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Bipartisan Budget Agreement Yields Important Achievement for Healthcare, including IPAB Repeal.
Following a brief government shutdown, Congress passed and the President signed the Bipartisan Budget Act of 2018, an agreement which ultimately led to an omnibus spending bill to fund the government through September 30th, the remainder of fiscal year (FY) 2018. While the Bipartisan Budget Act of 2018 raises the budgetary spending caps on defense and domestic spending by almost $300 billion, it also includes a number of important public health and health care priorities.

Most notably, the budget agreement fully repeals the Independent Payment Advisory Board or IPAB. Repeal of the IPAB has long been a goal of the specialty community because of the IPAB’s unfair targeting of providers in order to curb Medicare spending. While the Alliance shares in the goal of curbing waste in the Medicare program, it felt the IPAB was an unfair and an unaccountable means to do so and was thrilled to see its repeal – capping off almost a decade of advocacy to do so.

A more thoughtful, physician-led effort to control Medicare spending was the Medicare Access and CHIP Reauthorization Act (MACRA), which replaced the ineffective Sustainable Growth Rate (SGR) formula for Medicare physician reimbursement. While the Alliance was a big supporter of ending the SGR in favor of MACRA, it had been asking for some adjustments in the law and was glad to see the budget agreement made technical corrections to the application of the Merit-based Incentive Payment System (MIPS) to covered professional services and grant the Centers for Medicare and Medicaid Services (CMS) flexibility to reduce the weight of the MIPS Cost Performance Category for three additional years. The budget agreement also provided CMS three more years of flexibility to ensure a gradual and incremental transition to the “performance threshold,” which is the score that must be achieved in order to avoid a payment penalty under the MIPS program. Finally, the agreement updates the ability of the Physician-Focused Payment Model Technical Advisory Committee (PTAC) to further aid the development of physician led alternative payment models.

Funding for the National Institutes of Health (NIH) was also a big part of the budget agreement. NIH received a total of $6 billion ($3 billion for each of the fiscal years 2018 and 2019) to combat the opioid abuse epidemic. These funds will enhance state grants, public prevention programs, and law enforcement activities related to opioids and mental health care. Congress has also given $2 billion in budget authority to increase support for the National Institutes of Health (NIH) and additional scientific research for fiscal years 2018 and 2019.

The Alliance was also pleased to see Congress reach an agreement on funding the Children’s Health Insurance Program (CHIP) for a full decade.

Alliance Advocacy Fly In. July 16th-18th, 2018. Liaison Hotel, Washington, DC

NOTE: Participation in Alliance events is by invitation-only, with some exceptions. To learn more about how you or your organization can participate, please contact your organization's staff liaison to the Alliance or email us at info@specialtydocs.org.


"Narrow Networks Are Bad For Patients and Unlikely to Save Money". Morning Consult. -March 8, 2018.

"Bipartisan Payment System Improvements Mean More Physician Participation and Better Care." The Hill. -November 11, 2017

"Coalition of Medical Societies: Don’t Take Away MIPS" Becker’s Healthcare. -October 26, 2017

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Join the most powerful group of specialty physicians!
Joining forces with specialty doctors from across the country helps amplify the concerns specialty doctors share. By working together, specialty medical organizations can work more effectively to influence health care policy and ensure our primary goal: to continue to provide our patients the optimal care they need. As a part of the non-partisan umbrella organization representing all of specialty medicine, your organization will:

  • Promote specialty specific issues as part of a larger coalition, increasing visibility and understanding of issues.
  • Help increase exposure for specialty medical care.
  • Gain access to insider information, background materials and research on health policy initiatives and the political landscape.
  • Receive expert analysis on proposed legislation.
  • Caucus with other specialty organizations at the AMA House of Delegates and other forums to promote key issues that are important to specialty physicians.
  • Coordinate physician and patient grassroots efforts through a large and robust network.
  • Participate in future Alliance Fly-In events in Washington, D.C. Past events have included Capitol Hill visits and presentations by health policy experts.
For information on joining the Alliance of Specialty Medicine, visit our website at www.specialtydocs.org or contact Vicki Hart at vhart@hhs.com

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