Sequester is an automatic reduction in federal spending.4 Due to large spending packages by the government for COVID-19, additional sequester cuts—separate from the PFS—will begin Dec. 31 if not addressed. Expiration of a moratorium on a sequester that has been on pause through 2020 and 2021 will result in 2% cuts to reimbursement, and a new sequester, called PAYGO, will add across-the-board 4% cuts.
How you can help: Watch for calls to action on the ACR’s Legislative Action Center in support of suspending or repealing cuts.
Workforce
Workforce initiatives continue to be at the forefront of the ACR’s advocacy efforts. Nationally, pediatric rheumatology fellowship programs fill around 50% of their slots. Meanwhile, adult rheumatology fellowship slots must turn away applicants. The cap on Medicare support for graduate medical education has been in place for more than two decades via the Balanced Budget Act of 1997.
The Resident Physician Shortage Reduction Act (S. 834/H.R. 2256) was re-introduced. This bill adds 14,000 Medicare-funded graduate medical education slots over seven years.
The Pediatric Subspecialty Loan Repayment Program (PSLRP) would address the pediatric workforce shortage by providing funds for loan forgiveness when certain metrics are met. Although the PSLRP was authorized by the CARES Act in 2020, it has not yet been funded. The ACR is advocating for an initial $50 million appropriation.
At the state level, we are also making progress on our workforce initiatives. The ACR’s model, cognitive care loan forgiveness bill was re-introduced in the Georgia House of Representatives this year. In Washington, pediatric rheumatology loan forgiveness was amended into the state budget. This would be the first state to allow pediatric rheumatologists to apply to state loan forgiveness programs. We are working with our partners to ensure this provision stays in the budget that is sent to the governor.
How you can help: Visit the Legislative Action Center to find a pre-populated letter to legislators you can send showing your support for these workforce actions.
Arthritis Research
The U.S. Department of Defense allocates research funding to certain diseases, as well as a general fund. To date, researchers seeking grants related to rheumatic disease have had to apply via the general fund. The ACR is working toward having a line item dedicated to arthritis research, given that arthritis is the second-leading cause of medical discharge from the military. This slow-moving effort has gained serious traction, and I am hopeful we may be successful in this Congress.
