorities:

• Reinstate Consultation Codes: The ACR will continue to work with the American Medical Association and other specialty and state societies to reinstate consultation codes. Congress is generally unaware of Centers for Medicare and Medicaid Services’ decision to eliminate consultation codes in 2010 and the impact this is having on care coordination.
• Permanent Fix to SGR: The ACR will continue to advocate for a permanent fix to stabilize Medicare’s sustainable growth rate (SGR) program to ensure fair physician reimbursement and patient access to quality care. In the meantime, the ACR joins 66 national physician organizations and all state medical societies in asking Congress to prevent Medicare payment cuts through at least December 2011. Congress has indicated bipartisan support for this proposal, and discussions are underway to determine funding offsets during this short-term extension.
• Arthritis Research Funding: The ACR continually educates Congress on the importance of arthritis-related research.

Now is the perfect time for you to get involved with the ACR’s advocacy efforts. Most members of Congress are not aware that rheumatologists receive years of additional training to provide specialized care to patients with arthritis and rheumatic conditions. Reach out to your members of Congress and educate them on these issues. For questions about the ACR’s advocacy efforts, e-mail [email protected].