On October 14, the American Academy of Family Physicians (AAFP) sent a letter to President Trump regarding the Administration’s October 3 Executive Order “Protecting and Improving Medicare for Our Nation’s Seniors.” The AAFP, additionally, provided copies to Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma.
A summary of the Executive Order prepared by the AAFP reflects the Academy’s policies and positions on the recommendations put forth by the administration. The AAFP strongly supports the efforts to reduce administrative complexity and burden, applauds the continued commitment to create site-neutral parity in payments for health care services, and welcomes the opportunity to work with the administration to ensure network adequacy, especially with regard to appropriate access to family physicians.
The AAFP is strongly opposed to recommendations in the Executive Order that seek to eliminate supervision requirements and create parity in payments between physicians and non-physician providers. While the AAFP fully supports team-based care, it is critical to understand that while all members of the health care team are important, they are not interchangeable. The AAFP strongly disagrees that greater collaboration can be achieved through granting independent practice for non-physicians.
The AAFP is concerned with the movement by CMS to prioritize Medicare Advantage over the traditional Medicare program and urges caution in giving patients the ability to forgo all Medicare coverage by engaging in direct contracting arrangements beyond primary care. The AAFP is a strong supporter of giving patients the ability to engage in direct contracting arrangements with their family physicians but is concerned that by expanding direct contracting beyond primary care would fail to protect individuals from economic losses associated with high-cost health care events.
The AAFP continues to closely monitor this issue very carefully in order to support the positive aspects of this Executive Order and to oppose those that are contrary to AAFP policy.