Meet the AMA’s Capitol Hill allies protecting patients and practices

The AMA’s physician leaders and professional advocacy team have worked with a diverse group of lawmakers to help carry favorable legislation over the finish line or to block measures that would hurt patients and physicians.

On a wide range of issues that includes stopping Medicare payment cuts, working to end the drug overdose epidemic, and fostering telehealth sustainability and optimization, the AMA has worked with a broad bipartisan array of congressional champions.

Six of these legislators were introduced to physician advocates in “congressional perspective” sessions during the 2021 AMA National Advocacy Conference, held virtually this year due to the pandemic.

In alphabetical order, here are those senators and representatives who have worked to advance issues important to patients and physicians.

The 2021 Medicare physician payment schedule finalized AMA-developed, less burdensome coding and documentation reforms for office and outpatient evaluation and management (E/M) services. But then—in the name of budget neutrality—it also would have slashed some payment rates by 10.2%.

Dr. Bera and Rep. Larry Bucshon, MD, R-Ind., introduced the Holding Providers Harmless from Medicare Cuts During COVID-10 Act of 2020, which was eventually folded in the Consolidated Appropriations Act, 2021, a comprehensive, $1.4 trillion legislative package that included COVID-19 related relief for physicians and appropriations to fund government operations through fiscal year 2021, which ends Sept. 30.

“This issue hasn’t gone away,” Dr. Bera said. “But it does give us a little bit of breathing room.”

An internist who practiced in the Sacramento area, Dr. Bera is also working to reform prior authorization, which he said would have multiple beneficial effects—such as reducing physician burnout.

“This is really a critical issue because none of us went to medical school to learn how to do paperwork,” he said. “If we could get back to allowing doctors to see their patients and take some of that hassle factor out of this—one, we would address a little bit of the burnout issue. And two—we would actually increase productivity of practicing physicians.”

“We need all boats rise,” Dr. Bucshon said regarding his motivation to stave off the Medicare physician payment schedule cuts.

“Primary care, of course, has needed increased reimbursement for years, if not decades, but we also didn't want it to just be the same size pie and divided differently,” he explained. “We wanted a bigger pie.”

Dr. Bucshon, who practiced cardiothoracic surgery in Evansville, Indiana, and whose wife Kathryn is a practicing anesthesiologist, has been a leader in the fight to end the drug overdose epidemic.

“I've been trying to increase access to medication-assisted treatment,” he said, adding that another priority has been reducing the stigma connected to substance-use disorder (SUD).

The key is to treat SUD “as a disease process versus a personal moral failure, which society I think has looked at this for probably decades,” Dr. Bucshon said.

A member of the congressional Black Maternal Health Caucus and a cancer survivor, McBath is starting her second term.

Her son was in the back seat of friend’s car at a gas station when he was killed in 2012 by a man who fired 10 shots into the car after complaining the radio was too loud. McBath decided to enter politics after the 2017 shooting that killed 17 Stoneman-Douglas High School students in Parkland, Florida.

In addition to seeking bipartisan solutions to gun violence, McBath has worked to help small business and improve data collection at the Centers for Disease Control and Prevention and lower the cost of prescription drugs.

McBath thanked physicians for their heroism during the pandemic and noted how the nation’s COVID-19 death toll had just reached 500,000.

“They're not just numbers and data. Each person that we've lost leaves behind their own unique life story,” she said. “Each person also leaves behind a doctor or a nurse whose shoulders seem to get a little bit heavier and whose heart gets just a little bit more bruised with each and every one of the losses.”

Along with Rep. David McKinley, R-W.V., Schneider introduced the Medicare Sequester COVID Moratorium Act. This bipartisan bill would extend the current suspension of the 2% across-the-board Medicare sequester for the duration of the COVID-19 public health emergency.

“Across-the-board cuts in the midst of a pandemic just make no sense whatsoever,” Schneider said.

He also cosponsored the House version of the Medicare Accelerated and Advance Payments Improvement Act. The provisions of that measure, which created more favorable loan terms for physicians, were eventually included in the continuing resolution funding government operations that was approved Oct. 1.

Schneider has become a champion of the Conrad 30 waiver program and worked with the AMA against an ill-conceived Trump administration plan that would have disrupted the training of international medical graduates in the U.S. on J-1 visas. Schneider is also the sponsor of the House version of the Healthcare Workforce Resilience Act to reallocate unused visas.

Schneider also introduced a bill to create an office of supply chain resiliency that would identify potential gaps in the medical supply chain and take steps to address them to prevent being overly dependent on sources outside of the U.S. for a disproportionate share of critical products.

Sewell serves as vice-chair of the House Ways and Means Committee, where she sits on the health subcommittees and co-chairs the committee’s Rural and Underserved Communities Health Task Force. In that role, she has championed telehealth issues and expanding rural broadband internet access.

“We've got to make sure that we level the playing field and make sure that underserved rural and urban underserved communities have access to high-speed broadband that will allow telehealth to grow,” she said. “It's not just an issue in terms of telemedicine, but it's also an issue when it comes to distance learning and telecommuting.”

She has also worked with West Virginia Republican McKinley to sponsor the bipartisan Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act.

The bill, which the AMA supports, seeks to reduce barriers to nonopioid pain management for Medicare beneficiaries by removing disincentives to prescribe nonopioid treatments alternatives in surgical settings.    

A former small business owner, Shaheen was the first woman elected as both a governor and a U.S. senator, and helped pass the Affordable Care Act.

AMA Board Chair Russ Kridel, MD, described her as “one of the architects of the Payroll Protection Program.” She cosponsored the Senate version of the Medicare Accelerated and Advance Payments Improvement Act. The terms of that legislation, later signed into law as part of another measure in October, included:

• Postponing the recoupment of disbursed funds until 365 days after the advance payment has been issued to a physician practice; the balance would be due by September 2022. 
• Reducing the per-claim recoupment amount from 100% to 25% for the first 11 months and the 50% of claims withheld for an additional six months. If not repaid in full, the 10.25% interest rate kicks in. 
• Lowering the interest rate from 10.25% to 4%. 

“If our legislation hadn't gone into effect, you'd be paying 10.25% interest on those loans—it's like going to a loan shark,” Shaheen said of repayment to the Centers for Medicare & Medicaid Services (CMS).

“We don't want CMS to be a loan shark.”