Among its priorities, ACP is focused on physician payment reform, putting patients before paperwork, and patient access to care and medication
Jan. 24, 2025 (ACP) -- Bringing about meaningful physician payment reform, reducing administrative burdens, and ensuring access to care for all rank high on the list of the American College of Physicians advocacy priorities for 2025.
“There's still some unfinished business from 2024,” said George Lyons, Esq., ACP director of legislative affairs. “Certain items fell out of the year-end appropriations bill that aimed to keep the U.S. government funded.”
Specifically, the legislation did not stop the Medicare Physician Fee Schedule (PFS) payment cuts. As a result, a 2.83 percent physician payment cut took effect on Jan. 1, 2025.
ACP is working toward developing a more permanent fix so that reductions to the PFS do not come down to the wire every year. The College is urging passage of legislation that addresses cuts to the PFS caused by adjustments for budget neutrality, a policy that requires any increase in the relative expenditures in one area of the Medicare program to be offset by cuts in another.
ACP is also lobbying for Congress to reintroduce the Strengthening Medicare for Patients and Providers Act, which would preserve access to care for Medicare beneficiaries by providing an annual inflation update equal to the Medicare Economic Index for Medicare physician payment. In addition, ACP supports waiving copays for Advanced Primary Care Management Codes for patients with complex medical and social needs.
In 2025, ACP will also continue its efforts to put patients before paperwork. “We are working with the American Medical Association and others to simplify prior authorization processes and make them less burdensome,” Lyons said. “We are unhappy that the streamlined process for prior authorization in Medicare Advantage (MA) plans didn't get passed.”
This legislation aimed to establish an electronic prior authorization process for MA plans that would standardize transactions and increase transparency around prior authorization requirements, among other changes.
ACP will continue to push for the reintroduction and passage of the Safe Step Act, which will help ensure access to appropriate treatments based on clinical decision-making and medical necessity rather than step therapy protocols.
Another ACP priority is protecting Medicaid. “Republicans in Congress are considering changing its formula to per-capita payments, reducing the matching rate between federal and state, and adding a work requirement for potential beneficiaries,” Lyons said. “These are inconsistent with our policies, and we will continue to advocate against these changes on the Medicaid front.”
ACP is also focused on preserving premium tax credits for people who do not qualify for Medicaid but cannot afford plans on the Health Insurance Marketplace. These credits are supposed to expire at the end of the year. “We will continue to be part of a coalition to keep Americans covered and extend premium tax credits,” Lyons noted.
ACP will continue to champion for the ability of the Centers for Medicare & Medicaid Services (CMS) to directly negotiate drug prices with pharmaceutical companies. “Pharmaceutical companies are challenging CMS's ability to do this,” Lyons explained. More transparency and accountability of pharmacy benefit managers may also help reduce the price of prescription drugs.
Growing and strengthening the physician workforce is also high on the 2025 ACP priority list. The Conrad 30 Waiver program allows states to request visa waivers for 30 foreign physicians per state each year if they agree to work full-time in a federally designated Medically Underserved Area or Health Professional Shortage Area for three years.
“We are working to increase Conrad 30,” Lyons said. “Other efforts that will increase the workforce include deferred interest on student loans and adding new Medicare-supported graduate medical education positions.”
Finally, ACP will continue to fight for policies that protect and preserve patient-physician relationships, including access to reproductive health care and LGBTQ+ and gender-affirming care, Lyons noted.
Every member can do their part to help move the needle on these issues. “Join our Advocates for Internal Medicine (AIM) Network and take action on the AIM alerts we send out throughout the year,” he said.
More Information
“ACP 2025 Priorities” can be viewed on the ACP website.
Back to the January 24, 2025 issue of ACP Advocate