Filibusters & Fine Print

Recorded live at AMGA's Annual Conference in Las Vegas, the Filibusters & Fine Print team breaks down the biggest challenges facing medical groups today — and what AMGA is doing about them. The discussion covers the AMGA MACRA and Value-based Care Task Force and its six-pillar reform framework, which is gaining traction on Capitol Hill. The team also shares an update on bipartisan legislation to fix the Chronic Care Management code and expand access to preventive care. This episode also covers how AMGA members can get involved, from the District Advocacy Program to Capitol Hill Day on June 10, no lobbying experience required.

In this special bonus episode of Filibusters & Fine Print, recorded live at AMGA's 2026 Annual Conference, Chet Speed is joined by the Public Policy team to share their five biggest takeaways from the week, from members reimagining care delivery from the ground up, to the growing urgency of physician advocacy engagement on Capitol Hill. The team also tackles a sobering reality: for many members, the financial math simply is not adding up. Tune in for an honest, energetic conversation straight from the conference floor. Additional details are available on the AMGA website.

Affordability reform is coming but will Congress support positive policy reforms or undermine it? In this episode, we examine the latest congressional hearing on provider-driven health care costs through an AMGA lens. As policymakers scrutinize pricing, consolidation, and payment differences, we explore how these debates intersect with AMGA’s core legislative and regulatory priorities.

The AMGA Public Policy Team unpacks the growing focus in Washington, DC on combating waste, fraud, and abuse in federal healthcare programs. The discussion explores recent actions from the Trump Administration, ongoing congressional investigations, and a high-profile House hearing examining the role of CMS in safeguarding Medicare and Medicaid.

The clinician shortage is hardly easy as pie and in this week's episode, the AMGA policy team unpacks why fixing it is even harder than it looks. The conversation connects two federal issues: the House Ways and Means Committee's recent hearing on the next generation of America's healthcare workforce and proposed federal student loan caps under the One Big Beautiful Bill Act that could make medical education harder to finance. From GME funding and rural training gaps to the Department of Education's narrow definition of "professional degree," the team explores how federal policy shapes the healthcare workforce pipeline and what AMGA is doing about it.

In this week’s episode, the AMGA policy team break down our recently sent letter to HHS Secretary Robert F. Kennedy, Jr. and share what Dr. Oz said during Health Care Value Week. The conversation covers the real cost of prior authorization burdens, why automated patient portal notifications are causing harm, and why Congress must act to make pandemic-era telehealth flexibilities permanent. The team also digs into the long-term decline in inflation-adjusted physician payment, the case for eliminating the outdated Medicare skilled nursing facility three-day rule, and what recent CMS moves could mean for the future of Advanced APMs and coordinated care. Hear what the administration is saying and where AMGA is pushing back.

The Trump Administration and Congress are interested in deploying artificial intelligence to improve health care. But what does that mean for providers and patients? The AMGA team turns the podcast over to Claudi.ai to outline our discussion on HHS policy, congressional action, and how providers are deploying AI.

Congress is concerned about affordability in healthcare and is looking at how administrative and regulatory complexity is contributing to higher costs. The AMGA team discussed two recent hearings on how payment instability and burdens such as prior authorization contribute to physician burnout. After the policy trio welcomes a surprise guest, they turned their attention to congressional interest in pharmacy benefit managers and where Congress might turn its attention to next.

When is Medicaid financing "money laundering" and when is it "creative financing"? The Trump administration just finalized rules that will cut $900 billion from Medicaid over the next decade—closing the "B1/B2 test loophole” and slashing State Directed Payments. In this episode, the AMGA Public Policy team unpacks two massive rule changes that are about to upend how states fund Medicaid: new restrictions on provider taxes and dramatic cuts to State Directed Payments. We're talking about these cutsaffecting everything from rural hospital survival to medical education funding. By the end, you'll understand why this isn't just about Medicaid, but about whether we're inadvertently dismantling the financial foundation of American healthcare, one policy change at a time.

What do oligopolies and "maxxxing" have in common? Health insurance executives testifying on Capitol Hill. In this episode of Filibusters and Fine Print, the AMGA Public Policy team dives deep into the explosive House hearings on healthcare affordability, breaking down what the heat on insurers really means for physicians, patients, and what's next for health policy on the Hill. Don't miss this timely analysis of the testimony everyone's talking about. Plus, Lauren returns.

