As many of you know, KAAP recently sent out an alert to members after our National office notified us about a problem with the Medicaid coding of immunizations during office visits. We instructed providers to use the 25 modifier. The AAP Department of Federal Affairs staff has been working very hard to get this rescinded. CMS has just announced that they will allow each state to drop this requirement on an individual basis. It would seem much easier for this to be done on a national level but CMS is holding back. AAP President Tom McInerny, MD, FAAP has sent a letter to HHS Secretary Sebelius asking her to change this immediately. The DOFA staff is continuing to work on this issue.

Gun violence has taken a prominent position in discussions at the Federal level following the tragedy at Sandy Hook Elementary School. The AAP has supported President Obama's recommendations on preventing gun violence and AAP president Tom McInerny, MD, FAAP has spoken out on numerous occasions detailing the AAP policies concerning this issue. While most of the discussion has centered on assault weapons, high capacity magazines and mental health services one of the lesser known but important policies that the AAP has supported is to stop the restrictions that are currently in place on firearm research. On a similar note, the AAP worked to get a clarification concerning the ACA and providers discussing firearms with patients and parents. The Administration has indicated the ACA does not prohibit such discussions.

Below is a summary of the AAP policies concerning reduction of firearm tragedies taken from the website:

Firearm Safety

Enact stronger gun laws, including an effective assault weapons ban; mandatory background checks on all firearm purchases; and a ban on high-capacity ammunition magazines. 

Prevention and Public Health

Allow federal agencies to conduct research on the causes and prevention of gun violence, and stand by the President's clarification that the Affordable Care Act does not prohibit doctors from asking their patients about guns in the home. 

Access to Mental Health Services

Improve the identification of mental illnesses through increased screening, addressing inadequate insurance coverage and high out-of-pocket costs that create barriers to access, strengthening the overall quality of mental health access, and expanding the Medicaid reimbursement policy to include mental health and developmental services.

Reducing Gun Violence in the Media and Educating Children

Develop quality, violence-free programming and constructive dialogue among child health and education advocates, the Federal Communications Commission, and the television and motion picture industries, as well as toy, video game, and other software manufacturers and designers, to reduce the romanticism of guns in the popular media as a means of resolving conflict.

Just as at the state level, budget discussions are ever present in DC. The Washington staff works hard to assure that the projected cuts do not harm the children of our country. This seems to be a never ending battle, but one that is vitally important.