APA’s Government, Policy, and Advocacy Update (January 2022)

Physician Coalition Applauds Congressional Passage of Medicare Payment Adjustment

APA applauded the Senate passage, by a 59-35 bipartisan vote, of legislation that halts imminent Medicare cuts to physician and other clinician reimbursement. The House passed the bill a few days prior, and President Biden signed it into law.

Specifically, the bill extends a moratorium on the 2% Medicare sequester cuts to clinician reimbursement until April 1 and reduces the cuts from 2% to 1% from April 1 through June 30. The package would also stop the 4% statutory Pay-As-You-Go sequester from taking effect. In addition, the legislation extended the 2021 Medicare physician fee schedule conversion factor increase adjustment at 3% through the end of 2022.

APA has worked with physician groups over the past few months to encourage Congress to take action on these impending reimbursement cuts.

Group of Six Urges CMS to Reimburse for Vaccine Counseling

A physician coalition that includes APA urged the Centers for Medicare and Medicaid Services (CMS) to help increase uptake of the COVID-19 vaccine by ensuring clinicians are adequately paid for vaccine counseling of Medicaid and Medicare beneficiaries. The coalition, referred to as the Group of Six, represents more than 600,000 physicians.

Medicare and Medicaid do not pay clinicians for counseling patients about vaccines if that counseling is not part of a visit in which the vaccine is administered, the Group of Six explained in a letter to CMS. Yet for some patients and families, deciding whether to receive a COVID-19 vaccine requires multiple and lengthy discussions with their trusted physicians. The issue is even more important now, since the remaining unvaccinated may be particularly vaccine-hesitant, the group wrote. Parents also have many questions about vaccinating their children, requiring additional physician counseling time.

“Covering standalone vaccine counseling will ensure that physicians are appropriately compensated for the time they spend supporting their patients in making important immunization decisions,” the group wrote.

House Passes Build Back Better With Many Key MH/SUD Initiatives

APA applauded House passage of the Build Back Better (BBB) Act, the reconciliation package that includes significant investments in mental and substance use disorder care.

BBB was approved by the House by a vote of 220-213, mostly along party lines, yet now faces an uncertain future in the Senate. Senate committees will consider the measures before the full package reaches the Senate floor, and modifications are expected.

Some of the bill’s major provisions include levying penalties on employer-sponsored health plans that violate mental health parity laws, funding 4,000 new Medicare-supported graduate medical education slots in 2025 and 2026 (15% of which are designated for psychiatry), providing $75 million in grants for the maternal MH/SUD treatment workforce, allotting an additional $50 million for the SAMHSA Minority Fellowship Program, permanently increasing Medicaid funding for mobile crisis response, and providing $75 million for the National Suicide Prevention Lifeline (see “Transition to 988 Offers Opportunity to Transform Crisis Care”).

The legislation also makes several investments in the federal Medicaid program by extending coverage to 12 months postpartum, permanently enhancing federal funding for U.S. territories, and covering people 30 days prior to leaving jail or prison. ■