While working on a 1,000-piece puzzle of our country’s national parks (a 2020 Christmas present from my sister—and yes, I intend to finish soon!), I wondered how these great lands came to be protected for all to enjoy. I learned that President Theodore Roosevelt in 1901 spent significant time and resources to develop the U.S. Forest Service and lay the groundwork for what would become the National Park System. “We have fallen heirs to the most glorious heritage a people ever received, and each one must do his part if we wish to show that the nation is worthy of its good fortune,” he said.1
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During his tenure, President Roosevelt protected 230 million acres of public land. In 1915–16, a handful of conservation advocates amassed support and successfully lobbied Congress to develop the National Park System, which now comprises more than 85 million acres, roughly 3% of U.S. land.2,3
The men (since of course it was all men at that time) who protected the U.S. wildlands knew that having a seat at the table—whether in an office or in the park—was necessary to make bold strides in advocating for public lands.2 The same is true for moving health policy forward in 2022. Consider making a RheumPAC investment this year to help enable nonpartisan meetings with lawmakers working on issues that impact rheumatology patients and our profession.
In my final year as chair of the Government Affairs Committee (GAC), I would like to give an immense thank you to our GAC members, patients, physicians and interprofessional team members for making virtual advocacy a huge success. I also feel extraordinarily lucky to work with our ACR advocacy team, including Lennie Shewmaker McDaniel, JD, director of congressional affairs; Amanda Grimm Wiegrefe, MScHSRA, director of regulatory affairs; and Dan Redinger, director of political affairs and engagement, in Washington, D.C., and Joseph Cantrell, JD, senior manager of state affairs; Adam Cooper, vice president of practice, advocacy and quality; and the rest of the team in the Atlanta office.
As we look to 2022, we can expect the second year of the 117th Congress to be shaped by our 2021 experiences with large spending bills and top-down legislation formulated in the midst of the COVID-19 pandemic.
2022 Physician Fee Schedule Final Rule
Each year, the Centers for Medicare & Medicaid Services (CMS) releases rules on physician reimbursement. It uses recommendations from the AMA Relative Value Schedule Update Committee (RUC) to guide decisions on how to pay physicians from a single pot of money. In 2021, the CMS increased the value of certain Current Procedural Terminology (CPT) codes, including those often used by subspecialties, and modified documentation requirements to reduce administrative burdens. In the 2022 Physician Fee Schedule (PFS) Final Rule, rheumatologists maintained a boost in reimbursement. In this zero-sum game, other specialties were not as fortunate, with losses in surgery, radiology and physical therapy.