Prior Authorization Relief
The AAO-HNS is increasingly concerned about health insurers’ use of Prior Authorization (PA) as a tool to reduce health care spending. Excessive PAs do not curb healthcare expenditures, but actually cost patients time and money in addition to delaying their care.
In otolaryngology, insurers’ use of prior authorization has significantly increased in recent years. Basic procedures, such as ear tubes and in-office diagnostic procedures, often now require PA. On average, ENT physician offices complete more than 40 PA’s per week—the average approval takes 2-7 days (or longer) per claim, resulting in delays to necessary care. Many offices have staff dedicated solely to prior authorizations.
H.R. 3107, the “Improving Seniors’ Timely Access to Care Act of 2019” creates sensible rules that will help to relieve administrative burdens on practicing physicians by streamlining and standardizing prior authorization within the Medicare Advantage (MA) program. Under H.R. 3107, MA plans would be subject to increased transparency requirements. The AAO-HNS strongly supports this important legislation and urges you to contact your member of Congress to request that they co-sponsor this important legislation.
Oversight of Tobacco Products
Within the U.S. Department of Health and Human Services (HHS), the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) Office on Smoking and Health (OSH) are responsible for oversight and prevention efforts related to tobacco products.
The FDA was given authority over the manufacture, sale and marketing of all tobacco products via passage by the U.S. Congress of the Family Smoking Prevention and Tobacco Control Act (TCA) in 2009. As part of the TCA, Congress appropriately gave FDA the flexibility to determine the type of oversight that is appropriate for different tobacco products based on the protection of public health. While the TCA immediately applied all of FDA’s new authorities to cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco, it established a process for the Secretary of Health and Human Services to assert jurisdiction over other tobacco products, including cigars and e-cigarettes, and determine which requirements are appropriate for the protection of public health.
Despite the FDA’s clear authority to regulate ALL tobacco products, the tobacco industry continues to seek exemptions for various products—particularly cigars. No tobacco product should be exempt from oversight – and certainly not inexpensive and flavored cigars. The AAO-HNS opposes any legislation and/or appropriations policy riders that would exempt some cigars, including flavored cigars, from regulation under the TCA.
As a counterpart to the FDA’s oversight, the CDC OSH leads federal prevention and tobacco control efforts to reduce the use of tobacco products. The CDC OSH collects, studies, and shares information about tobacco use, supports comprehensive tobacco control programs to prevent and reduce tobacco use, and provides consumer-focused prevention and cessation campaigns.
2019 AAO-HNS Activities: The AAO-HNS signed on to two coalition letters addressed to U.S. Congressional appropriators requesting FY 2020 funding for tobacco control efforts:
- Click here to read a letter requesting funding for the CDC Office on Smoking and Health (OSH).
- Click here to read a letter requesting approval of $712 million in tobacco product user fees, the full amount authorized by the Tobacco Control Act, for the FDA to use in overseeing tobacco products.
Truth in Advertising
Currently, there is little “transparency” associated with the most fundamental and important component of healthcare delivery – the many health professionals who interact with patients every day. Recent studies confirm America’s patients prefer a physician-led approach to healthcare and are often confused about the level of training and education of their healthcare providers. Because of this uncertainty, patient autonomy and decision-making have been compromised. America’s patients deserve to be fully informed and able to easily identify in healthcare advertisements and interactions their providers’ credentials, licenses, and training when seeking treatment. The AAO-HNS is a strong supporter of federal truth-in-advertising legislation is committed to strengthening support for this issue in the 116th Congress.
Click here to read an organizational support letter regarding previous TIA legislation from the 115th Congress.
Repeal of the Independent Payment Advisory Board
UPDATE: IPAB Repeal signed by President as poart of broader spending package on February 9, 2018.
Created by the Affordable Care Act, the IPAB is a largely unaccountable body of individuals appointed by the President and charged with creating or modifying Medicare payment policy, thereby usurping the rightful authority of our elected Congressional officials to shape Medicare policy. By limiting Congressional oversight, the IPAB essentially eliminates the transparency of hearings, debate, and the meaningful opportunity for stakeholder input. The AAO-HNS urged Members of Congress to support IPAB repeal and cosponsor H.R. 849/S. 260/S. 251.
- February 1, 2017: U.S. Senator John Cornyn (R-TX) introduced S. 260, the “Protecting Seniors’ Access to Medicare Act of 2017.”
- February 1, 2017: U.S. Senator Ron Wyden (D-OR) introduced S. 251, the “Protecting Medicare from Executive Action Act of 2017.”
- February 3, 2017: U.S. Representative Phil Roe, MD (R-TN) introduced H.R. 849, the “Protecting Seniors' Access to Medicare Act of 2017.” *Identical to S. 260
- October 4, 2017: H.R. 849 passed (24-13) by the House Ways & Means Committee
- November 2, 2017: H.R. 849 passed (307-111) by U.S. House of Representatives
- February 6, 2018: H.R. 849 was included as part of broader spending package (H.R. 1892, the Bipartisan Budget Act of 2018)
- February 9, 2018: H.R. 1892 signed by the President.
Click here to read the AAO-HNS letter re: H.R. 849 from the 115th Congress.
Medical Liability Reform
The nation’s current medical liability system places patients in jeopardy of losing their access to vital healthcare services. With affordable and adequate medical liability insurance becoming difficult to find, physicians are retiring early, limiting their practices, or moving to states with less costly premiums. This disturbing trend is leaving entire communities without access to critical healthcare services. To reduce and learn from instances of medical error, the AAO-HNS has committed substantial resources to and engaged our Members in proactive quality improvement initiatives. However, further statutory changes are necessary to address flaws in our current tort system and enact proven reforms to reduce frivolous lawsuits. Members of Congress are urged to explore innovative solutions to alleviate the burdens associated with the current medical liability system.
- February 24, 2017: U.S. Representative Steve King (R-IA) introduced H.R. 1215, the “Protecting Access to Care Act of 2017.”
- March 22, 2017: H.R. 1215 amended by House Judiciary Committee
- March 22, 2017: H.R. 1215 discharged by House Energy & Commerce Committee
- March 30, 2017: U.S. Representative Marsha Blackburn (R-TN) introduced H.R. 1822, the "Good Samaritan Health Professionals Act of 2017."
- June 28, 2017: H.R. 1215 passed (218-210) by U.S. House of Representatives
- May 15, 2018: U.S. Senator Richard Burr introduced S. 2852, the "Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018."
- June 18, 2018: H.R. 1822 included as a provision in S. 2852.
Click here to read the H.R. 1215 organizational support letter from the 115th Congress.