Administrative Burden Advocacy
ACOG provides behind-the-scenes support for ob-gyns in all practice settings by working with federal policymakers to ensure minimal administrative burden. Through advocacy and policy analysis, ACOG provides recommendations and meets with federal career staff to ensure the perspective of the physician is considered.
Medicare & Medicaid
Medicare policies set the standards for Medicaid and third-party payers.
ACOG actively advocates with the Centers for Medicare & Medicaid Services (CMS) on issues such as:
- Physician payment
- Patient eligibility, enrollment and coverage
- Patients over Paperwork program
- Alternative payment models and value-based payment
- Quality metrics
- Health IT and interoperability
- Practice regulations (eg, physician self-referral and antikickback)
- Inpatient and outpatient hospital regulations
- Post-acute care (eg, home health, hospice)
- Open payments program (physician disclosure of financial relationships)
- National coverage determinations (NCDs) and Local coverage determinations (LCDs)
- Medicare Advantage policies
- Federal Medicaid policies
- Provider enrollment simplification
The Medicare Physician Fee Schedule sets national payment rates and policies that are applied to Medicaid programs and TRICARE (military health care program). The rates and policies serve as a baseline for third-party payers and affect all patients and physicians, regardless of payer sources or patient mix.
Other Federal Agencies
ACOG monitors proposed regulations and polices that may affect physician practice. Departments, agencies and federal policymakers include:
- US Department of Health and Human Services
-Food and Drug Administration (FDA)
-Centers for Disease Control and Prevention (CDC)
-Agency for Healthcare Research & Quality (AHRQ)
-Health Resources and Services Administration (HRSA)
-Office of the National Coordinator for Health Information Technology (ONC)
-Substance Abuse and Mental Health Services Administration (SAMHSA)
-National Institutes of Health
-Office of the Inspector General
- Medicare Payment Advisory Commission (MEDPAC)
- Medicaid and CHIP Payment and Access Commission (MACPAC)
- National Association of Medicaid Directors
- National Academies of Sciences, Engineering and Medicine
Third-party, private insurance payers issue national coverage policies. ACOG is establishing relationships with national policy makers to provide recommendations to third-party payer national coverage policies to ensure consistency with ACOG clinical practice guidelines.
We are engaged with payers on topics including prior authorizations, coverage of genetic tests, and surgical care.