Archive for Advocacy

With Net Neutrality Gone, What’s in the Future for Physicians?

With Net Neutrality Gone, What’s in the Future for Physicians?

Net neutrality changed the digital landscape for millions of Americans, specifically physicians and health care professionals, but these changes may diminish due to the repeal of net neutrality. In December, the Federal Communications Commission voted to repeal the net neutrality rules set in place by the Obama Administration in 2015, and on June 11, 2018, net neutrality was officially repealed leaving many questions for Americans. Previously, most professionals were unfazed by the net neutrality rules, and many are still unaware of the positive impact net neutrality had in areas of the health care profession, such as telemedicine and technology education since it passed in 2015. Despite these technological advancements, many doctors still do not understand net neutrality or the effect the repeal could have on their practice or their financial bottom lines.

What is net neutrality?

Net neutrality is the concept that Internet Service Providers (ISPs) like Verizon, AT&T, Comcast and Spectrum are required to handle all data equally. The previous net neutrality rules protected against blocking, throttling and prioritization — meaning ISPs were not able to slow down or block some websites but speed up others. Net neutrality required all websites to load at equal speeds and treated all online content fairly. It also protected the consumer from paying more for slower internet speeds. In other words, all internet users were on a level playing field with the same rights to equally fast internet, and all websites were available at the same speed and quality.

What does life look like without net neutrality rules?

Without net neutrality, non-profit and educational websites and databases could be de-prioritized in lieu of commercial websites, meaning the importance of educational materials and research would be left up to the internet service providers. Allowing ISPs the ability to decide the importance of internet content leaves the potential for the medical and academic community to suffer because their content could potentially load at slower speeds or worse, blocked. Additionally, slower internet speeds will affect the ability to live-stream, upload and download promptly. Finally, many worry ISPs could offer multiple plans with different options on internet speed, leaving consumers paying more for high-speed internet. Overall, a divide will form between those who can afford faster internet service options and those who are stuck with slower bandwidth.

What does this mean for physicians?

For physicians and health care professionals, the repeal of net neutrality leaves the potential for devastating effects. First, medical professionals could be forced to pay significantly more for high-speed internet capable of downloading, uploading, sending and receiving digital medical records. Also, all the advancements made in telemedicine could become stagnant. Despite recent advancements, the future of telemedicine remains uncertain even if a physician can afford the high-speed internet to treat patients, many patients may not be able to afford the high-speed internet capable of live-streaming with their physician. Additionally, the repeal could be detrimental for physicians practicing in rural areas or with patients living in rural areas reliant on telemedicine.

Likewise, educational endeavors could suffer a significant impact. It could cost more for high-speed internet capable of downloading and uploading medical books and research vital to medical education, leaving medical students with the potential for an increase in tuition. Physicians could find it harder to stay up-to-date on the most recent research and studies in their field if educational and non-profit websites become overshadowed by commercial websites paying ISPs. Finally, the competition created between commercial websites and educational and non-profit websites will hinder and slow-down research. Overall, net neutrality created a level playing field on the internet making it possible for technological advancements that empower physicians with the education and tools they need to best care for their patients.

What can the medical community do now?

As of right now, ISPs have not changed their services despite the repeal of the net neutrality rules. In fact, many ISPs have publically stated they will not block or throttle but have left open the potential to charge more for some data transportation. On the contrary, just because an ISP publically states it will continue as if net neutrality is still in place does not mean it is locked into obeying that standard. As time goes on without net neutrality, look out for changes with ISPs. Many predict the changes will start small and add up over time.

How can you make a difference?

The U.S. Senate voted to reinstate the net neutrality rules repealed in December. The legislation is currently in the U.S. House of Representatives where it is given little hope of advancing. Contact your district’s representative and express your concerns over the end of net neutrality and the effects it will have on physicians and health care professionals.

Posted in: Advocacy

Leave a Comment (0) →

Alabama Physicians Attend AMA Meeting in Chicago to Discuss State of Health Care

Alabama Physicians Attend AMA Meeting in Chicago to Discuss State of Health Care

Pictured from left in the back are Dr. Buddy Smith Jr., Dr. Jefferson Underwood and Dr. Jerry Harrison. In front from left are Dr. Steven Furr, Medical Student Delegate Hannah Ficarino from the University of South Alabama, Dr. Jorge Alsip and Dr. John Meigs.

