Health Equity
Medicaid Enrollment Touches 39% of the Residents of The District of Columbia; DC’s 70/30 FMAP is Vital for the Maintenance of Health & Human Services
A reduction in the District’s FMAP would not lead to long-term government savings and would have a ripple effect throughout the entire health system in the DMV, crippling access to care for not only Medicaid beneficiaries but also all those who live, work, and visit the District of Columbia, including members of Congress and their staffs.
.png?sfvrsn=9ac2d21b_0 "What Medicaid Cuts Actually Cost")
Why does DC receive an Enhanced FMAP Rate?
The DC FMAP rate of 70% established by the Revitalization Act resulted from bipartisan analysis, discussion, and negotiation by Congressional leadership aiming to balance fairness with the District’s restricted ability to generate revenue. Congress recognized that the District of Columbia faces unique financial challenges due to its non-state status and the significant amount of federally-owned land within its boundaries. The District is unable to tax non-residents’ earnings, so these workers pay no taxes to support the infrastructure and services, such as roads, public safety and emergency services that they benefit from in the District. The District is also unable to tax up to 40% of the real property within its borders due to statutory restrictions.
Why are we concerned about DC's FMAP now?
Members of Congress have proposed reducing the DC FMAP to the statutory minimum for all other states, which is currently 50% (but could be reduced even more). Such a change would impact every physician and every practice, regardless of type, location, and payers contracted. Even practices who take no insurance will not be able to send patients for specialist care, hospital admissions, or other types of care.
What can MSDC members do?
- If you know a member of Congress or staffer, reach out to them and share how DC cuts will hurt your patients.
- Share your relationships and outreach with hay@msdc.org so we can help coordinate advocacy efforts.
- Email hay@msdc.org if you would like to be paired with a physician member of Congress office and trained by MSDC staff on how to reach out.
Resources
- DC FMAP cut fact sheet
- California Medical Association fact sheet on Medicaid cuts
- MSDC and healthcare association letter to Congress arguing against DC FMAP changes.
- MSDC original story on Medicaid changes.
News, Statements, and Testimony on Health Equity Issues
MSDC Applauds Councilmember Cheh and Colleagues for Introducing Prior Authorization Reform Bill
Washington, D.C., February 15, 2022 – The Medical Society of the District of Columbia (MSDC), the largest medical organization in the District representing metropolitan Washington physicians, applauds Councilmember Mary Cheh for introducing B24-0655, the Prior Authorization Reform Amendment Act of 2022, and thanks co-introducers Councilmembers Allen, Bonds, Gray, and Lewis George. MSDC and its allies have fought to streamline prior authorization for ten years. As MSDC member Dr. Angus Worthing said, “This is the tenth anniversary of something that shouldn’t have a tenth anniversary.”
More than forty states have already passed legislation to reform prior authorization, a major impediment to timely patient care that raises the time and cost for treatment. According to the American Medical Association’s (AMA) 2021 nationwide physician survey, 93% of physicians report delays in care due to prior authorization requirements and 82% said prior authorizations can at least sometimes lead to abandoning care. In addition, 34% of physicians report that prior authorizations have led to a serious adverse event for a patient in their care. On average, physicians and their staff spend 13 hours a week (almost two business days) on prior authorizations.
Dr. Kirstiaan Nevin, President of the Medical Society of DC, said “MSDC is grateful to the Councilmembers, especially Councilmember Cheh, who introduced this legislation. Prior authorization is one of the biggest impediments to patient care, and this legislation would allow physicians to treat their patients without unnecessary paperwork and delays. We look forward to working with the Council and partners in passing this important bill.”
Councilmember Cheh’s introduction statement notes that, “prior authorization requirements mean that an insurer is able to overrule the treatment prescribed by a patient’s medical provider – and make that determination without ever seeing the patient or their medical records. While insurers may claim that prior authorization is currently required for only complex procedures, a growing number of basic, everyday treatments require prior authorization.”
# # #
Media Contact:
Pia Duryea
Medical Society of the District of Columbia
duryea@msdc.org
(202) 355-9414
About the Medical Society of the District of Columbia
With over 3,100 members, the Medical Society of the District of Columbia (MSDC) is the largest medical organization representing metropolitan Washington physicians in the District of Columbia. The Medical Society, founded in 1817, is the leading voice of medicine and public health advocate on issues impacting the diverse population of our Nation’s Capital. MSDC is dedicated to ensuring the well-being of physicians and their patients in metropolitan Washington. For more information, visit msdc.org.
Leave a comment