Preserving Patient Access to Primary Care Act

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and CHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the CHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). H.R. 4213, the American Jobs and Closing Tax Loopholes Act of 2010, which contained a temporary extension of current SGR payments to physicians; H.R. 3962, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which sets 2.2% as the update to the single conversion factor in the formula for determining physician payment rates for June 1, 2010, through November 30, 2010; Urged action on legislation to provide stability and predictability for Medicare physician payments at least through 2011. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 and FY2011 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Appropriations FY2011: Advocated for strong investment in Titles VII and VIII programs in FY 2011 Labor, Health & Human Services & Educations appropriations bills; these programs provide direct financial support for health care workforce development and education. Advanced Care Planning: The Personalize Your Care Act of 2010; provides coverage under Medicare for voluntary consultations between doctors and patients to discuss advance care plans. It would also provide states and communities with grants to create or expand programs that assist with advanced care planning. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification; Appointments to the new Workforce Commission, and Patient-Centered Outcomes Research Institute (PCORI), as created under the Patient Protection and Affordable Care Act.

Client expense: $277,506 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), President of the U.S., SENATE

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and CHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the CHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). H.R. 4213, the American Jobs and Closing Tax Loopholes Act of 2010, which contained a temporary extension of current SGR payments to physicians; H.R. 3962, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which sets 2.2% as the update to the single conversion factor in the formula for determining physician payment rates for June 1, 2010, through November 30, 2010; Urged action on legislation to provide stability and predictability for Medicare physician payments at least through 2011. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 and FY2011 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Appropriations FY2011: Advocated for strong investment in Titles VII and VIII programs in FY 2011 Labor, Health & Human Services & Educations appropriations bills; these programs provide direct financial support for health care workforce development and education. Advanced Care Planning: The Personalize Your Care Act of 2010; provides coverage under Medicare for voluntary consultations between doctors and patients to discuss advance care plans. It would also provide states and communities with grants to create or expand programs that assist with advanced care planning. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification; Appointments to the new Workforce Commission, and Patient-Centered Outcomes Research Institute (PCORI), as created under the Patient Protection and Affordable Care Act.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). H.R. 4213, the American Jobs and Closing Tax Loopholes Act of 2010, which contained a temporary extension of current SGR payments to physicians; H.R. 3962, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which sets 2.2% as the update to the single conversion factor in the formula for determining physician payment rates for June 1, 2010, through November 30, 2010. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 and FY2011 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification; Appointments to the new Workforce Commission, and Patient-Centered Outcomes Research Institute (PCORI), as created under the Patient Protection and Affordable Care Act.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). H.R. 4213, the American Jobs and Closing Tax Loopholes Act of 2010, which contained a temporary extension of current SGR payments to physicians; H.R. 3962, the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which sets 2.2% as the update to the single conversion factor in the formula for determining physician payment rates for June 1, 2010, through November 30, 2010. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 and FY2011 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage: Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification; Appointments to the new Workforce Commission, and Patient-Centered Outcomes Research Institute (PCORI), as created under the Patient Protection and Affordable Care Act.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962/H.R. 3590/H.R. 4872): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis; the establishing of a new CMS Innovation Center to pilot-test new payment models, such as the medical home; implementing a new 2-prong demonstration project consisting of an independent practice-based medical home model and a community-based medical home model, a State Medicaid health (medical) home option, an Independence at Home demonstration project that contains many medical home features, the use of the medical home model for treatment or services under private health plans, the requirement of health plans to provide incentives to promote and report on medical home services provided, the establishment of community health teams and a primary care extension program to educate and support primary care practices in the delivery of medical home services, and the establishment of a demonstration project to educate physicians and other clinicians in training in the competencies required to deliver care consistent with the medical home care model. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions; enacting a 10% bonus payment under Medicare for primary care services. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962 and H.R. 3590): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification.

Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula; and replacing the Sustainable Growth Rate (SGR) formula with a long term solution that provides for stable, predictable updates for physicians (H.R. 3961). Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation (H.R. 3962 and H.R. 3590): Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury. Additional issues under H.R. 3590 and H.R. 3962. Requiring a study by the Institute of Medicine of geographic variations in quality and cost of care and methodologies to reduce such variation; Establishing Innovation Center to fast-track testing of new payment models; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; Increasing Medicaid payment rates to physicians to those of Medicare; Funding for a transparent process to conduct Comparative Effectiveness Research (CER); Administrative simplification.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation: Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation: Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation. Reform the medical liability system and the enormous costs associated with frivolous lawsuits and defensive medicine; Impose caps on non-economic damages; and test and fund new models--like health courts, which would have cases heard by an expert panel rather than by a lay jury.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation: Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192/S. 1174, the Preserving Patient Access to Primary Care Act; S. 1004 and H.R. 2307, the Reaching Elders with Assessment and Chronic Care Management and Coordination Act, or the RE-Aligning Care Act, would create a Medicare benefit for a comprehensive geriatric assessment for beneficiaries with chronic diseases or dementia. The legislation would also provide a separate Medicare monthly payment to physicians who provide ongoing care coordination services for such patients. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula. Medical Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation. Improving Access to Primary Care in the Context of Comprehensive Healthcare Reform Legislation: Ensure that all Americans will have access to affordable coverage. Provide sliding scale subsidies based on income to buy coverage from qualified plans; Qualified plans should: provide evidence-based benefits, including preventive services; and be prohibited from excluding persons with pre-existing conditions, charging them more, cherry-picking enrollees, or cancelling or failing to renew coverage; Expand Medicaid to cover all persons below the Federal Poverty Level and ensure fair payments to participating physicians; As coverage becomes affordable, all persons should participate and coverage should be guaranteed; Responsibility for financing should be shared by individuals, employers and government. Pilot test new Medicare payment models that re-align incentives to support effective, efficient, patient-centered, coordinated care. Priority should be given to models designed to support the value of services provided by primary care physicians as well as to models that would create incentives, across physician specialties and sites of services, to improve the quality, effectiveness, and efficiency of care provided. Policy criteria for selecting the most promising models for pilot testing should be developed, in consultation with outside experts; The Patient-Centered Medical Home (PCMH), which has shown great promise in meeting the policy objectives suggested above, should be among the models selected for broader testing on a national pilot basis. Improve Medicare fee for service system payments to make primary care competitive with other specialties. Direct the Secretary of HHS to conduct a market analysis to determine how much payments for primary care should be increased to make primary care physicians competitive with other specialties within five years, starting with a major increase in 2010 as the first step toward market competitiveness; Replace the Sustainable Growth Rate formula with a system that provides fair, predictable, and stable updates for physician services, and fully account for such changes in the Medicare baseline spending assumptions. Establish a national workforce policy to ensure sufficient numbers of primary care and other physicians. Establish a national workforce commission to recommend national goals relating to the numbers and distribution of physicians and other health care professionals, including increasing the supply of primary care physicians; Increase the number of Medicare-funded graduate medical education positions available each year in adult primary care specialties; Provide new loan repayment and medical school scholarship programs in exchange for primary care service in critical shortage health facilities, or in critical shortage areas of the country; Increase funding for scholarships and loan repayment programs under Title VII as well as increase funding for the National Health Service Corps (NHSC); Provide new practice-entry bonus for scholarship or loan repayment award recipients who remain in underserved communities after completion of service obligation.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192, the Preserving Patient Access to Primary Care Act; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula. Primary Care Workforce: Establish a primary care advisory committee to provide explicit planning at the federal level to increase the primary care workforce to meet anticipated health care needs of the nation. Medicare Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Medicare Payment Advisory Commission (MedPAC): Provide support for an internal medicine physician, and member of the College, as a candidate for MedPAC in 2009; candidacy discussed with members of Congress and the Government Accountability Office (GAO). Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation.