During the AMA’s Annual Meeting held June 8-13, 2018, the House of Delegates debated a wide range of issues and adopted policies to expedite the free exchange of key patient data between EHR systems; to make e-prescribing of controlled substances and access to state PDMPs less cumbersome, and to reduce the MIPS reporting burden. The AMA also reaffirmed its strong opposition to the legalization of physician-assisted suicide and euthanasia.

Medical Association President Jefferson Underwood, M.D., joined the delegation in Chicago and represented Alabama physicians at the inauguration of the AMA’s new president, Barbara McAneny, M.D.

“The AMA House of Delegates is much like Congress in that the views of its members vary from region to region, and few members agree with every decision made by the organization. However, a state’s representation in the HOD is based on their number of AMA members, and Alabama along with the other Southeastern states are working vigorously to increase their AMA membership. I encourage our Medical Association members to also join the AMA, so we can have a greater impact on policy and help elect officers who share our views and values.” said Jorge Alsip, M.D., who chairs Alabama’s AMA Delegation.

Pictured are Association President Underwood and his wife, Sara.

Posted in: Advocacy

Leave a Comment (0) →

President Trump Signs VA Mission Act

President Trump Signs VA Mission Act

UPDATE JUNE 6, 2018: President Trump signed the VA Mission Act designed to increase veterans’ access to timely and private health care. The new VA law aims to combine and expand existing community care programs during the next year with intentions to roll out one centralized community care program next May.

Building off the positive changes enacted by the Choice Program, which was created in 2014 after two veterans died waiting for appointments, the Mission Act broadens the circumstances for which veterans can receive non-VA health care. Presently, veterans can seek third-party medical care if they live more than 40 miles away from a VA facility or if they must wait over 30 days for an appointment. The Mission Act will also allow veterans access to non-VA health care if they are in need of a service the VA does not offer or if their doctor thinks it is in the best interest of the patient.

With access to non-VA health care becoming more accessible, some lawmakers became fearful the new law would undermine the VA. The Mission Act recognizes this potential and includes incentives and funding to ensure the Act does not drive veterans away from the VA. The order will boost funding to allow the VA to hire more health care professionals in addition to offering scholarships to medical students willing to work for the VA.

Additionally, the new measure will help pre-9/11 veterans by giving them benefits to help cover the cost of in-home caregivers. Post-9/11 veterans already have access to such benefits. These benefits offer an alternative to institutionalized health care and will help take some of the cost of local governments.

While the Mission Act passed overwhelmingly in both the House and Senate with bi-partisan support in May 2018, there is a debate on exactly how the measure will be funded after May 2019. Sen. Richard Shelby (R-Ala.), head of the Senate Appropriations Committee, is working across party lines in both the Senate Appropriations Committee and the Veteran’s Affairs Committee to help establish the best possible funding plan for the VA Mission Act.

Posted in: Advocacy

Leave a Comment (0) →

President Trump Signs Right-to-Try Act

President Trump Signs Right-to-Try Act

On Wednesday, May 30, 2018, Pres. Donald Trump signed the Right-to-Try Act, which allows terminally ill patients the ability to try drugs in preliminary testing but not-yet-approved by the Food and Drug Administration. The aim is to make it easier for those patients suffering from fatal illness who have exhausted all other resources to access drugs unapproved by the FDA, which may provide them some relief from their illnesses.

The Right-to-Try Act is also intended to create a more open and competitive market for drugs still seeking FDA approval, therefore, lowering the cost of the drugs since insurance companies do not cover them. Supporters of the legislation say it gives hope to those who are out of options, while opponents argue the legislation gives a false hope to many who are already in a vulnerable and fragile state.

While the intent is to allow patients to try drugs not otherwise available to them, many point out the FDA already allows patients access to these drugs through an expanded access program. This program allows terminally ill patients access to drugs not FDA approved, ensures the drug is administered correctly and certifies those receiving the medication are adequately informed. Additionally, the approval rate of patients completing the application requesting these drugs since 2006 is 99 percent.

Supporters of the Right-to-Try Act argue these numbers do not reflect the hundreds of patients neglected by the application process through incomplete applications and other factors. Now, the Right-to-Try Act takes the FDA out of the equation and leaves the power with patients and their physicians to work with drug companies directly to access unapproved drugs.

