Know Your Rights: Timely filing denials

August 24, 2015
Area(s) of Interest: Advocacy GME Funding 

August 24 to 28 is the American Medical Association’s (AMA) “Save GME Action Week.” During this week, AMA is asking medical students and residents to urge Congress to protect funding to protect and expand graduate medical education (GME) programs and ensure we are training enough physicians to meet current and future demand.

The United States is facing a severe shortage of doctors, which is expected to get exponentially worse as the population continues to grow and our aging physician workforce moves toward retirement. It is projected that by 2025 we will have up to 90,000 fewer physicians than the country needs. While advances in technology and workflow will certainly make physicians more efficient over time, the need for more doctors is still larger than ever to take on the current challenges in the health care system.

GME is the hands-on training phase of physician education that is mandatory in order for physicians to obtain licenses for independent practice. During this clinical training, residents also provide needed care for one out of every five hospitalized patients, including our seniors, veterans and patients in underserved communities.

With a growing demand for health care services, cuts to federal funding for physician residency programs will only worsen physician shortages across the country. Workforce experts predict a physician shortage of 62,900 as soon as 2015, which will increase to 130,000 by 2025.This shortage increases demand on our health care delivery system as more seniors begin to join the Medicare program and newly insured Americans seek access to care.

Although federal, state and private funds pay for GME, federal contributions through Medicare make up the bulk of the funding, about $9.5 billion annually nationwide. This figure hasn’t changed in nearly 20 years. Inadequate funding for residency programs means that last year, 440 U.S. seniors in M.D. programs did not find a residency spot – and that needs to change!

During “Save GME Action Week” medical students and residents across the country are urging Congress to help alleviate this problem and protect our most vulnerable patients by retaining Medicare support and federal funding for GME.

AMA and the California Medical Association are supporting two legislative initiatives: the Resident Physician Shortage Reduction Act of 2015 (H.R. 2124/S. 1148) and the Creating Access to Residency Education Act of 2015 (H.R. 1117). AMA is seeking additional champions in Congress as well as innovative solutions to help advance this critical issue, which will dramatically affect access to health care for the entire country.

For more information and details on how you can get involved, including sample letters, tweets and talking points, visit www.savegme.org.


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