The North Carolina contingent, participating in the American Medical Association’s 2024 National Advocacy Conference, delivered an urgent call for action to the offices of each North Carolina US Senate and US House representative on numerous health policy issues.  Making the trip to Washington were NCMS President Dr. Eileen Raynor, NCMS Board of Directors member Dr. Karen Smith, NCMS AMA Delegation member Dr. Mary Ann Contogiannis, and NCMS Vice President, External Affairs Alan Skipper.

The event held from February 12-14 showcased speeches by national experts and congressional member, including a keynote address from former NC DHHS Secretary, Mandy Cohen, MD, who currently serves as the Director of the CDC.  In 2022, the AMA honored Dr. Cohen the Award for Outstanding Government Service, acknowledging her exceptional leadership during the COVID-19 pandemic and her efforts to address the coverage gap in North Carolina through Medicaid expansion.

The NCMS team greets Dr. Mandy Cohen, accompanied by

Dr. Sandra Fryhofer, AMA Board of Trustees member

The highlight of the conference was going to Capitol Hill, where we met with all 16 of our House and Senate offices. The primary message emphasized a pressing appeal for Congress to reverse the 3.37% Medicare physician payment cut implemented on January 1.  The “ask” was for support of H.R. 6683, the Preserving Seniors’ Access to Physicians Act, introduced by Rep. Dr. Greg Murphy (NC-3). The proposed legislation aims to nullify the entire 3.37 percent physician payment cut.

Another vital Medicare-related bill discussed, which has remained a congressional priority over the past year, is H.R. 2474, the Strengthening Medicare for Patients and Providers Act. This bill seeks to include physicians among the providers under Medicare eligible for automatic payment adjustment to account for inflation. Physicians are currently excluded from this annual payment adjustment and have experienced a net 26 percent payment reduction from 2001 to 2023 due to inflation.

A third Medicare payment bill H.R. 6371, the Provider Reimbursement Stability Act, was also addressed.  This proposed legislation aims to raise the threshold that would initiate the budget neutrality requirement from $20 million to $53 million, ensuring that budget neutrality adjustments are based on the actual utilization.

Addressing the escalating challenge of a growing physician workforce shortage, discussions with House and Senate members, along with their staff, underscored the need for backing pending legislation aimed at expanding residency slots. Specifically, support was sought  for H.R. 2389 / S. 1302, known as the Resident Physician Shortage Reduction Act. These bills propose an increase in the number of residency positions eligible for graduate medical education payments under Medicare for qualifying hospitals, including those in rural areas and health professional shortage areas. The proposed expansion entails an in crease of 2,000 positions per fiscal year from FY2025-FY2031.

Additionally, emphasis was placed on garnering support for H.R. 4942 / S. 665, the Conrad State 30 and Physician Access Reauthorization Act, as a means to alleviate the growing physician workforce shortage. Primarily, this legislation seeks to eliminate the requirement that foreign medical graduates who come to the U.S. for residency/fellowship training must return to their country of citizenship for at least two years. It also proposes a three year expansion of the Conrad State 30 program, allowing states to request J-1 visa waivers for foreign physicians to work in federally designated shortage and underserved areas. The bill further aims to  increase state allocations from 30 to 35 physicians per year and provide flexibility to expand the number of waivers in states where demand exceeds that limit.

Advocating for medical debt relief, our team also asked for support of H.R. 1202, the Resident Education Deferred Interest (REDI) Act. This bill enables borrowers in medical or dental internships or residency programs to defer loan payments until the completion of their programs.

Medical practice viability was another key point of emphasis. A recent bill introduced by Rep. Dr. Greg Murphy (NC-3), H.R. 6487, the No Fees for EFTs Act, is to eliminate unwarranted charges by insurance companies.  Support for this legislation was a major ask in every office, aiming to prohibit health plans and vendors charging physicians fees for electronic fund transfer (EFT) payment transactions.

Addressing step therapy relief remains a focal point in our legislative priorities during our congressional advocacy.  Last year, significant progress was achieved as we garnered support from our NC members of the US House of H.R. 2630, the Safe Step Act of 2023.  Our NCMS team emphasized the positive impact that relief from onerous step therapy restrictions would have on patient care.

Maternal mortality and morbidity stand as prominent concerns in North Carolina. A pertinent opportunity arose with pending legislation in the US Senate, S. 712, the Connected MOM Act, allowing our group to advocate for health policies leveraging technological advances in patient care.  This bill would provide resources to states to enhance maternal health outcomes for pregnant and postpartum women.  Some members of the North Carolina House expressed commitments to introduce a companion bill in that chamber.

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