US Lawmakers Express Strong Support for AAPI’s Legislative Agenda During AAPI’s Legislative Day on Capitol Hill

AAPI’s legislative agenda during aapi’s legislative day on Capitol Hill

Released: 31-Mar-2014 12:00 PM EDT
Source Newsroom: American Association of Physicians of Indian Origin (AAPI)
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Newswise — (Washington, DC: March 28th, 2014) Physician Shortage, J-1 Visa Waiver Program, Immigration Reform, Permanent Fix to the Medicare SGR, Medical Liability Reform, Tuberculosis Prevention and Funding, and Support for the Nomination of Dr. Vivek H. Murthy as Surgeon General of the United States were part of the Legislative Agenda for 2014 discussed during the annual Legislative Day, organized by the Association of American Physicians of Indian Origin (AAPI), the largest ethnic organization of physicians, representing over 100,000 physicians of Indian origin on Capitol Hill, Washington, DC on March 26th and 27th, 2014.

In their efforts to make their voices heard on Capitol Hill, particularly on issues relating to healthcare, over 120 members of AAPI from around the nation shared of the need to fix the many vital healthcare issues that confront the physicians in the US, even as the nearly two dozen US Lawmakers from both the Parties endorsed AAPI’s agenda and expressed strong support, while promising to do the needful in the US Congress.

AAPI’s Legislative Day and Reception on “Doctors Making a Difference” began with a Indian Buffet Dinner Reception at Rayburn House Office Building on Capitol Hill on Wednesday, March 26th, 2014. In his keynote address, India's Ambassador to the United States, Dr. S. Jaishankar, praised the Indian American community, and in particular, the physicians of Indian origin, for their great achievements and contributions to the their motherland, India, their adopted land, the US and in a very significant way to the transformation of the Indo-US relations. He emphasized the key role AAPI’s Global Healthcare Summits have made in transforming the delivery of healthcare system in India. “If India has changed, the credit goes to you the physicians of Indian origin,” he said. “You have made a change in the perception of India in the US by your hard work, commitment and great achievements. And we are truly grateful to you,” he added.

In her keynote address on Thursday, March 27th, Assistant Secretary of State, Nisha Desai Biswal, the Obama administration's point person for South Asia, praised the Indian American physicians and the broader Diaspora community for not just being catalytic in fostering the India-United States relationship, but for being the solid anchor that sustains this partnership through good times and bad. “AAPI has been a tremendous organization for what you do here in the United States and for what you do in India and for what you do to improve and extend the US-India relationship,” she said.

Among the areas of cooperation between the two nations, she referred to India’s “partnership with the United States on the Global Call for Action on Child Survival, which was a global effort to end preventable child deaths.” Biswal hailed India for being “a leader and a partner on so many health innovations and we are working together, like I said, in advancing health issues in India, but then also partnering with India on taking these innovations globally. These are all indicators of how important and valued this relationship is for both countries but also the future trajectory, which is on a very positive path.” She acknowledged that, “All of this is possible because of the very early investments that all of you have made over the decades, and your continued engagement and activism is most welcome and always, always, needed.”

Rep. Jim McDermott, MD (D-WA), co-chair of India Caucus in the US House, acknowledged the “need to fix to the Medicare sustainable growth rate (SGR) formula.” While responding to AAPI leaders referring to the temporary Bill passed in January 2013, averting a 26.5 percent cut, which expires in April 2014. Rep. Steny Hoyer, Chief Democratic Party Whip, pointed out that everyone in the Congress is in agreement that the SGR be fixed permanently. However, the difference is about to how to pay for the increase in healthcare cost that is estimated to be $134 Billion when SGR is fixed.

Rep. Tulasi Gabbard, who began the deliberations on March 27th, while acknowledging the need for a permanent fix to SGR, said, “We don’t allow it to lapse, without fixing. The way we get this done is through discussion and respect for each other’s views, working out the differences.” Rep. Tom Price, MD (R-GA) said, “Healthcare problem is not a Republican or a Democratic problem, It is an American problem and we will need to work together and find amicable solutions to it.” Congresswoman Tammy Duckworth (D-IL), a double amputee, surviving a crash during Operation Iraqi Freedom, spoke eloquently of the need to fix the immigration system, the SGR formula and of the need to increase the Residency Slots in order to meet the growing demand for physicians.

