BRETT BAKER

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. Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). 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 a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; 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). Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 in the 111th Congress). Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. 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. 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 (in the 110th Congress), to 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. 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; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. 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;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; 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. Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). 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 a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; 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). Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 in the 111th Congress). Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. 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. 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 (in the 110th Congress), to 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. 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; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. 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;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; 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. Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). 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 a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; 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). Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 in the 111th Congress). Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. 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. 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 (in the 110th Congress), to 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. 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; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. 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;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; 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. Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). 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 a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; 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). Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 in the 111th Congress). Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. 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. 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 (in the 110th Congress), to 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. 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; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. 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;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; 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. Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). 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 a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; 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). Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 in the 111th Congress). Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. 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. 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 (in the 110th Congress), to 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. 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; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. 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;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; 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. Support Implementation and Improvement of the Affordable Care Act (P.L. 111-148, P.L. 111-152) by: Expanding coverage and improving Medicare benefits; Providing needed protections to guard against insurance practices that unfairly limit, deny or rescind coverage based on health status; Ensuring access to primary care physicians; and beginning to bend the cost curve; Prohibiting insurers from excluding or charging excessive rates to children based on pre-existing conditions, which later will be expanded to all persons; Covering young adults on their parents' plans; Eliminating lifetime and annual limits on health insurance coverage; Requiring that health insurers spend more on patient care and less on administration; support enactment of S. 248, the Empowering States to Innovate Act, which amends the Patient Protection and Affordable Care Act to: (1) allow states to apply for waivers of certain health insurance coverage requirements in such Act (including requirements for the establishment of qualified health plans and health insurance exchanges) for plan years beginning on or after January 1, 2014 (currently, January 1, 2017), and (2) require the waiver application process to begin not later than 180 days after the enactment of this Act; Phasing out the Medicare Part D doughnut hole; Eliminating patient cost-sharing for preventive services offered by Medicare or private insurers; Increasing Medicare and Medicaid payments to primary care physicians; Establishing a new Patient-Centered Outcomes Research Institute to help physicians and patients make care decisions based on the best available evidence; Creating a new Center on Medicare and Medicaid Innovation to fund pilots of delivery models to improve outcomes and reduce costs, including patient-centered medical homes; Training more primary care physicians through the National Health Service Corps, Title VII health professions funding, and redistributing unused graduate medical education positions to primary care specialties facing shortages; Beginning in 2014, ensuring that nearly all Americans have access to coverage either through subsidized private health insurance offered by state health exchanges or through Medicaid, if they don't already have access to coverage through an employer, Medicare, or another public program. Center for Medicare and Medicaid Services (CMS): Support the re-nomination of Don Berwick, MD, as the Administrator of CMS and urge the Finance Committee to approve his nomination in a timely manner; Support delaying the date from Apr. 1, 2011 to no earlier than July 1, 2011 at which CMS would fully enforce the so-called physician face-to-face encounter rule that is the outgrowth of section 6407 of the Patient Protection and Affordable Care Act (PPACA). 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 a voluntary shared savings program, Accountable Care Organizations, that promotes accountability for services delivered to a defined Medicare fee-for-service (FFS) patient population with the goals of increasing the quality and efficiency of services delivered; 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). Urged action on legislation to provide stability and predictability for the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 in the 111th Congress). Healthcare in the FY2012 Budget: recommend funding of $65 billion for discretionary public health programs (Function 550) in the FY 2012 budget resolution. 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. 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 (in the 110th Congress), to 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. 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; Urge enactment of H.R. 5, the HEALTH Act, which would set national standards for medical malpractice, including a $250,000 cap on non-economic damages. 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;; Improving the Physician Quality Reporting Initiative (PQRI) and ensuring that no punitive payment penalties are imposed under PQRI; 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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). 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 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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). 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 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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). 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). 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 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 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). 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). 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). 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 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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). 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). 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 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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). 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). 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 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). 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 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 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 Medicare's 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 the Medicare physician payments at least through 2011; The Medicare and Medicaid Extenders Act of 2010, H.R. 4994, prevents the 25 percent physician payment cuts under Medicare, brought on by the flawed Sustainable Growth Rate (SGR) formula, from going into effect on Jan.1, 2011, and continues current rates through Dec. 31, 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 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). 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. 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. 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.

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.

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.

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. 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.

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, 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/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.

