IMS federal advocacy is closely linked with that of the AMA, which retains an army of federal staff to advocate on behalf of American physicians. There are times, however, where Iowa physicians may disagree with an AMA position or an issue uniquely impacts the practice of medicine in our state. In those moments, it is critical that Iowa physicians have established relationships with Iowa’s Congressional Delegation and federal Executive Branch Agencies.
In 2018, the IMS Board of Directors recognized the importance of establishing a broader, more sustained federal presence with the formation of the IMS Federal Policy Council. Comprised of the eight members of the Iowa AMA Delegation, this group draws upon the federal experience and close working relationships its members have honed after years of participating in federal policy discussions at the AMA House of Delegates.
This group meets once a year in conjunction with the AMA’s fall Interim Meeting to formalize recommendations to the IMS Board of Directors for federal policy priorities for the coming year. The group also consults on an ad hoc basis throughout the year as issues arise to help guide IMS federal advocacy efforts. In February of each year, a group of IMS physician leaders and staff travel to Washington, DC, to participate in the AMA’s National Advocacy Conference. This annual event is an opportunity for Iowa physicians to carry the IMS Federal Priorities to members of our congressional delegation and to learn the latest updates from the AMA’s federal advocacy staff.
Recommended 2022 IMS Federal Policy Priorities
The IMS Federal Policy Council met on November 14 to formalize recommendations for the 2022 IMS Federal Policy Priorities. These recommendations will now go to the IMS Board of Directors for approval at their December 16 meeting.
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Issue
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Description
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Responding to
COVID-19
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The COVID-19 pandemic continues to challenge Iowa practices. Federal action provided much-needed financial support to help offset reduced clinic volume and mandatory clinic shutdowns, and to ensure regulatory flexibilities to help physicians adapt to the changing practice environment. With the pandemic still unfolding, practices continue to need flexibility to appropriately respond. In 2022, IMS will work with our federal partners to critically evaluate temporary policy flexibilities to determine where it is appropriate to make temporary policies permanent. Recognizing the ongoing financial strain practices have sustained as a result of the pandemic, IMS will push our federal partners to forgive provider payment advances and for additional time to repay payment advances where forgiveness is not possible.
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Addressing Medicare Payment Geographic Disparity
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For nearly 30 years, IMS has fought to correct the geographic disparity in Medicare payment rates as a result of the geographic practice cost index (GPCI) calculations. The temporary 1.0 Physician Wage GPCI floor, which expires December 31, 2023, protects physicians in rural states like Iowa from inappropriate payment adjustments that would further reduce payments to Iowa practices by more than $69 million a year. In 2022, IMS will continue to pursue a long-term solution to this problem including addressing the flawed data sources used in these calculations, making permanent the protections of the GPCI floors, and thinking creatively about new payment models that accurately reimburse for the quality of care delivered to Medicare members.
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Expanding Physician Workforce
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Over the past year and a half, IMS has led a large coalition of stakeholders who helped author the Iowa Rural Healthcare Workforce Strategic Action Plan – our state’s first-ever comprehensive, coordinated strategic plan to address the provider workforce shortage. In 2022, IMS will push for federal action to implement the policy elements of this action plan. These include expansion of recruitment initiatives like the Conrad 30 program, which waives the Visa waiting period for international students who attend an American medical school and agree to practice in workforce shortage areas. This also includes addressing the limitations on funding for graduate medical education (GME) to help increase the availability of sustainable residency positions in our state.
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Increasing Rural Access to Case
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The rapid, widespread expansion of telehealth services during the COVID-19 pandemic has helped increase access to care and demonstrated the potential for greater technological solutions to rural access and workforce shortage concerns. Temporary measures, including coverage for audio-only telehealth and easing of site restrictions during the public health emergency (PHE) helped unleash the rapid expansion of telehealth services. In 2022, IMS will continue pushing to make permanent those temporary measures that have proven so critical during the PHE and for congressional action to ensure telehealth payment parity for ERISA-governed commercial insurance plans. IMS will work with our federal partners to ensure strategic allocation of newly-authorized funding to sustain broadband expansions, which will help foster greater telehealth utilization, and support improvements to other rural infrastructure including EHR upgrades to improve integration and functionality.
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For more information on IMS federal advocacy efforts, please contact Dennis Tibben with the IMS Center for Physician Advocacy.