Rep. Joe Wilson, said, “I have born with a deep appreciation for the Indian American community in the US, and I join you today to have a permanent fix to SGR.” While referring to Members of both the Parties coming together to address and express support for AAPI’s agenda, he said, “You have brought together people who never talk to one another.” Rep. Joe Crowley lamented that the US has not been working towards meeting the growing demand for Doctors by educating and raising the Residency Slots in the country. “Our country has the best, the finest, bravest physicians in the whole world,” he said. While referring to the Indian elections, he praised the peaceful transfer of power through the largest democratic exercise in the world.

Rep. Andy Barr (R-KY) and Rep. Ami Bera, M.D. (D-CA), in their remarks, referred to the bipartisan Bill they both introduced in the US Congress, Saving Lives, Saving Costs Act. “This legislation would lower healthcare costs and improve patient care by reducing medical malpractice and insurance fraud using evidence-based guidelines developed by doctors,” Barr said. “Doctors who practice using these guidelines would be eligible for liability protection, known as a “safe harbor,” if the case involves a federal statute or if federal money was used to pay for care,” Dr. Bera added.

Ambassador Taranjit Singh Sandhu, Deputy Chief of Mission - Embassy of India, in hid address, said, “AAPI was one of the first Indian groups to recognize the need for outreach on the Hill. He urged AAPI to continue with the outreach, while crediting the Diaspora for enhanced Indi-US relations, contributing to the advance in global peace and prosperity.

Dr. Jennifer Flood, President of the National Tuberculosis Controllers Association, urged AAPOI delegates to support the initiative to control and prevent tuberculosis throughout the nation and the world. In his response, Dr. Shah referred to AAPI cosigning two coalition letters to Congress on Tuberculosis prevention in December 2013. The first one supported USAID's international TB prevention work and the second one focused on domestic TB prevention by the Centers for Disease Control (CDC).

Rep. Frank Pallone, who was the last speaker of the event, admitted that the gridlock in the US Congress has resulted in many important initiatives not succeeding in the Congress. He along with the other Congressmen promised to work in a bi-partisan way, reforming the immigration system, fixing the SGR formula permanently and the liability reforms.

The Indian Buffet Reception on Capitol Hill on March 26th was addressed by: Rep. Alan Nunnelee (R-MS); Rep. Zoe Lofgren (D-CA); Rep. Tom Price, MD (R-GARep. Steny Hoyer (D-MD); Rep. Phil Gingrey, MD (R-GA); Rep. Ed Royce (R-CA); Rep. Joe Heck, DO (R-NV); Rep. Tammy Duckworth (D-IL); Rep. Gregg Harper (R-MS); and Rep. Mike Honda (D-CA).

Among the US lawmakers who addressed the AAPI delegates and endorsed AAPI’s agenda on several issues, during the conference on March 27th included Rep. Ed Royce (R-CA), Chairman – House Foreign Affairs Committee;. Zoe Lofgren (D-CA), Ranking member, Immigration Subcommittee and House Judiciary Committee, Rep. Alan Nunnelee (R-MS); Rep. Phil Gingrey, MD (R-GA); Rep. Ed Royce (R-CA); Rep. Joe Heck, DO (R-NV); Rep. Tammy Duckworth (D-IL); Rep. Gregg Harper (R-MS); Rep. Mike Honda (D-CA); Rep. Doris Matsui (D-CA); Rep. Judy Chu (D-CA); Rep. John Delaney (D-MD); and Rep. Steve Israel (D-NY).

Underscoring the tremendous contributions of the 100,000 strong Indian American community in delivering the healthcare in the US, they praised the NRI Doctors for their hard work, commitment to patients and their constant efforts to make health care affordable, accessible and efficient for everyone in this country. The Congressmen were highly appreciative of AAPI’s presence on the Hill during the SGR vote in the US Congress. “Unfortunately a Temporary Patch for one year with delay in ICD 10 implementation was voted by a voice vote in the Congress,” Rep. Pallone announced with a grim voice, while promising to work towards a permanent fix to SGR formula in the coming months.

“AAPI has been seeking to collectively shape the best health care for the people of US, with the physician at the helm, caring for the medically underserved as we have done for several decades when physicians of Indian origin came to the US in larger numbers,” said Dr. Jayesh Shah, president of AAPI. “AAPI was abler to draw the attention and elicit support from US lawmakers on Medicare SGR, Immigration Reform, Combating Obesity, Implementation of Affordable Care Act and of course on growing US-India relations.” He reminded AAPI members that, their “presence today has made it possible for us to be part of the process in the implementation of the health care reform in this country.” Dr. Shah promised that AAPI will continue to advocate for permanent fix of SGR formula in the coming months.

