Legislative Affairs

Chair: Seema Jain, MD
Director: Dino Teppara, Esquire
Contact: LegislativeAffairs@aapiusa.net


AAPI Condemns Taliban Attack on Indians in Afghanistan
February 26, 2010
Washington, D.C. – AAPI released the following statement condemning a terrorist attack by the Taliban aimed at Indian physicians, government officials and other international residents in Kabul. Read more here.

AAPI Responds to Terrorist Attack in Pune
February 14, 2010
Washington, D.C. – AAPI released the following statement in response to the terrorist attack in Pune yesterday. Read more here.

AAPI Responds to State of the Union Address
January 27, 2010
Washington, D.C. – Today, AAPI released the following statement in response to President Barack Obama’s first State of the Union address. Read more here.

AAPI Responds to Glenn Beck’s Comments
Dec 17, 2009
Washington, D.C. – Today, AAPI released the following statement in response to comments made on the air by TV personality Glenn Beck during one of his recent shows where he seemingly maligned the quality of medical schools in India. Read more here.

AAPI Signs Coalition Letter Regarding GME Slots
December 15, 2009
Washington, D.C. – Today, AAPI released the following statement after signing onto a coalition letter sent to all U.S. Senators in support of an amendment introduced to the health care reform bill that would add 15,000 residency slots to the current system. Read more here.

AAPI President Attends State Dinner
Nov 25, 2009
Washington, D.C. – Dr. Vinod K. Shah attended the State dinner at the invitation of President Barack Obama. Read more here.

AAPI President Praises House Vote to Permanently Repeal Flawed Medicare Physician Payment Formula
Nov 20, 2009
Washington, D.C. – Today, AAPI President Dr. Vinod K. Shah announced that the U.S. Congress voted in favor of repealing the flawed Medicare physician payment formula. Read more here.

AAPI President Announces Three-year Extension of Conrad 30/J-1 Visa Waiver Program
November 17, 2009
Washington, D.C. - Today, AAPI President Dr. Vinod K. Shah announced that the Conrad 30/J-1 Visa Waiver Program had been extended by Congress for three additional years. Read more here.

AAPI President Commends Dr. Rajiv Shah for Receiving Top USAID Appointment
November 11, 2009
Washington, D.C. – Today, AAPI President Dr. Vinod K. Shah congratulated Dr. Rajiv Shah for being nominated Administrator of the United States Agency for International Development by President Barack Obama. Read more here.

AAPI Receives Health Care Reform Bill and Supporting Documents
October 29, 2009
AAPI received the text of the health care reform bill, which was introduced in the U.S. House of Representatives today. Due to its length of 1,990 pages, we have also included supporting documents containing summaries of the bill, implementation timeline, and a section-by-section analysis.
The documents are as follows:

Health care reform implementation timeline
Changes from introduced bill
Immediate investment reforms
Summary of health care reform bill
Health care reform bill section-by-section
Text of health care reform bill

AAPI Visits Capitol Hill to Discuss Legislation Increasing Medical Residency Slots
October 15, 2009
AAPI President Dr. Vinod K. Shah, Director of Legislative Affairs Dino Teppara, Dr. Gaurav Shah, and Dr. Yamah Alam visited Capitol Hill to discuss legislation that would increase medical residency slots in the U.S. The pending bills, H.R. 2251 and S. 973, would add 15,000 residency slots to existing medical residency programs. Read more here.

AAPI Sends Letters to Capitol Hill in Support of a Three-Year Extension of the Conrad 30/J-1 Visa Waiver Program
September 30, 2009
Today, AAPI President Dr. Vinod K. Shah sent 33 letters to the Members of the House and Senate appointed to the FY 2010 Homeland Security Appropriations Conference Committee. The letter expressed AAPI’s support of three immigration provisions critical to physicians of Indian origin and the Indian American community. These provisions include: a three-year extension of the Conrad 30/J-1 Visa Waiver Program; a three-year extension of the religious worker visa program; and allowing surviving spouses and children of deceased U.S. citizens to continue their applications for permanent residency.

The letters were sent to the following Senators: Robert Byrd (D-WV), Daniel Inouye (D-HI), Patrick Leahy (D-VT), Barbara Mikulski (D-MD), Patty Murray (D-WA), Mary Landrieu (D-LA), Frank Lautenberg (D-NJ), Jon Tester (D-MT), Arlen Specter (D-PA), George Voinovich (R-OH), Thad Cochran (R-MS), Judd Gregg (R-NH), Richard Shelby (R-AL), Sam Brownback (R-KS), and Lisa Murkowski (R-AL).

