ASSOCIATION OF AMERICAN MEDICAL COLLEGES

Draft Higher Education Act Reauthorization Issues: Support affordable income driven repayment plans for borrowers and the ability for student borrowers to borrow up to the cost of attendance. Oppose cuts to graduate/professional student loan and repayment plans, including Public Service Loan Forgiveness, and elimination of Direct PLUS loans. H.R.4985/S.3175 - Expanding Medical Education Act Issue: Support grants to create, expand, and support medical schools and regional medical campuses, including minority serving institutions (MSIs). Draft Pathway to Practice Act Issue: Support Pathway to Practice medical school scholarships and graduate medical education (GME) positions for underrepresented students. Draft National Medical Corps Act Issue: Support improving the pathway from community college to careers in medicine. Issue: Educate Congress and the administration on the impact of medical education debt on career decisions like specialty choice. Issue: Educate Congress on the role academic medicine can serve with the Commission on the Social Status of Black Men and Boys. Issue: Support the elimination of taxes on non-tuition student scholarship and grant aid. H.R.6585 - Bipartisan Workforce Pell Act Issue: Oppose limiting financial aid access for students at institutions subject to the endowment tax. H.R.6077 - Protecting Our Students by Terminating Graduate Rates that Add to Debt (POST GRAD) Act Issue: Support reinstating graduate student eligibility for Federal Direct Subsidized Loans. H.R.6951 - College Cost Reduction Act Issue: Oppose elimination of DirectPLUS loans and other limitations on graduate/professional borrowing. Support eliminating student loan origination fees and interest capitalization. H.R.7725/S.4115 - Embracing anti-Discrimination, Unbiased Curricula, and Advancing Truth in Education (EDUCATE) Act Issue: Oppose policies that prohibit graduate medical schools from receiving federal financial assistance if they or accrediting associations adopt certain policies and requirements relating to diversity, equity, and inclusion. H. Res. 1180 Issue: Support efforts to increase awareness and recognize the importance of diversity, equity, and inclusion in medical education. Issue: Support loan repayment incentives for rural health care providers. Issue: Support tax incentives for clinical preceptors. H.R.8070 Servicemember Quality of Life Improvement and National Defense Authorization Act for Fiscal Year 2025 Issue: Oppose amendments to NDAA that would attach the Bipartisan Workforce Pell Act and DETERRENT Act.

H.R. 6980/S.2719 - Directing Our Countrys Transfer of Residency Slots (DOCTORS) Act, Issue: Educate Congress on policies related to mending the Immigration and Nationality Act to provide for the reallocation of unused waivers of the foreign residency requirement for certain J visa holders. H.R.4942/S.665 - Conrad State 30 and Physician Access Reauthorization Act Issue: Support expansion of the Conrad 30 program and improvements to physician immigration. H.R.4875 - Doctors in our Borders Act Issue: Support expansion of the Conrad 30 program and improvements to physician immigration. Educate Congress on policies allowing undocumented students to attend U.S. medical schools and graduate medical education. S.3211 - Healthcare Workforce Resilience Act Issue: Support reduction of green card backlogs for health professionals.