Preserving Access to Primary Care Services: Address the shortage of primary care physicians; designate primary care as a shortage profession; provide scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas; provide grants for medical school mentorship programs and primary care training in community health centers; increase Title VII funding for primary care health programs; increase funding for the National Health Service Corps, provide regulatory relief for primary care physicians; H.R. 7192, the Preserving Patient Access to Primary Care Act; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Health Coverage: Guarantee all Americans access to health coverage; create tax credits to subsidize coverage for low income persons to buy into the Federal Employees Health Benefits Plan (FEHBP); create new options for small businesses to buy into group coverage based on the FEHBP; expand Medicaid and SCHIP; support state experimentation. Economic Stimulus Legislation: Increase the federal matching rate under the Medicaid program, re-authorize the SCHIP program with additional funding to assure adequate coverage of all eligible children; target increases in Medicare payments for primary care physicians; target incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home; provide subsidies for newly unemployed workers to obtain COBRA coverage; provide temporary Medicaid coverage to laid-off workers; increase funding for community health centers; provide substantial funds for the Prevention and Wellness Fund to fight preventable chronic diseases; support healthcare research and quality programs to compare the effectiveness of different medical treatments funded by Medicare, Medicaid and CHIP; support existing work being done by public and private sector partnerships on HIT policy, standards and certification; H.R. 1, the American Recovery and Reinvestment Act. Medicare Physician Payment Reform: Increase Medicare Fee Schedule Payments to make primary care competitive in the market with other physician career and specialty choices; create a fast track authority to develop and implement new physician payment models that better align payment with effective, efficient, patient-centered care such as the Patient Centered Medical Home; provide separate Medicare payment for specific care coordination services provided principally by primary care physicians; revise Medicare budget neutrality rules to recognize the value of primary care in reducing Medicare baseline spending; increase the accuracy of physician work relative value units under the Medicare physician fee schedule; improve the accuracy of practice expense RVUs under the Medicare Fee Schedule; increase Medicare bonus payments for primary care services provided in designated shortage areas; provide stable, positive, predictable updates under Medicares reimbursement formula. Primary Care Workforce: Establish a primary care advisory committee to provide explicit planning at the federal level to increase the primary care workforce to meet anticipated health care needs of the nation. Medicare Education: Provide incentives to medical schools, community health centers, or hospitals, to increase the numbers of physicians choosing primary care; authorize HHS to selectively eliminate GME caps for residency programs in primary care; restore the 20/220 loan deferment pathway (S.646). Healthcare in the FY2010 Budget: Account for the costs of preventing Medicare physician pay cuts under the Sustainable Growth Rate formula; address the negative impact of Medicare payment cuts on small physician practices; support the concept of dedicating funding for health care reform; support funding for physicians to acquire health information technology (HIT) to be used in a meaningful way; note concerns about penalties that would reduce baseline payments to physicians not using certified HIT systems beginning in 2015; support a policy reserve fund for physician payment reform, as reported out of the House Committee on the Budget, including the language to ensure primary care receives appropriate compensation. Medicare Payment Advisory Commission (MedPAC): Provide support for an internal medicine physician, and member of the College, as a candidate for MedPAC in 2009; candidacy discussed with members of Congress and the Government Accountability Office (GAO). Public Health Programs and Funding: Increase funding to accomplish the core missions and activities of the major federal public health agencies, including: biomedical and behavioral research, disease prevention and health promotion, access to safety net health care services, health professions education, mental health and substance abuse, health services research, health care for American Indians and Alaska natives, food and drug safety. Preserving the Safety Net Function of Federally-funded Health Care Programs, such as CHIP: H.R. 5268, provide for a temporary increase of the Federal medical assistance percentage under the Medicaid Program; include expansion of the medical home as well as transformation grants for the medical home in CHIP re-authorizing legislation.

P.L. 110-24, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Increased funding for the Agency for Healthcare Research and Quality in Fiscal Year 2009, Adequate funding for NHSC to relieve student debt. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

P.L. 110-204, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 7192, Preserving Patient Access to Primary Care Act, To provide support for medical training for primary care and for primary care physician practices. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Increased appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs.

Client expense: $755,699 · Firm income: Not reported

P.L. 110-204, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 1695, Follow-on Biologics, Determine AAFP position. S. 2029, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. H.R. 5605, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Preserving Patient Access to Primary Care Act, To provide support for medical training for primary care and for primary care physician practices. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for AHRQ. No Bill, Prevents cuts to the National Health Services Corps in FY 2009, Adequate funding for NHSC to relieve student debt. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care.

