NCAFP Continues to Advocate for Student Loan Repayments and Physician Pay

September 12, 2025

By Kevin LaTorre 
NCAFP Communications and Membership Manager

The NCAFP has been hard at work advocating for our members. Just in the last week, the NCAFP has written three letters to state and federal agencies advocating for Family Medicine. They include:

• A letter to NC Department of Health and Human Services Secretary Dr. Dev Sangvai encouraging the state to include a strong primary care-based component in the state’s funding request to the federal government for a portion of the Rural Health Transformation Fund established federally as part of HR 1. The Academy requested that up to 20% of the state’s rural transformation funding grant go straight to primary care, including enhanced payment for primary care, additional loan repayment for primary care physicians in rural areas, and incentives for preceptors who teach medical students in rural and underserved areas of the state, among other things.
• A letter to Dr. Mehmet Oz, Administrator for the Centers for Medicare and Medicaid Services (CMS), that highlighted both positives and concerns regarding the proposed 2026 Payment Policies and Fee schedule for Medicare. For example, the letter encourages CMS to cover the G2211 code for home-based medical care services as well as in-office primary care services as proposed in the new fee schedule. The letter also encouraged CMS to remove patient cost-sharing for add-on codes for behavioral health integration and collaborative care management. Another comment encouraged CMS to consider additional ways to support independent practice participation in the Medicare Shared Savings Program.
• Finally, a third letter written to U.S. Department of Education Secretary Linda McMahon expressed concerns about a proposed rule that would redefine “qualifying employer” under the Public Service Loan Forgiveness (PSLF) program. The NCAFP’s letter asks the Department to withdraw the proposed rule or to make significant changes. The proposed rule would allow the Department to disqualify entire employers form PSLF based on vague and undefined standards of “substantial illegal purpose,” without due process, potentially having a chilling effect on the health care workforce especially in large health systems where a single office’s alleged violation could jeopardize PSLF eligibility for large numbers of physicians who had no involvement in the matter.

NCAFP is also continuing to work to prevent or mitigate proposed Medicaid rate cuts scheduled to go into effect in North Carolina in early October. It appears that the advocacy from the health care community at large is helping, as some legislators are now asking the NC Medicaid programs to stop or at least pause any cuts. Look for additional information on this and other advocacy efforts in the coming weeks.

About the North Carolina Academy of Family Physicians

The North Carolina Academy of Family Physicians, Inc. (NCAFP) is a nonprofit professional association headquartered in Raleigh which represents over 4,300 family physicians, family medicine residents, and medical students across the state. It is the largest medical specialty association in North Carolina and is a constituent chapter of the American Academy of Family Physicians, based in Leadwood, KS.