H.R.2389/S.1302 - Resident Physician Shortage Reduction Act of 2023 H.R.7050 - Substance Use Disorder Workforce Act Draft Bipartisan Senate Medicare GME Expansion proposal Issue: Support increased Medicare funding for graduate medical education (GME). H.R.751 - Fair Access in Residency Act Issue: Oppose legislative interference in residency training program requirements and policies requiring the Medicare program to consider specific physician licensing exams for residency program applications. H.R.834/S.230 - Rural Physician Workforce Production Act Issue: Oppose legislation redesigning Medicare GME payment formulas that reduce current DGME/IME payments to teaching hospitals. H.R.2584/S.2768 - Safety From Violence for Healthcare Employees (SAVE) Act Issue: Support legislation providing protection for health care workers by creating a criminal offense for knowingly assaulting or intimidating hospital workers and providing grants to reduce violence in hospitals. H.R.5378 - Lower Costs, More Transparency Act Issue: Oppose legislation that pays for workforce investments and mitigation of DSH cuts paid for by cuts to hospital outpatient departments. H.R.5013 - Value in Health Care Act Issue: Support legislation that ensures the continued move to value-based care. H.R.8235 - Rural Physician Workforce Preservation Act Issue: Educate Congress about the likely impact of legislation that would alter the distribution of Medicare-supported GME slots from the CAA, 2021 and 2023. Issue: Educate Congress on status of CMS distribution of the 1,000 new GME slots authorized by the Consolidated Appropriations Act, 2021 (P.L.116-260). Support CMS changing its distribution methodology to end the practice of super prioritization. Issue: Support Medicare GME per resident amount and cap-setting technical corrections and administrative relief. Issues: Support lifting cap on number of residents Medicare will count when determining teaching hospitals' Medicare Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. Issue: Oppose reduction of Medicare GME/IME payments. Issue: Oppose the redesign of Medicare Indirect Medical Education financing and redistribution. Issue: Oppose establishing nationality-based restrictions on medical residencies supported by Medicare. Draft Senate Finance Medicare Physician Fee Schedule request for information Issue: Support efforts to reform the Medicare physician fee schedule. H.R.2474 - Strengthening Medicare for Patients and Providers Act Issue: Support legislation that reforms the Medicare Physician Fee Schedule by providing an annual inflation-based payment update based on the Medicare Economic Index (MEI). S.4338 - Pay PCPs Act Issue: Respond to Senate RFI on hybrid payments for Medicare physicians. P.L.118-42 - Consolidated Appropriations Act, 2024 Issues: Oppose reduction in Medicare hospital outpatient department reimbursement for drug administration and other services. Oppose site-neutral expansion to excepted off-campus provider-based departments (PBDs). Oppose creation of National Provider Number/unique identifier for off-campus hospital outpatient departments. Oppose Medicare hospital, and provider cuts. Support mitigation of Medicare Physician Fee Schedule cuts. Support delaying or eliminating scheduled cuts to the Medicaid disproportionate share hospital (DSH) program. Support extension of alternative payment model (APM) bonus. H.R.2665 - The Supporting Safety Net Hospitals Act Issue: Support eliminating two years worth of scheduled reductions to the Medicaid DSH program. Issue: Educate Congress on role of academic medicine as it relates to price transparency or disclosure initiatives. Issue: Protect patients from delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program and providing program oversight and transparency. Issue: Support necessary changes and improvements to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Issue: Educate Congress and policymakers on the financial challenges facing teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Educate Congress on potential financial implications of entitlement reform on teaching hospitals and health systems, medical schools, and faculty practices and the impact on patients access to care and the nations health. Issue: Support policies to close the Medicaid coverage gap and ensure access to coverage in non-expansion states, as well as financial incentives to help states maintain existing expansions. Support mandatory 12-month Medicaid coverage for post-partum individuals. Issue: Oppose efforts by states to impose work or other community engagement activities as a requirement for continued Medicaid eligibility or coverage for certain Medicaid beneficiaries. Issue: Support waiving budget neutrality requirements associated with the E/M code changes or temporarily holding harmless physicians and other health care professionals. Issue: Support extension of Acute Hospital at Home program waiver of 24/7 nursing requirement. Issue: Support extension of Medicare telehealth waivers and efforts to expand patient access to telehealth. Issue: Support policy to permanently remove requirement for Medicare beneficiaries to be seen in-person every six months for telehealth visits for mental health services. H.R.1397 - The Telehealth Improvement for Kids Essential Services Act Issue: Support providing states with guidance to increase telehealth access in Medicaid and CHIP. Issue: Support increased access to behavioral health and substance use disorder treatment services under Medicare and Medicaid. Support the removal of regulatory barriers to telehealth-enabled mental health care, including electronic interprofessional consults (eConsults). Issue: Support creation of new Medicare outpatient IME payment in addition to existing Medicare IME payment inpatient methodology. Oppose policies to create budget neutral IME payments for outpatient services. H.R.2377/S.1000 - The Saving Access to Laboratory Services (SALSA) Act Issue: Support legislation to modify Medicare payment rates for clinical diagnostic laboratory services to avoid statutory cuts to these payments. Issue: Support authorization of Medicare advance and accelerated payments in the wake of cyberattacks on providers. H.R.2829 - Chronic Care Management Improvement Act of 2023 Issue: Support removing cost-sharing obligations from the chronic care management (CCM) code in Medicare.