The letters were sent to the following Members of Congress: David Obey (D-WI), David Price (D-NC), José Serrano (D-NY), Luis Gutierrez (D-IL), Ciro Rodriguez (D-TX), C.A. “Dutch” Ruppersberger (D-MD), Alan Mollohan (D-WV), Nita Lowey (D-NY), Lucille Roybal-Allard (D-CA), Sam Farr (D-CA), Steven Rothman (D-NJ), Jerry Lewis (R-CA), Harold Rogers (R-KY), John Carter (R-TX), John Culberson (R-TX), Mark Kirk (R-IL), and Ken Calvert (R-CA).

To see a sample of the letter, please click here.

AAPI Sends Letters to House Democratic Leaders Regarding the Need to Increase Medical Residency Slots
September 28, 2009
Today, AAPI sent letters to the Democratic leadership of the U.S. House of Representatives regarding legislation that would increase the number of medical residency slots nationwide. The letters were sent to the following Members of Congress: Speaker Nancy Pelosi; Majority Leader Steny Hoyer; Majority Whip James Clyburn; Democratic Caucus Co-Chair John Larson; and Assistant to the Speaker Chris Van Hollen. To read a sample letter, click here.

AAPI Signed Onto a Letter Led by a Coalition of Community Organizations Asking for a Three-year Extension of the Conrad 30/J-1 Visa Waiver Program
September 2, 2009
AAPI signs onto a letter led by a coalition of community organizations to U.S. House and Senate conferees on the Homeland Security Appropriations Conference Committee asking for a three-year extension of the Conrad 30/J-1 Visa Waiver program, which is set to expire on September 30, 2009. See the letter here.

Past AAPI President Honored in Congressional Record
July 31, 2009
Dr. Sanku S. Rao, immediate past President of AAPI, was honored by his Member of Congress for his service to the organization. See full text here

AAPI Commends Congressional Briefing Testimony Offered by Professor Dr. K. Srinath Reddy Before the Congressional Global Health Caucus
July 17, 2009
Washington, D.C. – Today, the American Association of Physicians of Indian Origin (AAPI) commended the testimony offered by Dr. Reddy, President of the Public Health Foundation of India, at a congressional briefing focusing on the global impact of chronic diseases.
Read full press release here

AAPI's Spring Legislative Day Praised in Congressional Record
June 8, 2009
The following statement was inserted into the Congressional Record by U.S. Congressman Bill Cassidy (R-LA), a physician from Louisiana: Read statement here

Member of Congress sends letters to AAPI Leaders
June 4, 2009
U.S. Congressman Mike Rogers (R-MI) mailed letters on health care reform to current AAPI President Dr. Sanku S. Rao and President-elect Dr. Vinod K. Shah
To see letters click here

AAPI Holds Successful Legislative Conference and Reception on Capitol Hill
April 29, 2009
20 Members of Congress and more than 175 people joined AAPI on Capitol Hill for our Spring conference and reception. To read a summary of the day's events click here

AAPI Receives Copy of House Health Care Reform Bill
To view the legislation click here


AAPI Initiatives
By Dino Teppara, Esq.
AAPI Director of Legislative Affairs

Increase the Size of Entering Medical School Classes
From 1980-2005, while medical school enrollment remained flat, the U.S. population increased by more than 70 million people.  Because the percentage of baby-boomer generation doctors (55 and older) rose from 27% to 34% during this time, the Association of American Medical Colleges (AAMC) predicts that 250,000 active physicians will retire by the year 2020.  Medical school class sizes should be increased to meet future health care needs.  This issue is vital as it pertains to health care reform, as more physicians will be needed to provide quality health care to our nation’s uninsured patients.

Increase Residency Slots Nationwide
Increased residency slots across the U.S. are needed to address the current physician shortage.  Currently, there are 25,000 available residency slots with more than 35,000 applicants on an annual basis, resulting in more than 10,000 physicians who are unable to begin their residencies, delaying their training and ability to become licensed physicians.  The “Resident Physician Shortage Reduction Act of 2009,” (H.R. 2251, S. 973) fills a critical need for residency positions by distributing residency slots to hospitals of need and increasing overall residency positions by 15%.  With an aging U.S. population, more residency slots are needed today to fill much-needed physician positions in the future.  The Indian American community is uniquely situated to fill these positions as our nation experienced a surplus of physicians and a shortage of available residency slots by more than 10,000 this past year.  As a result, hundreds of well-qualified Indian Americans and International Medical Graduates (IMGs) were unable to begin their residency programs.

This legislation was recently incorporated into “America’s Affordable Health Choices Act of 2009,” (H.R. 3200) in the portion marked up by the House Committee on Ways and Means and in the portion marked up by the Senate Finance Committee. It is awaiting further action in the House and Senate, although the part of the bill providing for extra residency slots was removed in committee.

