The AHA July 15 commented to Sens. Sheldon Whitehouse, D-R.I., and Bill Cassidy, R-La., responding to a request for information based on the Pay PCPs Act, legislation designed to improve support and pay for primary care providers. The AHA expressed concerns that its proposed hybrid per-member-per-month and fee-for-service payment structure in the physician fee schedule for primary care could result in payment cuts, and that there may be variation in the PMPM depending on the type of provider. The bill also has language implying that there is latitude for the PMPM to not be risk-adjusted and possibly restrict what could be included in the risk adjustment, AHA said. 

The AHA voiced support for a provision in the legislation that would reduce beneficiary cost-sharing for primary care services by 50% under the hybrid payment model. The association also shared principles for Congress to consider when designing alternative payment models to make participation more attractive for potential participants.
 

Related News Articles

Headline
The AHA April 18 filed friend-of-the-court briefs in three cases in support of Louisiana's 340B contract pharmacy law that prohibits drug companies from…
Headline
A Minnesota state court April 15 dismissed a lawsuit filed by PhRMA challenging the state’s law protecting 340B pricing for contract pharmacy arrangements. The…
Headline
The White House April 15 released an executive order directing federal agencies to undertake a broad range of tasks aimed at reducing the costs of prescription…
Perspective
Public
Congressional lawmakers are heading home for a two-week district work period after both the Senate and House passed a revised budget resolution for fiscal year…
Headline
Story Updated April 5 at 8:30 a.m. ETThe Senate by a vote of 51 to 48 passed its revised budget resolution for fiscal year 2025 with Sens. Rand…
Headline
The AHA and dozens of other organizations yesterday urged House and Senate sponsors of the Conrad State 30 and Physician Access Reauthorization Act to…