This episode examines the administrative burden in American healthcare, where physicians spend an average of two full business days weekly on paperwork rather than patient care. Outdated regulations create unnecessary complexity, requiring extensive documentation for routine matters like approving basic medical equipment. In for Season 2, Episode 19, the AMGA policy team examines how this administrative waste costs billions annually while directly reducing time healthcare providers spend treating patients. The episode explores why the system has become so bureaucratic and its impact on both providers and patients.

Congress is facing another deadline of Jan. 30 to extend critical healthcare policies and programs. Join the AMGA public policy team for Season 2, Episode 17 of Filibusters and Fine Print as they add flavor to the critical healthcare extenders debate before Congress such as Medicare telehealth flexibilities, Hospital-at-Home, the GPCI floor, and Medicaid DSH cuts. This package is a little different as some of the extensions are for a few years which is longer than in past compromises, but AMGA keeps pushing for more permanent solutions. Time is ticking, Congress only has a few days before these policies face expiration and patients suffer. Additional details and all episodes are available on the AMGA website.

In our latest Filibusters & Fine Print episode, we break down CMS's Contract Year 2027 MA proposed rule—but the real story is the Request for Information asking fundamental questions about Medicare Advantage's future direction. With MA covering over half of Medicare beneficiaries, plans facing unexpected costs, providers caught between payment cuts and Congressional scrutiny through the "No Upcode Act," and a January 26, 2026 comment deadline approaching, this is a defining moment for the program. The AMGA team explains what CMS is asking about risk adjustment reform and Star Ratings overhaul, the gap between proposed burden reductions and what AMGA members actually need, and most importantly, what AMGA members should do before the comment deadline. Additional details and all episodes are available on the AMGA website.

Congress may have missed the memo that 2026 has arrived; they're still stuck in 2025 mode, and the clock is ticking toward a critical Jan. 30 deadline. Join the AMGA public policy team for the Season 2, Episode 15 of Filibusters and Fine Print as they break down the high-stakes healthcare extenders on the line: Medicare telehealth flexibilities, Hospital-at-Home, the GPCI floor, and Medicaid DSH cuts. What happens if Congress doesn't act? Spoiler alert: it's not good for patients, providers, or the healthcare system. Tune in for expert analysis, legislative tea, and a clear-eyed look at what's needed to stop the endless cycle of short-term patches and finally bring stability to healthcare policy. Additional details and all episodes are available on the AMGA website.

It's been a year of seismic shifts, hard-won victories, and unexpected chaos in healthcare policy. From the longest government shutdown in history to regulatory achievements, the AMGA Public Policy team has been in the trenches the whole way. In this special year-end episode of "Filibusters & Fine Print," the AMGA team counts down their top 10 accomplishments of 2025—and then debates live which achievement deserves the number one spot. Will it be protecting telehealth access during a government shutdown? Fixing Medicare's broken conversion factors? Or launching the MACRA Taskforce to reimagine physician payment for the future?

In episode #14 of Season 2 of "Filibusters & Fine Print," the AMGA team cuts through the seemingly disparate regulations of the Trump Administration and reveals four major policy themes shaping healthcare delivery: systematically shifting care to lower-cost settings, supporting Medicare Advantage as the future of Medicare, scaling mandatory alternative payment models that demonstrate measurable savings, and implementing transparency requirements that use private market rates to inform government payment. Rather than simply explaining what's changing, we explore the "why" behind these decisions—the financial logic, strategic priorities, and interconnected goals driving the administration's approach.

The 2026 Medicare Physician Fee Schedule Final Rule dropped on Halloween, and while it's not quite a horror show this year, it's far from a treat. For the first time, CMS split the conversion factor—creating separate rates of $33.5675 for qualifying APM participants (3.77% increase) and $33.4009 for non-qualifying providers (3.26% increase)—with most of the boost coming from last-minute congressional intervention. The team discussed welcome telehealth flexibilities and new remote patient monitoring codes, but concerns about the mandatory Ambulatory Specialty Model starting in 2027. The fundamental problem remains: Medicare payment rates have fallen 29% over two decades when adjusted for practice costs, and budget neutrality creates a zero-sum game among specialties. AMGA is advocating for systematic reform because the current pattern of annual crises and temporary patches is unsustainable and threatens Medicare beneficiary access to care.