Client expense: $755,699 · Firm income: Not reported

S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, CMS Meetings regarding Medicare payment, PCMH Pilot, GME. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas.

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Agency for Healthcare Research and Quality (AHRQ) FY 2009 Appropriations, Adequate funding for Health Information Technology and Comparable Effectiveness Research. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Antitrust issues related to health care plan consolidation and physician collective bargaining, Oppose anticompetitive insurance consolidation. Allow physicians to bargain collectively; remove antitrust barriers on physicians; reform Federal Trade Commission regulation. No Bill, Collective Negotiation by Physicians with Health Plans, To allow physicians to bargain collectively with health plans. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Physician Quality Reporting Initiative; Value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Promoting the US health delivery system reform to a Patient Centered Medical Home model of care, Promoting health care reform based on the PCMH model of care. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas. No Bill, Title VII Health Professions Grants for Primary Care Medicine Training Reauthorization, Promote Title VII Health Professions Grants for Primary Care Training programs.

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act H.R. 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442, TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act H.R. 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442, TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: $40,345 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R. 7148, Medicare Beneficiary Freedom to Choose Act of 2008, all provisions S. 2029, Physician Payments Sunshine Act of 2007, all provisions H.R. 7192, Preserving Patient Access to Primary Care Act, all provisions H.R. 6331, Medicare Improvements for Patients and Providers Act of 2008, provisions on transparency, calculation of successful participation, reform PQRI feedback reports, and quality incentive payment programs Medicare Program - HIPAA: ICD-10 Medicare Program - HIPAA: electronic transactions version 5010 Medicare Program - Current Procedural Terminology (CPT) Medicare Program - Regulatory Reform Medicare Program - NPI enrollment problems Medicare Program - Medicare Prescription Drugs, price negotiation authority Medicare Program - Physician Quality Reporting Initiative (PQRI) Medicare Program - Recovery Audit Contractor (RAC) program Medicare Program - billing for consultations Medicare program - billing for audiologists Medicare Program - Physician Payment Reform/Rebasing SGR/Directed Scoring/Remove Drugs from SGR Calculations Medicare Program - Balance Billing Medicare Program - Incident-to billing policies Medicare Program - SGR Alternatives Medicare Program - Part D Drugs Program Medicare Program - Advance Payment Policy Medicare Program - E-Prescribing Medicare Program - Uses of Government Claims Data; Medicare Claims Data and BQI Pilots Medicare Program - Medicare Administrative Contractors (MACs) Medicare Program - 2009 Medicare physician fee schedule final rule Medicare Program - Medicare Resource Use Reports Medicare Program - 2010 Physician Update Medicare Program - AMA/Specialty Society Relative Value System (RVS) Update Committee's PLI recommendations Medicare Program - Medicare Advantage

Client expense: $4,940,000 · Firm income: Not reported

P.L. 110-204, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 1695, Follow-on Biologics, Determine AAFP position. S. 2029, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. H.R. 5605, Physician Payments Sunshine Act, To discourage requiring pharmaceutical companies from having to report unrestricted grants for CME. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Preserving Patient Access to Primary Care Act, To provide support for medical training for primary care and for primary care physician practices. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for AHRQ. No Bill, Prevents cuts to the National Health Services Corps in FY 2009, Adequate funding for NHSC to relieve student debt. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care.

Client expense: $3,119,054 · Firm income: Not reported

S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

P.L. 110-204, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 7192, Preserving Patient Access to Primary Care Act, To provide support for medical training for primary care and for primary care physician practices. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Increased appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs.