An amendment was introduced on December 4, 2009 to the Senate health care reform bill that would add 15,000 residency slots to our current system. To learn more, please click here.

Defer Federal Student Loan Payments During Residencies
The “Medical Economic Deferment for Students (MEDS) Act,” (H.R. 1615, S. 646), allows medical students to defer payments on their federal student loans during their medical residencies.  This legislation reverses legislation passed by Congress in 2007, and once again would allow students to defer their federal loan payments for three years.  For many residents, their average salary during residency is only $44,000 while the average medical school debt is $140,000.  This common-sense bill recognizes the financial limitations most residents experience during their residency, especially since many must work at hospitals in urban areas with very high costs of living.  This bill does not seek to forgive federal student loans, but simply defers payments during the time when medical residents are saddled with their highest debt, lowest salary, and under immense pressure during their residencies.

The Conrad 30 Program/J-1 Visa
International Medical Graduates (IMGs) can participate in medical education or training in the U.S. while on a J-1 visa for up to seven years under the Exchange Visitor Program.  This visa requires physicians to return to their home country for two years before attempting to reenter the U.S. on another visa.

The Conrad 30 program was established in 1994, allowing state health agencies to provide up to 30 waivers per fiscal year to qualified J-1 visa holders willing to work in underserved or rural areas where there is a shortage of medical professionals.  This important program expired on September 30, 2009.  AAPI signed a letter to U.S. House and Senate conferees on the Homeland Security Appropriations Conference Committee asking for a three-year renewal of the Conrad 30/J-1 visa waiver program.

International Medical Graduates comprise more than 20% of incoming residents in the U.S. and outnumber U.S. medical graduates by a 3:1 ratio in rural, underserved areas.   Additionally, IMGs offer unique experiences from their international backgrounds making their skill-sets an invaluable and integral part of their medical practice.  Many highly skilled Indian physicians successfully practice medicine in underserved areas across the U.S. while on J-1 visas. The Conrad 30 Program/J-1 Visa Waiver was renewed for three additional years through September 30, 2012. AAPI signed a coalition letter on this subject
and also sent individual letters to Members of Congress on this issue.

With many qualified Indian physicians ready to practice medicine in the U.S. and with a strong need for health care in underserved communities, AAPI is pleased that this vital visa waiver program was renewed for three additional years. H.R. 1127 was signed into law on March 20, 2009 (Public Law No: 111-009), and extended the J-1 visa waiver program until September 30, 2009.  With many qualified Indian physicians ready to practice medicine in the U.S. and with a strong need for health care in underserved communities, it is vital to renew this visa waiver program for three additional years.

Protect Medicare and Medicaid Physician Reimbursements
Medicare and Medicaid physician reimbursements should be protected while eliminating unnecessary medical costs.  These reimbursements are in constant jeopardy of being reduced, adversely affecting doctors and hindering physician-accessibility for patients.  Reimbursement cuts lead to decreased patient-physician time and fewer physicians accepting Medicare and Medicaid patients.  Projections by the American Medical Association (AMA) suggest that 45% of physicians would decrease or stop accepting new Medicare patients if the annual reimbursement cuts were to take place.  Medicare reimbursements have remained constant from 2001 to 2008 and are expected to decrease by 5% to 10% annually in the near future, despite a growing patient-class of Medicare-eligible citizens.  Legislation is pending that protects physician reimbursements under the Medicare and Medicaid programs.

Establishing Meaningful Liability Reforms Nationwide
On any given day, there are 125,000 lawsuits pending against physicians.  In 2005, the Physician Insurers Association of America (PIAA) found that 75% of medical liability claims were closed without any payment to the plaintiff.  Only 7% of cases went to trial, and in those, physicians prevailed 83% of the time but incurred nearly $100,000 in legal costs.  According to the Centers for Medicare and Medicaid Services, medical malpractice insurance premiums paid by physicians rose 15% over just two years.  Such steep insurance premium rises fosters an unhealthy environment of “defensive medicine,” where health care costs are inflated by unnecessary tests and defensive spending.  Furthermore, states such as Texas that have instituted caps on malpractice claims have noted a 30% rise in licensing applications by physicians because they prefer to practice in these “physician friendly” environments.

Fewer physicians today practice in areas such as obstetrics and gynecology, surgery, and emergency medicine, due to increased lawsuits and skyrocketing malpractice insurance premiums.  AAPI is concerned over these costs, which results in fewer doctors practicing in vital specialty areas and fewer medical residents willing to enter such fields.  Federal and state legislation is pending that places effective caps on non-economic damages, limits the use of joint-and-several liability, and limits the statutes of limitations for filing medical malpractice claims.