H.R.3046/S.1403 - Medical Student Education Authorization Act of 2023 Issue: Support grants for primary care training in medically under-resourced communities. Draft Social Determinants Accelerator Act Issue: Support grants to address social determinants of health. Draft Health Equity and Accountability Act Issue: Support programs to improve health equity and address social determinants of health. S.2333 - Pandemic and All-Hazards Preparedness and Response Act H.R.4420 - Preparedness and Response Reauthorization Act H.R.4421 - Preparing for All Hazards and Pathogens Reauthorization Act H.R.4697 - Protecting PAHPA Act of 2023 Issues: Support the reauthorization of the Pandemic and All-Hazards Preparedness Act with increased funding authorization levels. Issue: Support authorities to strengthen CDCs and ASPRs ability to prevent and respond to existing and emerging threats. S.1995 - Public Health Infrastructure Saves Lives Act Issue: Support investments in core public health infrastructure. Issue: Educate Congress on how the 340B Drug Pricing Program helps safety-net providers to fulfill their missions and care for patients and communities. Support measures to preserve and strengthen the 340B Drug Pricing Program and oppose efforts to reduce the scope of the program, restrict the use of contract pharmacies, define patient in the context of the program, and impose additional reporting requirements on 340B hospitals. H.R.2534 - Preserving Rules Ordered for the Entities Covered Through 340B Act of 2023 (PROTECT 340B Act) Issue: Support measures to prevent pharmacy benefit managers and commercial insurers from imposing discriminatory reimbursement policies on 340B covered entities. H.R.3290 - To amend title III of the Public Health Service Act to ensure transparency and oversight of the 340B drug discount program. Issue: Oppose efforts to impose additional reporting requirements on 340B hospitals. Draft Supporting Underserved and Strengthening Transparency, Accountability, and Integrity Now and for the Future of 340B (SUSTAIN 340B) Act Issue: Support efforts to prohibit pharmaceutical and pharmacy benefit manager (PBM) discrimination against covered entities. Oppose efforts to define patient in the context of the program. Oppose efforts to impose additional administrative and reporting requirements on 340B hospitals. H.R.8574 - 340B ACCESS Act Issue: Oppose efforts to restrict hospital eligibility for the 340B program. Issue: Educate Congress about the impacts of drug shortages on academic medical centers and the patients they serve. Support measures to address drug shortages and strengthen the pharmaceutical supply chain. Draft End Drug Shortages Act Issue: Support policies to increase visibility into the pharmaceutical supply chain. Issue: Oppose insurance plans that do not meet Affordable Care Act requirements. Issue: Support policies to improve maternal health outcomes through expanded Medicaid coverage, enhanced data collection, and improved access to behavioral health care during the perinatal period. H.R.2369 - Verifying Accurate Leading-edge IVCT Development (VALID) Act of 2023 Issue: Educate Congress on development of laboratory developed tests (LDTs) at academic medical centers and oppose policies that would increase burdensome regulations and negatively impact patients access to care by allowing FDA regulation of the development of LDTs at academic medical centers. Issue: Educate Congress on the medical education and training continuum, the annual residency Match, and the role of the National Resident Matching Program (NRMP) in medical education and residency. Issue: Provide guidance on the implementation of the No Surprises Act (P.L.116-260). Issue: Educate Congress and the administration on the role of academic medicine in the provision of mental and behavioral health care, including initiatives to respond to the opioid epidemic. Support policies to strengthen the behavioral health workforce, promote the uptake of integrated behavioral health models, advance mental health research, and ensure access to coverage and care. Issue: Educate Congress about the financial challenges facing academic medical centers, including reimbursement challenges, workforce challenges, inflation, and others. Issue: Educate Congress and the administration about the impact of the unwinding of the COVID-19 public health emergency on the academic medicine community and the patients they serve. H.R.3887 - Childrens Hospital GME Support Reauthorization Act of 2023 H.R.3841 - To amend title III of the Public Health Service Act to reauthorize the program of payments to children's hospitals that operate graduate medical education programs Issue: Support clean reauthorization of the Childrens Hospital GME program. Issue: Express concern regarding actions to inappropriately undermine FDA regulatory authority. Issue: Educate Congress and the administration about medical education on nutrition, hunger, and health; reproductive health; substance use disorders; medication assisted treatment for opioid use disorders; trans health; preventing fraud and abuse; diversity, equity, and inclusion; menopause management; health care for people with disabilities; and maternal health. Issue: Educate Congress and the administration about resident physician practice decision making post Dobbs. Issue: Educate Congress on resident expectations related to clinical practice and oppose so-called physician service mandates. H.R.7855 - Rural Residency Planning and Development Act of 2024 Issue: Support codification of HRSAs rural residency planning and development program. Issue: Educate Congress on vaccine safety. Issue: Encourage changes to HRSA financial aid programs as a result of FAFSA updates. Issue: Educate Congress on the use of artificial intelligence (AI) in academic medicine. S.4031 - Providing Resources and Opportunities for Health Education and Learning (PRO-HEAL) Act Issue: Support HRSA grants to expand provider pipeline programs to create pathways to health care careers. H.R.7258/S.3968 - Community Training, Education, and Access for Medical Education, and Access for Medical Students (TEAMS) Act Issue: Support enhanced community-based training opportunities for medical students, particularly in rural and medically underserved areas, and fostering long-term sustainable physician practices in high-need communities. H.R.7153 - Dr. Lorna Breen Health Care Provider Protection Reauthorization Act Issue: Support ability of HRSA to implement evidenced-based practices for preventing suicide and improving mental health and resiliency among health care professionals, and for training health care professionals in appropriate strategies to address substance use disorders.

Issue: Educate Congress and the administration about the impact of regulatory burden on medical research. Issue: Educate Congress and the administration about preparedness and lab safety for pathogens with pandemic potential. Issue: Support the role of academic medical centers in engaging with Advanced Research Projects Agency for Health (ARPA-H). Issue: Oppose inappropriate use of march-in authority. Issue: Educate Congress and the administration about opportunities to strengthen medical research supported by NIH.