Client expense: $3,119,054 · Firm income: Not reported

P.L. 110-24, Federal programs to screen for heritable disorders in newborn children, Public awareness, training to offer quality care for infants. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. S. 3101, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. S. 3708, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. H.R. 2583, Medicare and Medicaid Graduate Medical Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6331, Medicare physician payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Repeal sustainable growth rate and provide positive update for Medicare physician payments and prevent 10.6 percent cut to Medicare physician payments. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. H.R. 7302, Public Health Service Act Title VII health professions education reauthorization, Promote Title VII Health Professions Grants for Primary Care Training Programs. No Bill, Health Care reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Increase appropriations for Rural Health programs in FY 2009, Adequate funding for HHS Rural Health and programs. No Bill, Increase appropriations for Title VII health professions grants in FY 2009, Adequate funding for HRSA's Title VII grants. No Bill, Increased funding for the Agency for Healthcare Research and Quality in Fiscal Year 2009, Adequate funding for NHSC to relieve student debt. No Bill, National Coalition on Health Care, Universal Coverage. No Bill, Physician quality reporting initiative; value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Prevents cuts to the National Health Services Corps in FY 2009. No Bill, Racial and Ethnic Disparities, To reduce disparities in health care. No Bill, Title VII health professions grants funding and reauthorzation, Promote Title VII Health Professions Primary Care Training grant programs. No Bill, Truth in Health Advertising, Ensure patients know who is a medical doctor.

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act HR 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442 TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: $61,364 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act HR 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442 TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

See page 7 for specific Health Care issues. Specific Health Issue bills: H.R. 5605/S. 2029, the Physician Payment Sunshine Act H.R. 1407, the Higher Education Affordability and Equity Act S. 1066, the Medical Education Affordability Act H.R. 2583, the Physician Workforce and Graduate Medical Education Enhancement Act HR 7192, Preserving Patient Access to Primary Care Act H.R. 6357, the ProTECHt Act H.R. 5442 TRUST in Health Information Act of 2008 H.R. 6898 Health-e Information Technology Act of 2008 S. 1693 Wired for Health Care Quality Act of 2008 H.R. 6791 The National Cancer Act of 2008

Client expense: $97,022 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Veterans Affairs, Dept of (VA)

H.R. 1424, Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (as included in the Emergency Economic Stabilization Act of 2008), provisions on mental health parity and physician-owned hospitals H.R. 6983, Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, all provisions S. 558 Mental Health Parity Act of 2007, all provisions S. 3335, Jobs, Energy, Families, and Disaster Relief Act of 2008, provisions on mental health parity H.R. 6049, Energy and Tax Extenders Act of 2008, provisions on mental health parity H.R. 6357, PRO(TECH)T Act of 2008, all provisions H.R. 6898, Health-e Information Technology Act of 2008, all provisions S. 1693, Wired for Health Care Quality Act, provisions relating to data collection, quality, and performance reporting H.R. 6179, Promoting Health Information Technology Act of 2008, all provisions S. 3300, Rural Hospital Assistance Act of 2008, provisions on physician-owned hospitals and self-referral S. 334, Healthy Americans Act, all provisions H.R. 6569, Public Health Emergency Response Act of 2008, all provisions H.R. 1841, AmeriCare Health Care Act of 2007, all provisions H.R. 2357, MediKids Health Insurance Act of 2007, all provisions H.R. 5873, Family Leave Insurance Act of 2008, all provisions H.R. 5639, Physical Activity Guidelines for Americans Act of 2008, all provisions H.R. 3257, Fitness Integrated with Teaching Kids Act, all provisions S. 3575, Labeling Education and Nutrition Act of 2008 (LEAN Act of 2008), all provisions H.R. 2833, Preexisting Condition Exclusion Patient Protection Act of 2007, all provisions H.R. 2842, Children's Health Protection Act of 2007, all provisions H.R. 6845, Fair Copyright in Research Works Act, all provisions H.R. 3544, Catalyst to Better Diabetes Care Act of 2007, all provisions H.R. 1532, Comprehensive Tuberculosis Elimination Act of 2007, all provisions H.R. 2994, National Pain Care Policy Act of 2007, all provisions H.R. 1283, Arthritis Prevention, Control, and Cure Act of 2007, all provisions S. 2731, to improve the oversight and regulation of tissue banks and the tissue donation process, and for other purposes, all provisions S. 3040 and H.R. 6100, Kid-Safe Chemicals Act of 2008, all provisions H.R. 2464, to amend the Public Health Service Act to provide a means for continued improvement in emergency medical services for children, all provisions H.R. 7192, Preserving Patient Access to Primary Care Act, all provisions H.R. 758, Breast Cancer Patient Protection Act of 2008, all provisions S. 3354, Volunteer Healthcare Program Act of 2008, all provisions S. 3408, Comparative Effectiveness Research Act of 2008, all provisions H.R. 6752 and S. 3396, Independent Drug Education and Outreach Act of 2008, all provisions S. 1695, Biologics Price Competition and Innovation Act of 2007, all provisions H.R. 5620, Fresh Produce Safety Act, all provisions H.R. 1038 and S. 623, to amend the Public Health Service Act to provide for the licensing of comparable and interchangeable biological products, and for other purposes, all provisions H.R. 1956, Patient Protection and Innovative Biologic Medicines Act of 2007, all provisions S. 1505, Affordable Biologics for Consumers Act, all provisions H.R. 6498 and S. 976, Genomics and Personalized Medicine Act of 2008, all provisions H.R. 2823, Fair Balance Prescription Drug Advertisement Act of 2007, all provisions Health Disparities Inclusion of Minorities in Clinical Trials Health Savings Accounts Medical devices - standardization of expiration dates Disability Nondiscrimination (Americans with Disabilities Act/hearing interpreters) The Uninsured, AMA's Plan Childhood Obesity Social Security Administration Disability Claims Processing Blood and Blood Components Safety Pregnancy and Lactation Prescription Drug and Biological Products Labeling Children's Health Insurance Program Directive Post-marketing Surveillance of Prescription Drugs DEA - E-Prescribing Constraints E-Prescribing Incentive Program Provider Conscience Clause Home Stockpiling of Antivirals National Ambient Air Quality for Lead