Dr. Harbhajan Ajrawat, chair of AAPI’s Legislative Committee, led a discussion on the Affordable Care Act and the need for Liability Reforms. Dr. Ajrawat, while referring to AAPI’s efforts to reach out to US Senators in support of Surgeon General Nominee of President Obama, Dr. Vivek Murthy, urged AAPI leaders to meet with their Congressmen and Senators, urging them to support his nomination on the Floor of the Senate, when it comes to vote.

Dr. Sampat Shivangi, co-chair of AAPI’s Legislative Committee, while summarizing the deliberations said, “In addition to the need for immigration reform, which will benefit millions of immigrants and their families, AAPI has been able to draw the attention of the Congressmen on several important issues that confront the physicians across the nation.”

Dr. Shashi Shah, Chairman of the Board of Trustees of AAPI, urged the members of Congress to include physicians graduating from U.S. residency programs for Green Cards in the comprehensive immigration reform bill. “Physicians graduating from accredited U.S. residency programs should also receive similar treatment. Such a proposal would enable more physicians to be eligible for Green Cards and address the ongoing physician shortage,” Dr. Seema Jain, Vice-President of AAPI, said.

Dr. Ravi Jahagirdar, President-elect of AAPI, said, “AAPI has once again succeeded in bringing to the forefront the many important health care issues facing the physician community and raising our voice unitedly before the US Congress members.” He gave an overall view of the many programs he has planned for AAPI as he is preparing to lead AAPI during the Convention in Texas in June this year.

For more information on AAPI’s the Legislative Day, please visit: http://www.aapiusa.org/calendar/event/365.aspx

Captions:

1. Rep. Steny Hoyer addressing the AAPI delegates during AAPI Legislative Day Dinner Reception on Capitol Hill on March 26th, 2014
2. Dr. S. Jaisankar, India’s Ambassador to the US, delivering keynote address on Capitol Hill
3. Assistant Secretary of State, Nisha Desai Biswal, the Obama administration's point person for South Asia
4. Rep. Andy Barr (R-KY) and Rep. Ami Bera, M.D. (D-CA) along with AAPI leaders on Capitol Hill
5. Sections of the audience during the Legislative Day on Capitol Hill

AAPI’s Legislative Initiatives

1) Physician Shortage

a) Increase Residency Positions
In the 113th Congress, AAPI strongly supports the “Resident Physician Shortage Reduction Act of 2013,” introduced by U.S. Congressman Joe Crowley (D-NY) (H.R. 1180) and U.S. Senator Bill Nelson (D-FL) (S. 577), which would provide an additional 15,000 residency positions in Fiscal Years 2015-2019. Our nation is currently experiencing a physician shortage, which will be exacerbated by retiring baby boomers. The result of such a shortage may affect thousands of patients’ access to a physician, and ultimately the health care they need. The only way to address this future crisis is to increase the number of residency positions available for future physicians to get trained, so that our nation can effectively manage the need for increased patient care. Increasing the size of medical school classes is not enough. There must be a simultaneous increase in the size of residency positions to train these future doctors. As Congress capped the number of residency positions in 1997, it is time for Congress to act NOW to remedy this critical situation. AAPI believes that ALL Americans have the right to see a physician.
Recommendation: AAPI urges members of Congress to cosponsor H.R. 1180 and S. 577

b) Increase the Size of Entering Medical School Classes
From 1980-2005, while medical school enrollment remained flat, the U.S. population increased by more than 70 million people. Because the percentage of baby-boomer generation doctors (55 and older) rose from 27 percent to 34 percent during this time, the Association of American Medical Colleges (AAMC) predicts that America will need 90,000 physicians by 2020. The number of physicians needed by 2025 according to the AAMC will reach a staggering 130,000. One way to address this shortage is to increase medical school class sizes to meet this future health care need. This issue is vital as it pertains to health care reform, as more physicians will be needed to provide quality health care to our nation’s uninsured patients.