The government shutdown is over, but what did it mean for health care and what's coming next? In this episode, the team breaks down the immediate impacts of the shutdown on Medicare and Medicaid claims processing, why healthcare providers were particularly vulnerable, and what's actually in (and notably missing from) the compromise funding deal that reopened the government. Our panel explores the political chess game that led to the shutdown, including Democrats' push for enhanced Premium Tax Credits that didn't make it into the final agreement. We discuss which critical healthcare policies got extended—including telehealth flexibilities, GPCI floors, Hospital at Home waivers, and Medicaid DSH cut delays—and what the claims reprocessing means for providers.

It's 11 PM on a Friday night, and you just received a portal notification: your test results suggest cancer. Your doctor won't be available until Monday. This is the unintended consequence of well-meaning federal rules designed to give patients faster access to their health information. In this episode, the AMGA public policy team explores the Cures Act's "information blocking" provisions and why immediate test results—delivered without context, counseling, or compassion—are causing real harm. From miscarriage notifications via text alert to cancer diagnoses released over the weekend, we examine the collision between technology and patient care. Four years after AMGA first raised concerns, we're still advocating for a middle ground that honors both patient access and quality care delivery.

Is $50 billion enough to save rural healthcare? In this episode, the AMGA team dives deep into the Rural Health Transformation Fund—a program born from the One Big Beautiful Bill Act that promises up to $500 million per state over five years. But there's a catch: the same legislation cuts almost $1 trillion from Medicaid over the next decade. Join the AMGA public policy team as we unpack what this means for rural hospitals on the brink of closure, the communities they serve, and why funding rural healthcare isn't just a rural problem. We'll explore the application requirements, the real impact of Medicaid cuts, and what Secretary Kennedy might prioritize as states compete for these critical funds.

The team sits down with incoming AMGA Chair Beth Averbeck to discuss her experience with palliative and hospice care, from both a clinical and policy perspective. Ensuring patient dignity and wishes at end of life presents a number of policy challenges, and Dr. Averbeck and the team discuss possible solutions.

In Season #2 Episode 8, the AGMA team discussed how the government shutdown is affecting healthcare. The team discussed how the shutdown is disrupting telehealth and hospital-at-home programs, how AMGA members are responding to the shutdown, and what the key political sticking points preventing a resolution are. Additional details and all episodes are available on the AMGA website.

In Season #2, Episode #7: The AMGA team discusses our regulatory priorities and how outdated regulations and rules hinder care and create administrative burden. The team compared some of them to “microwaving fish” in the staff break room. The team explained how Medicare rules and regulations can be updated, so they support care modern care delivery systems. Additional details and all episodes are available on the AMGA website.

In Season #2, Episode #6: The AMGA team discusses the government shutdown and the ramification for AMGA members. The team explain that while Medicare will continue to pay claims, several key healthcare flexibilities, such as telehealth, expired and need to be reauthorized. Additional details and all episodes are available on the AMGA website.

In Season #2, Episode #5: The AMGA team discusses the importance of developing relations with congressional staff and providing real-world experience and expertise. The team explains how offering concrete policy recommendations will go a long way to achieving policy aims. Additional details and all episodes are available on the AMGA website.

With another government shutdown looming, the AMGA team explains how the appropriation process is supposed to work, in the context of a viral TikTok trend.

HRSA’s new 340B model will test a rebate model for 340B drugs, requiring providers to file for a rebate rather than receiving an upfront discount. The AMGA discusses the ramifications of this change, along with CMS’ plan to accelerate a repayment plan as part of its proposed outpatient rule.

The AMGA Public Policy team discusses how CMS rhetoric on prior authorization does not match the details of its new model, which extends prior authorization into fee-for-service Medicare for the first time.

The AMGA Public Policy is Back for Season 2 of Filibusters and Fine Print and the fall congressional session. The team discusses AMGA's fall legislative priorities, funding deadlines and attempts to get Lauren to be more enthusiastic about the legislative session. Spoiler alert, it kinda works.