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.

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.

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.

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, 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/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. 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, 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.

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, 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.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing 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 SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: 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, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing 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 SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: 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, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing 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 SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: 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, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing 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 SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: 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, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing 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 SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: 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, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506 Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; H.R. 2351, the Healthcare Act of 2007; S. 1169, the State-Based Health Care Reform Act. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing 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 SCHIP re-authorizing legislation. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007. Economic Stimulus Package: 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, targeted increases in Medicare payments for primary care physicians, targeted incentives directed toward primary care physicians in smaller practices to acquire health information technology (HIT) applications to support care coordination through the medical home.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking, vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care.

Health Information Technology (HIT); providing incentives for the successful adoption of HIT: S.1693, the Wired for Healthcare Quality Act; H.R. 3800, Promoting Health Information Technology Act; H.R. 1952, the National Health Information Incentive Act of 2007; H.R. 6357, the Protecting Records, Optimizing Treatment, and Easing Communication through Healthcare Technology Act of 2008 or the PRO(TECH)T Act of 2008. Expanding health insurance coverage to ensure that more Americans will have access to affordable health insurance: H.R. 506/S.325, Health Partnership through Creative Federalism Act; Health insurance reform, Medicaid, Association Health Plans, Medical Savings Accounts, Tax credits and purchasing pools; S. 1169, the State-Based Health Care Reform Act; H.R. 2351, the Health Care Act of 2007. Reforming the medical liability system in this country to ease existing financial burdens on practicing physicians and to ensure greater patient access to care: S. 243, the Medical Care Access Protection Act of 2007 (MCAP Act); H.R. 2580, the Help Efficient, Accessible, Low Cost, Timely Healthcare (HEALTH) Act of 2007. Medical liability demonstration projects. Reforming the Medicare physician reimbursement formula to provide for greater predictability and stability in payments: S. 40, the Geriatric and Chronic Care Management Act, Reform the Sustainable Growth Rate - S. 2785, Save Medicare Act of 2008, H. R. 5445; H.R. 5545 and S. 2729, the Ensuring the Future Physician Workforce Act of 2008, Pay-for-Performance, Patient Centered Medical Home H.R. 3162, the CHAMP Act, care coordination, primary care shortage, CMS proposed changes to work relative value units (RVUs), Medically Unbelievable Edits program, CMS Request for Information (RFI) for Cycle 1 of the Medicare Administrative Contractor (MAC), CMS Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2007 Rates, Health Care Price Transparency. H.R. 6331/S.3101, the Medicare Improvements for Patients and Providers Act. Ensure adequate funding for federal health programs in the FY08 and FY09 appropriations: Labor/HHS/Education Appropriations bill (including Title VII health professions and student loans) and VA healthcare and research). Address inadequacies in public health programs and funding: Healthcare disparities, anti-smoking (S.625/H.R. 1108, the Family Smoking Prevention and Tobacco Control Act), vaccines (e.g. smallpox, influenza), CMS - Payment for the recently approved Herpes Zoster (Shingles) vaccine and its administration, DEA how e-prescribing systems can meet the Drug Enforcement Administrations (DEAs) prescription requirements under the Controlled Substances Act. Provide loan debt relief for medical students through enhancements to existing programs and the creation of new programs: H.R. 1093, Resident Physician Shortage Reduction Act of 2007; S. 588, Resident Physician Shortage Reduction Act of 2007; S. 1066, Medical Education Affordability Act; Reauthorization of the Higher Education Act, including the restoration of the 20/220 pathway; S. 2303/H.R. 4344, a bill to amend section 435 of the Higher Education Act of 1965 regarding the definition of economic hardship. Preserving the safety net function of federally-funded health care programs, such as SCHIP: H.R. 5268, providing for a temporary increase of the Federal medical assistance percentage under the Medicaid Program. Preserving access to primary care services: the impending shortage of primary care physicians, designation of primary care as a shortage profession, scholarships and loan forgiveness in exchange for primary care service commitments to practice in critical shortage areas, grants for medical school mentorship programs and primary care training in community health centers, increased Title VII funding for primary care health programs, Medicare payment reforms to support the Patient Centered Medical Home, regulatory relief, studies on primary care; S. 1340/H.R. 2244, the Geriatric Assessment and Chronic Care Coordination Act of 2007.