Strike Force advocates in Washington

The 2019 Advocacy Council Strike Force trip to Washington, DC last week was, once again, a great success. We spent two days meeting with congressional leaders as well as with our own senators and representatives.

On May 7, Strike Force members representing the College and Advocacy Council were:

  • Todd Mahr, MD, FACAAI, president
  • Allen Meadows, MD, FACAAI, president-elect
  • Michael Blaiss, MD, FACAAI, executive medical director
  • Stephen Imbeau, MD, FACAAI, Advocacy Council chair
  • Jim Tracy, DO, FACAAI, Advocacy Council vice chair
  • James Sublett, MD, FACAAI, executive director of advocacy and government affairs.

David Lang, MD, the Academy’s president and Tom Fleisher, MD, the Academy’s executive vice president joined the Strike Force.

Highlights of the day’s activities included:

  • Thanking Representative Rohit Khanna (D-CA) for taking a leadership role in seeking increased funding for food allergy research.
  • Thanking Representatives Morgan Griffith (R-VA) and Robert Aderholt (R-AL) for their critical roles in preserving our right to mix allergy extracts in our offices.
  • Meeting with senior staff for the Senate HELP (Health, Education, Labor and Pensions) Committee 
  • Meeting with staff from the:
    • Senate Finance Committee.
    • House Ways and Means Health Subcommittee.
    • House Energy and Commerce Health Subcommittee.
  • Sitting down with a senior health policy advisor to Health and Human Services (HHS) Secretary Alex Azar to discuss the College’s Asthma Alternative Payment Model (APM). 

In our meetings we focused primarily on our concerns related to:

  • Network adequacy.
  • Surprise billing.
  • Physician focused payment.

J. Allen Meadows, MD, FACAAI, president-elect, with U.S. Representative Gary Palmer (R- AL).

The network adequacy/surprise billing issues are linked so we discussed them in tandem. One of the reasons so many physicians – including allergists – are out-of-network, is that networks have become increasingly narrow. Several of the surprise billing proposals being mentioned in Congress would limit the ability of allergists to balance bill patients, potentially changing the negotiating dynamic between health plans and allergists. This will embolden health plans to create even more narrow networks.

The failure of HHS to seriously consider most of the physician-focused payment models developed by specialty societies is a growing concern. The models are developed in response to the Congressional authorization for consideration of such plans. The threshold tests for consideration and the failure of the Centers for Medicare and Medicaid Services (CMS) and HHS to approve most proposals is having a chilling effect on development of these types of plans. CMS/HHS needs to demonstrate a true willingness to consider payment models developed by physicians and not rely on plans CMS develops that have little or no correlation to the real world. 

Dr. Meadows said, “All the folks we visited with on the legislative side of government (Congress and Senate – republican and democrat) were supportive of the College’s APM. Many agreed to reach out to CMS on behalf of physician-focused alternative payment models.”

Todd Mahr, MD, FACAAI, president, with U.S. Representative Steny Hoyer (D-MD) and Tonya Winders, president and CEO, Allergy and Asthma Network.

On May 8 we worked in cooperation with our partners at the Allergy and Asthma Network, teaming-up with patients for the annual Allergy and Asthma Day on Capitol Hill.

The following College members joined Drs. Mahr, Meadows, Blaiss and Imbeau for the day:

  • Warner Carr, MD, FACAAI
  • Dane McBride, MD, FACAAI
  • John Seyerle, MD, FACCAI
  • Gary Steven, MD, FACAAI
  • Maeve O’Connor, MD, FACAAI

In total, over 110 teamed up to meet with their representatives or staff on:

  • Access to appropriate care and affordable medications.
  • Increased funding for asthma and allergy research.
  • Health equity.
  • Cross contamination of food allergens that should be noted on food labels.

Plan to join us next year! This annual event is usually the first or second week of May – it coordinates with Asthma Awareness Week. Contact the Advocacy Council office and we’ll send information when it becomes available early next year.

Advocacy Issue: 
Billing, Coding & Payments
Skinny Networks
APMs