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Agency for Healthcare Research and Quality (AHRQ) FY 2009 Appropriations, Adequate funding for Health Information Technology and Comparable Effectiveness Research. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, Antitrust issues related to health care plan consolidation and physician collective bargaining, Oppose anticompetitive insurance consolidation. Allow physicians to bargain collectively; remove antitrust barriers on physicians; reform Federal Trade Commission regulation. No Bill, Collective Negotiation by Physicians with Health Plans, To allow physicians to bargain collectively with health plans. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Physician Quality Reporting Initiative; Value-based purchasing, To continue this bonus payment for reporting program as a voluntary program. No Bill, Promoting the US health delivery system reform to a Patient Centered Medical Home model of care, Promoting health care reform based on the PCMH model of care. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas. No Bill, Title VII Health Professions Grants for Primary Care Medicine Training Reauthorization, Promote Title VII Health Professions Grants for Primary Care Training programs.

P.L. 110-275 (H.R. 6331, S. 3101), Medicare physician Payment reform to prevent 10.6 percent cut from taking effect on July 1, 2008, Prevent 10.6 percent cut to Medicare physician payments. P.L. 110-329 (H.R. 2638), Increased funding for Rural Health Programs in FY 2009 Appropriations, Adequate funding for HHS Rural Health Programs. P.L. 110-329 (H.R. 2638), Increased funding for Title VII Health Professions Grants for Primary Care Medicine Training FY 2009 Appropriations, Adequate funding for HRSA's Title VII grants. P.L. 110-329 (H.R. 2638), Prevent cuts in funding to National Health Service Corps in FY 2009 Appropriations, Adequate funding for NHSC. S. 2408, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 2583, Medicare and Medicaid Graduate Medial Education reform for primary care health professions workforce education, Protect GME payments needed to train primary care physicians. H.R. 3800, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 4296, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 5442, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 6357, Health Information Technology, To subsidize HIT for small and medium sized physician practices. H.R. 7192, Patient-Centered Medical Home, To introduce federal government to this model of primary care. No Bill, CMS Meetings regarding Medicare payment, PCMH Pilot, GME. No Bill, Health Professions Shortage Areas, To ensure fairness in the designation process. No Bill, Healthcare reforms to improve access to health care, To introduce AAFP views on health reform to Senate HELP Committee. No Bill, Medicare Advantage, To make sure Congress understands how these costly plans (esp PFFS) lead to beneficiary confusion and provider underpayment. No Bill, Racial and Ethnic Disparities, To reduce and eventually eliminate disparities in health care. No Bill, Rural and underserved health issues, geographic practice cost indices, physician scarcity bonus, To ask Congress to extend these incentives for physicians to locate and practice in rural and underserved areas.