AHA Annual Membership Meeting 2024 Advocacy Messages Card

America’s hospitals and health systems provide high-quality care to all patients in every community across the country.

However, hospitals and health systems continue to face unprecedented challenges, including workforce shortages, soaring costs of providing care, severe underpayment by Medicare and Medicaid, and overwhelming regulatory burdens. These challenges are jeopardizing patients’ access to 24/7 care and services.

Your mission on Capitol Hill is to urge Congress to:

1. Reject funding cuts and extend key policies to ensure patients’ access to care.
2. Support and strengthen the health care workforce.
3. Hold commercial insurers accountable for practices that delay, deny and disrupt care.
4. Bolster support to enhance cybersecurity of hospitals and the entire health care system.

1. Reject Funding Cuts and Extend Key Policies to Ensure Patients’ Access to Care

Reject Harmful Site-neutral Payment Policies

• Reject Medicare cuts to hospital care that threaten patients’ 24/7 access to essential health services, especially in rural and underserved communities.
• Site-neutral proposals fail to recognize that hospital outpatient departments: treat sicker, lower-income Medicare patients with more complex and chronic conditions than those treated in independent physician offices or ambulatory surgery centers; maintain emergency stand-by services such as ICUs; and are held to stricter regulatory and safety requirements than other sites of care.
• Medicare already severely underpays hospitals for the care they provide to patients. In 2022, Medicare paid a record low 82 cents for every dollar spent by hospitals caring for Medicare patients, resulting in about $100 billion in Medicare underpayments that year alone.

Prevent Medicaid DSH Cuts

• Address the billions in Medicaid disproportionate share hospital cuts scheduled to begin Jan. 1, 2025. Without congressional action, these hospitals will find it challenging to serve patients and their communities.

Protect Access to Care in Rural Communities

• Pass legislation to extend the Medicare-dependent hospital program and enhanced low-volume adjustment program, which are set to expire on Dec. 31, 2024.

Protect the 340B Drug Pricing Program

• Protect the 340B program from any harmful changes to ensure access to more affordable drug therapies and programs that advance health.

Extend Telehealth and Hospital-at-Home Programs

• Extend or make permanent coverage of certain telehealth services made possible during the COVID-19 pandemic, as well as create a permanent hospital-at-home program.

Create a Metropolitan Anchor Hospital Designation

• Create a new designation of metropolitan anchor hospital for certain hospitals that provide critical health care services to marginalized and underrepresented communities.

2. Support and Strengthen the Health Care Workforce

Urge Cosponsorship of the SAVE Act

• Urge your senators and representatives to cosponsor the Safety from Violence for Healthcare Employees (SAVE) Act (H.R. 2584/S. 2768), which would provide federal protections for health care workers similar to those that apply to aircraft and airport workers. Although hospitals and health systems have worked diligently to establish protocols and programs to protect employees and promote a safe environment for patient care, violence against health care workers has escalated in recent years.

Mitigate Health Care Provider Shortages

• Enact the Healthcare Workforce Resiliency Act (H.R. 6205/S. 3211) that would recapture 25,000 unused employment-based visas for foreign-born nurses and 15,000 for foreign-born physicians to help address staffing shortages.
• Pass the Conrad State 30 and Physician Access Reauthorization Act (S. 665/H.R. 4942) to extend and expand the Conrad State 30 J-1 visa waiver program, which waives the requirement to return home for a period if physicians holding a J-1 visa agree to stay in the U.S. for three years to practice in a federally designated underserved area.

Support America’s Front-line Workers

• Reauthorize the Dr. Lorna Breen Health Care Provider Protection Act through 2029 to provide grants to help health care organizations offer behavioral health services for front-line health care workers.

3. Hold Commercial Insurers Accountable for Practices that Delay, Deny and Disrupt Care

Streamline Prior Authorization

• Enact efforts to streamline prior authorization requirements and operations to facilitate patients’ access to timely care, reduce burdens on health care providers and decrease administrative costs.

Require Insurers to Promptly Pay for Care Provided

• Enact policies to increase oversight and accountability of commercial health plans, including establishing more stringent standards for timely payment to address certain insurer tactics that delay and deny payment to health care providers.

Enhance Oversight of Commercial Insurers

• Support appropriate federal oversight of anticompetitive deals and business conducted by large commercial health insurance companies, including continuing to press the Department of Justice’s Antitrust Division to challenge anticompetitive deals.

4. Bolster Support to Enhance Cybersecurity of Hospitals and the Entire Health Care System

Strengthen Cybersecurity Efforts

• Hospitals have invested billions of dollars and taken many steps to protect patients and defend their networks from cyberattacks that can disrupt patient care and erode privacy by the loss of personal health care data.
• Congress and the Administration should address cybersecurity challenges in the health care field holistically, including strengthening federal coordination and helping providers and business associates prepare for and respond to cyber threats.

Support for Voluntary Goals, Not Penalties

• Support federal voluntary cybersecurity performance goals that would be implemented by all facets of the health care sector.
• Oppose proposals for mandatory cybersecurity requirements and penalties being levied on hospitals as if they were at fault for the success of hackers in perpetrating a crime.
• Many recent cyberattacks against the health care system, including the Change Healthcare cyberattack, have originated from insecure third-party technology, business associates and other vendors – not hospitals. Singling out hospitals for regulation, imposing fines or cutting Medicare payments will not effectively mitigate the systemic cyber risk the entire sector faces. This would reduce hospital resources to combat cybercrime and be counterproductive to preventing cyberattacks.