2) Immigration Reform

a) Include Physicians Graduating from Accredited U.S. Residency Programs for Green Cards
As part of comprehensive immigration reform, a proposal may include international students graduating with degrees in science, technology, engineering and mathematics (STEM) being fast-tracked for Green Cards. This proposal enables highly-skilled workers to remain in the United States after receiving their higher education in America. Physicians graduating from accredited U.S. residency programs should also receive similar treatment. Such a proposal would enable more physicians to be eligible for Green Cards and address the ongoing physician shortage. These physicians would still be required to meet all U.S. licensing standards before they could officially practice medicine. Hospitals and physician practices would be able to quickly hire qualified physicians who can make an immediate impact in local communities. They can forgo years of waiting in line for a Green Card, thousands of dollars in attorney fees and do what they know best – practice medicine and take care of patients.
Recommendation: AAPI urges members of Congress to include physicians graduating from U.S. residency programs for Green Cards in the comprehensive immigration reform bill.

b) Make the J-1 Visa Waiver Program Permanent
In the 112th Congress, AAPI helped secure the introduction of the “Doctors for Underserved Areas in America Act,” (H.R. 2805), by U.S. Rep. Zoe Lofgren (D-CA), which would make the J-1 Visa Waiver Program permanent. The J-1 visa gives international medical graduates the opportunity to perform their medical training and residency in the United States. Once their training is over, they must return to their home country for two years before becoming eligible to reenter the United States. Under the waiver program, a physician can waive the two-year requirement by agreeing to work in a medically underserved area for three years. The waiver program has greatly benefited local communities by giving them access to critical health care by a U.S.-trained physician. Congress has repeatedly passed legislation reauthorizing the program, and making the waiver program permanent would bring certainty to the system. Legislation has been introduced in the Senate to make the waiver permanent by U.S. Sen. Amy Klobuchar, the “Conrad State 30 and Physician Access Act” (S. 616).
Recommendation: AAPI urges members of Congress to cosponsor legislation making the J-1 Visa Waiver Program permanent when it is reintroduced in the House and to cosponsor S. 616

3) Provide a Permanent Fix to the Medicare SGR
AAPI supports Congress providing a permanent fix to the Medicare sustainable growth rate (SGR) formula. In January 2013, Congress passed a temporary patch to avert a 26.5 percent cut, which expires in 2014. For more than a decade, Congress has delayed passing a permanent fix. Without such a fix, physicians’ reimbursements will be cut by nearly 27 percent next year. This will detrimentally affect physicians’ ability to provide critical health care to patients. Congress can and should fix the Medicare SGR formula without cuts to physicians’ reimbursements to give certainty to the Medicare system. AAPI supports the bipartisan “Medicare Physician Payment Innovation Act of 2013,” (H.R. 574) which would bring certainty to the reimbursement system by eliminating the complex sustainable growth rate system, provide five years of consistent payments to physicians and test new payment models that would take into account the numerous changes that have occurred in our health care delivery system.
Recommendation: AAPI urges members of the House to cosponsor H.R. 574 to bring certainty to the Medicare reimbursement system

4) Medical Liability Reform
AAPI supports a healthy doctor-patient environment by curbing aggressive litigation targeting physicians. Such lawsuits have had a chilling effect and driven up the cost of health care, through extra testing and the practice of defensive medicine. In the 112th Congress, The “Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act of 2011,” (H.R. 5) limited the conditions for lawsuits and punitive damages for health care liability claims. It established a statute of limitations and limited noneconomic damages to $250,000. AAPI signed a coalition letter led by the American Medical Association to the Deficit Reduction Committee, which noted that the Congressional Budget Office estimated the cost savings from implementing medical liability reform, including limits on noneconomic damages, to be $62.4 billion over 10 years. Fewer physicians today practice in areas such as obstetrics and gynecology, surgery and emergency medicine, due to increased lawsuits and increasing malpractice insurance premiums.
Recommendation: AAPI supports federal and state legislation that places effective caps on non-economic damages, limits the use of joint-and-several liability, provides physicians with flexibility to negotiate settlements with medical insurers and limits the statute of limitations for filing medical malpractice claims.

5) Tuberculosis Prevention and Funding
AAPI cosigned two coalition letters to Congress on Tuberculosis (TB) prevention in December 2013. The first one supported USAID's international TB prevention work and the second one focused on domestic TB prevention by the Centers for Disease Control (CDC). Please see theUSAID letter here and CDC letter here. We fully support TB prevention and funding both domestically and overseas in countries like India.

6) Nomination of Dr. Vivek H. Murthy as Surgeon General of the Untied States
AAPI fully supports the nomination of Dr. Vivek H. Murthy as Surgeon General of the United States. Dr. Murthy has impeccable academic credentials and has been a longtime supporter of advancing health care across the United States. He has also worked tirelessly to support health care initiatives in rural India through his volunteerism and entrepreneurship.

AAPI sent letters to all the members of the Senate Health, Education, Labor, and Pensions Committee. Additionally, AAPI President Dr. Jayesh B. Shah led a team of AAPI members on Capitol Hill the day before Dr. Murthy's confirmation hearing, to meet with key Senators, urging them to support his confirmation.


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