Advocacy & Policy Updates

PCC Opposes H.R. 5741; Calls to Protect CMMI’s Ability to Advance Value-Based Models for Medicare Beneficiaries

March 6, 2020

On March 6, 2020, PCC submitted a letter to members of Congress to express opposition to HR 5741 "Strengthening Innovation in Medicare and Medicaid Act." This proposed legislation risks weakening CMMI's leadership role and autonomy. HR 5741 has the potential to politicize CMMI models with the introduction of congressional approval. It would also restrict model parameters and create unneccessary administrative burden that would effectively hinder CMMI's ability to flexibly deploy and adapt models to meet beneficiary needs.

Connecticut Primary Care Spending Target

January 22, 2020

On January 22, 2020, Governor Lamont of CT signed into law Executive Order No .5, which directs OHS to monitor healthcare spending across payers, set annual benchmarck for 2021 through 2025. It also requires that the benchmarks should account for primary care spending and have targets within each year to increase primary care spending to 10% of total healthcare spending by 2025.

Physician Fee Schedule Comment Letter

September 30, 2019

On Friday, September 27, 2019, PCPCC submitted formal comments regarding the physician fee schedule. Specifically, PCPCC commented on the evaluation and management (E/M) codes, Medicare coverage for opioid use disorder, physician supervision for physician assistants, care management services, payment bundles, and and updates to the Quality Payment Program. While PCPCC was pleased with many of the updates in the proposed rule, there were some concerns, including the risk that removing the accreditation organizations for Patient-Centered Medical Home for performance improvement under MIPs could dilute standards for PCMH.

Physician Fee Schedule Letter

September 6, 2019

On Thursday, September 5, the PCPCC submitted a letter of comments to CMS regarding support of some of the changes made in the proposed 2020 physician fee schedule such as the changes to E/M codes. More detailed, formal comments will be submitted to the Federal Register later in the month. Read the letter here.

Primary Care First Letter to CMMI

August 6, 2019

On Friday, August 2, the PCPCC sumbitted a letter of comments and concerns to CMMI regarding some facets of the new Primary Care First Model. These included suggestions around the risk groups, performance incentives, and quality measures. Learn more and read the letter here.

2020 Physician Fee Schedule

July 29, 2019

The  CY 2020 Medicare Physician Fee Schedule Proposed Rule  with comment period was placed on display at the Federal Register on July 29, 2019. This proposed rule updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2020. CMS will accept comments on the proposed rule until September 27, 2019, and will respond to comments in a final rule.

PCPCC and other Leaders Applaud Congress for Bill to Increase Access to Preventative Treatments

June 25, 2019

PCPCC supports the Chronic Disease Management Act of 2019, legislation that would enable health plans to offer pre-deductible coverage of high-value services to patients that can improve outcomes and reduce complications. The legislation would create a preventive care safe harbor for treatment of chronic conditions. 

Health Organizations Support Removing Cost-sharing from Chronic Care Management

June 25, 2019

PCPCC joined other health organizations in supporting legislation that would remove cost-sharing obligations from the Chronic Care Management (CCM) code to allow more chronically ill Medicare beneficiaries to receive care coordination and case management services. The current cost-sharing requirement creates an unnecessary barrier to care. 

Executive Order on High-Deductible Plan Flexibility

June 24, 2019

Included in the White House Executive Order on Healthcare Transparency was a provision directing HHS to issue guidance allowing high-deductible health plans to cover preventive care before the deductible – particularly for individuals with chronic conditions.   PCPCC has advocated for greater flexibility in pre-deductible coverage, as it would improve access to high-value primary care for the many individuals covered by high-deductible health plans. The order also included a provision potentially allowing direct primary care arrangements to be funded by Health Savings Accounts.

Multi-Stakeholder Coalition Applauds Congress for Bill to Continue Federal Funding for the National Quality Forum

June 20, 2019

As part of a broad group of organizations under the Friends of NQF, PCPCC applauds Congress for the introduction of HR 3031 to continue federal funding for the National Quality Forum. The group also encourages several key changes to the bill to enhance NQF's work, namely increasing public transparency and accountability, advancing reforms to reduce administrative burden and increase alignment, and encouraging innovation in measurement to advance national health priorities.

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