For those who didn’t attend Leadership Day, we need your help to amplify their advocacy and ensure Congress hears our message. Please consider sending a message using the sample message provided. If you attended Leadership Day, we thank you for your advocacy and encourage you to make sure you’ve sent thank you notes for your meeting.

Here is what Leadership Day attendees asked their members of Congress to do:

• Passing H.R. 2389/S.1302, the Resident Physician Shortage Reduction Act of 2023, which increases by 14,000 over seven years, the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions. 
• Passing H.R. 6545, the Physician Fee Schedule Update and Improvements Act. The bill would raise the threshold to implement budget-neutral payment cuts in Medicare to $53 million and use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every five years.
• Passing H.R. 2630/S. 652, the Safe Step Act, which requires group health plans to provide an exception process for any medication step therapy protocol to help ensure that patients can safely and efficiently access treatment.

Background: ACP supports increased investments in federal programs that support and expand the primary care physician workforce, such as increasing graduate medical education (GME) slots. Even before the Coronavirus crisis, the Association of American Medical Colleges (AAMC), estimated that there would be a shortage of 17,800 to 48,000 primary care physicians by 2034.

With an aging population with higher incidences of chronic diseases, it is especially important that patients have access to physicians trained in comprehensive primary and team-based care for adults—a hallmark of internal medicine GME training. We therefore urge Congress to pass H.R. 2389/S.1302, the Resident Physician Shortage Reduction Act, to increase the number of residency positions by 14,000 slots over seven years.   

We also urge Congress to act this year to pass H.R. 6545, the Physician Fee Schedule Update and Improvements Act, which would provide the Centers for Medicare and Medicaid Services (CMS) more flexibility in setting payment rates, updating average costs doctors incur in calculating reimbursement and making payments more predictable. The bill would require CMS to raise the budget neutrality threshold to $53 million from $20 million and would use cumulative increases in the MEI to update the threshold every five years afterwards. The $20 million threshold was established in 1992 and has not been updated since. Raising the budget-neutrality threshold would allow for greater flexibility in determining pricing adjustments for services without triggering across-the-board cuts in Medicare physician pay. We believe that this is a practical approach which would help account for inflation. 

Finally, Congress should pass H.R. 2630/S. 652, the Safe Step Act, a bipartisan bill which requires insurers to implement a clear and transparent process for a patient or physician to request an exception to a step therapy protocol. The bill lays out five exceptions to fail first protocols and requires that a group health plan grant an exemption. Pharmacy Benefit Managers (PBMs) and group health insurers have developed a series of price management tools to curb the rising cost of prescription drugs. Among these, step therapy policies, commonly called “fail-first” policies, require patients to be initiated on lower-priced medications before being approved for originally prescribed medications. Carriers can also change coverage in an attempt to force patients off their current therapies for cost reasons, a practice known as nonmedical switching. 

Action Requested: Please send an email to your members of Congress asking for their support on these important priorities. A sample message has been provided for you that can be personalized. Simply click on the “Take Action” link below, follow the prompts, and send your messages. If you attended Leadership Day and are sending a thank you message or otherwise following-up with your member of Congress, you do not need to take action, but we would like you to share this alert and encourage your peers to take action.

Please contact Shuan Tomlinson at stomlinson@acponline.org with any questions about this campaign.