In Episode #27, “Two Rules Walk into a Podcast,” the AMGA team wraps Season 1 of Filibuster & Fine Print by discussing the highlights from the recently proposed 2026 Physician Fee Schedule and Outpatient Prospective Payment System rules, including CMS’ efforts to introduce an “efficiency adjustment.” Filibuster & Fine Print will be back in the Fall with more episodes. Additional details and all the episodes are available on the AMGA website.

The latest episode of Filibusters & Fine Print is now available. In Episode #26, “Law of the Land,” the AMGA team discusses the final negotiations and policies in the Big Beautiful Act law reducing access to care through changes to Medicaid and Affordable Care Act. Additional details and all episodes are available on the AMGA website.

The AMGA team explores what successful lobbying looks like and discusses the success of AMGA Capitol Hill Day in June. AMGA member advocacy opens doors to legislative possibilities. Listen and discover what your impact could be. Additional details and all episodes are available on the AMGA website.

The AMGA team takes a dip in the Byrd Bath while discussing the state of President Trump's Big Beautiful Bill in the Senate. The team also discusses the evolution of the healthcare provisions in the bill and the key impact the Senate Parliamentarian may have in deciding which policies can pass the Senate before President Trump's July 4th deadline.

The AMGA team is joined by Dr. Scott Hines, chair of AMGA’s MACRA and Value-Based Care Task Force. They discuss the policies and regulations within the Medicare reimbursement system that hinder providing optimal care and the recommendations to fix them.

The AMGA team discusses the advocacy effort to support alternative payment models, along with recent finding from the Medicare Shared Savings Program.

The White House is looking to clear out rules and requirements. The AMGA team discusses a response to a request for information on outdated Medicare rules .. along with their favorite time of year.

The Center for Medicare and Medicaid Innovation announced a new strategic direction, including an emphasis on downside risk for new alternative payment models. The AMGA team discusses this new approach and the ramifications for the transition to high-value care.

House Republican leadership is building a legislative package that needs to win support of fiscal hawks while not cutting Medicaid benefits. The AMGA team discusses the provisions in the reconciliation package and how it has evolved over the last few weeks.

AMGA’s public policy department’s lobbying emphasis has been on the transition to high-value care. But, the team’s portfolio of issues has expanded to respond to a shift in how AMGA members deliver care. The team discusses their new issues, which include Medicaid, Graduate Medical Education, and tax credits on the ACA exchanges, among others.

Republicans must figure out a way to deliver on the President’s goals through the reconciliation process, while not cutting Medicaid benefits and also responding to concerns about budget cuts. The team discusses the impact of possible Medicaid cuts and the political problem facing congressional Republicans.

AMGA’s Dr. John Kennedy joins to policy team to discuss the value summit at this year’s AMGA Capitol Hill Day.

Congressional Republicans are considering billions in cuts to the Medicaid program through the budget reconciliation process. The AGMA team discusses what that means for AMGA members and the result of a survey on what actions AMGA members will take if Medicaid is cut.

The CONNECT Act, which expands vital telehealth flexibilities, has been reintroduced in Congress. The AMGA team talks about member experience with telehealth and how care delivery has evolved to incorporate it since the COVID pandemic.

The 2026 Medicare Advantage rate notice is available and increases payment rates by more than 5%. The AMGA team discusses recent Medicare Advantage rules and updates and how providers and Congress might respond

Three AMGA members discuss the importance of federal advocacy and their experiences with AMGA’s Capitol Hill Day.

Congressional Republicans are expected to cut Medicaid by $800 billion as part of a budget reconciliation plan. The AMGA team discusses the plan and what it means for providers and patients.

Dr. Mehmet Oz’s confirmation hearing to serve as the Administrator of the Centers for Medicare & Medicaid Services means potential changes for the agency’s focus and goals.

Congress did act to prevent a government shutdown, but competing interests and goals made it an interesting week. Despite the outcome, there are still options to secure AMGA priorities, such as a doc fix.

Despite broad bipartisan support, telehealth flexibilities may expire unless Congress acts.

Congress must act to prevent a government shutdown. National parks will close, but what does that mean for Medicare providers and patients?