Here is a quick rundown of major issues being discussed by policymakers from an endocrine perspective and the Society’s current advocacy work. 

What is Happening in Washington

And now for some news not involving Omarosa: The Federal Budget may not sound sexy, but it is about to return to be the focus in Washington

The U.S. Senate returned to Washington on Wednesday after a short one-week recess.  The Labor-HHS-Education appropriations measure (S 3158), which includes funds for the National Institutes of Health (NIH) is poised for action. The health agency spending bill is paired in a package with the Defense measure (S 3159). A vote on the funding package is now expected to occur early next week.

The White House isn’t (yet) threatening to veto the Senate Defense/Labor-HHS package if it makes its way through both congressional chambers, but administration officials are making it very clear they feel left out of the process and are unhappy that their budget proposals are largely being ignored.  In a Statement of Administration Policy (SAP) issued this week, the Trump administration was critical of what it views as “wasteful” or “duplicative” domestic programs, noting that the Labor-HHS bill does not include numerous administration proposals aimed at reducing spending and improving program effectiveness and the administration’s interest to lower (aka cut) nondefense spending. The statement asks lawmakers to engage with administration officials to work on reducing spending levels below the cap that was set six months ago in the Bipartisan Budget Act of 2018.

What We are Working On

Taking Action on Funding for NIH – As noted above, the Senate is now scheduled to vote on or about August 20 on the Fiscal Year 2019 appropriations bill that includes funding for the NIH. We are advocating for $39.3 billion for the NIH.  We have sent an action alert to all U.S. member researchers. We have also sent a special member to Endocrine Society journal authors who are NIH funded.  We hope to get 100% APOCC participation in our campaign.

Weighing in on Physician Payment Changes – The Centers for Medicare and Medicaid Services (CMS) is collecting comments on its 2019 Medicare Physician Fee Schedule proposed rule. The proposed rule is causing great concern in the physician community because it includes significant revisions to the way that evaluation and management (E/M) services would be reimbursed and documented. (Read our summary here.)  We oppose CMS’s approach to reduce the reimbursement for the E/M codes that account for the most complex services.

While CMS did propose new add on codes to address prolonged visits, we do not believe these codes will be used by a significant number of endocrinologists because of the time requirements. We also believe that consolidating the E/M codes would penalize specialists, like endocrinologists, who treat more complex patients and require a higher degree of documentation regardless of Medicare’s requirements for billing. We are working with the Clinical Affairs Core Committee (CACC) to prepare comments (due September 10) that request a delay in the implementation of the proposal and an alternative proposal that recognizes the work of cognitive specialists provide.

Working with the Environmental Protection Agency (EPA) – This week we had a call with staff from the EPA Office of Science Coordination and Policy to discuss the latest developments and plans for the Endocrine Disruptors Screening Program (EDSP).  EPA staff highlighted upcoming opportunities for Endocrine Society members to share expert advice on new testing approaches and screening methods to identify EDCs. They also expressed appreciation for our activities to bring attention to the public health and ecological harms associated with EDCs.  We also sent a letter to the EPA encouraging the adoption of systematic review approaches in the evaluation of chemicals under the new Toxic Substances Control Act.  We asked EPA to be more specific and transparent in explaining how it will evaluate scientific research for potential harmful effects of chemicals and we recommended that EPA develop clearly-defined criteria for expert reviewers, including explicit policies governing conflicts of interest.

To find out how you can become more involved in endocrine advocacy, please contact [email protected].