TMA focuses most of its advocacy activities on the Texas Legislature and state agencies and courts. Because the federal government plays such an outsize role in health care policy and programs, however, TMA also conducts extensive advocacy with the U.S. Congress and federal regulatory agencies. As on the state level, much of TMA’s work in Washington is intended to ensure physicians receive fair payment for the medical services they provide to patients, and to win relief from onerous government regulations.
Keep What’s Good; Fix What’s Broken
Given the split partisan control of the 116th Congress, most experts expect little or no major health care legislation to pass. TMA, however, will continue to push for repeal of unfair or illogical provisions in the Affordable Care Act (ACA) and other health care laws, while supporting those parts of the ACA that improve patients’ access to quality care.
TMA recommends that the U.S. Congress:
- Repeal the moratorium on physician-owned hospitals.
- Repeal the prohibition on physician joint ownership of diagnostic laboratories.
- Allow physicians to contract directly for services with Medicare beneficiaries.
- Maintain insurance coverage for patients with pre-existing conditions.
- Maintain essential health benefit requirements.
- Impose no federal caps on state Medicaid funding.
- Increase or eliminate the Medicare GME funding cap, and increase GME capacity for primary care, and in rural and underserved areas.
- Relax restrictions on self-referral for physicians serving rural, medically underserved, and economically depressed areas.
Cut Federal Red Tape
TMA’s primary federal objective in the near future will be to obtain continued regulatory relief from the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), and other administrative agencies.
TMA recommends that federal agencies:
- Ensure appropriate pay for Medicare services provided.
- Enact extensive reforms to Medicare’s Quality Payment Program (QPP), eliminating all penalties, reducing QPP’s overwhelming administrative and technology burdens, and using fair and clinically appropriate quality metrics.
- Further reduce QPP’s administrative requirements for small and rural practices.
- Hold electronic health record (EHR) vendors more accountable for interoperability and data submission errors.
- Develop appropriate risk requirements for physicians participating in Medicare’s advanced alternative payment model (APM) tracks.
- Streamline Medicare and Medicare Advantage enrollment and credentialing.
- Reduce federal administrative burdens and bureaucracy surrounding participation in Medicaid.
- Help Texas implement cost-reducing, quality-improving Accountable Care Organizations (ACOs) in the Medicaid program.
- Modernize and streamline enrollment, access to service, eligibility verification, medical records management, billing, and appropriate payment in the Veterans Choice Program.
Last Updated On
January 16, 2019
Originally Published On
January 10, 2019