Despite its potential for success, the Right-to-Try Act comes with a significant downside. Since the only requirement for the drugs are that they have passed Phase I testing with the FDA stating they are safe on humans, there is no real understanding of possible side effects these drugs may have on patients. The uncertainty and margin of error around medications not approved by the FDA leave physicians concerned for the health and safety of the patients who choose to use them.

Posted in: Advocacy

Leave a Comment (0) →

Demand for Non-Physician Providers Rose to Make Up for Physician Shortage

Demand for Non-Physician Providers Rose to Make Up for Physician Shortage

The Medical Group Management Association has released its 2018 MGMA DataDive Provider Compensation Survey revealing primary care physicians’ compensation rose by more than 10 percent over the past five years. This increase, which is nearly double that of specialty physicians’ compensation over the same period, is further evidence of the worsening primary care physician shortage in the American health care system.

A closer look at this data shows this rise in compensation is not necessarily tied to an increase in productivity. When broken down by primary care focus, family medicine physicians saw a 12 percent rise in total compensation over the past five years, while their median number of work relative value units (wRVUs) remained flat, increasing by less than one percent. Practices offered more benefits to attract and retain physicians, including higher signing bonuses, continuing medical education stipends, and relocation expense reimbursements.

“MGMA’s latest survey has put strong data behind a concerning trend we’ve seen in the American healthcare system for some time—we are experiencing a real shortage of primary care physicians,” said Dr. Halee Fischer-Wright, President and Chief Executive Officer at MGMA. “Many factors contribute to this problem, chief among them being an increasingly aging population that’s outpacing the supply of chronic care they require. And with a nearly two-fold rise in median compensation for primary care physicians over their specialist counterparts and increased additional incentives, we can now see the premium organizations are placing on primary care physicians’ skills to combat this shortage.”

Further supporting this trend, the new survey identified meaningful growth in compensation for non-physician providers over the past 10 years. Nurse practitioners saw the largest increase over this period with almost 30 percent growth in total compensation. Primary care physician assistants saw the second-largest median rise in total compensation with a 25 percent increase.

“In many communities that we visit, nurse practitioners and other advanced practice providers provide immediate care and same day access. These providers play an important role in today’s health care system. It’s more efficient and less expensive than visiting the emergency room,” said Nick Fabrizio, Principal Consultant at MGMA.

Based on comparative data from over 136,000 providers in over 5,800 organizations, the 2018 MGMA DataDive Provider Compensation is the most comprehensive sample of any physician compensation survey in the United States. The survey represents a variety of practice types including physician-owned, hospital-owned, academic practices, as well as providers from across the nation at small and large practices.

Other highlights from the survey include:

  • Over the past five years, rises in median compensation varied greatly by state. In two states, median total compensation actually decreased for primary care physicians: Alabama (-9 percent) and New York (-3 percent). Many states saw much larger increases in median total compensation compared to the national rate, the top five being Wyoming (41 percent), Maryland (29 percent), Louisiana (27 percent), Missouri (24 percent) and Mississippi (21 percent).
  • Current median total compensation for primary care physicians also varies greatly by state. The District of Columbia is the lowest paying with $205,776 in median total compensation. Nevada is the highest paying state with $309,431 in median total compensation.
  • Over the last five years, looking beyond just nurse practitioners, overall non-physician provider compensation has increased at a rate of 8 percent. Looking at the changes over the past 10 years, that rate has doubled to 17 percent. As non-physician providers have increasingly become patients’ primary care providers over the past 10 years, combined with a subsequent shortage of non-physician providers, compensation rates continue to grow for nurse practitioners and primary care physician assistants.
  • The difference in compensation between the highest-paid state compared to the lowest ranges between $100,000 and almost $270,000 for physicians depending on specialties, and $65,000 for non-physician providers.

The 2018 MGMA DataDive Provider Compensation is the most trusted compensation survey in the U.S., undergoing a rigorous evaluation and inspection. Learn more at www.mgma.com/data.

Posted in: Advocacy

Leave a Comment (0) →

Trump Administration Releases Drug Pricing Blueprint

Trump Administration Releases Drug Pricing Blueprint

On May 11, The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs, along with a request for information. The Blueprint was framed as advancing four specific goals:

  • Reducing list prices;
  • Improving government’s ability to negotiate better prices;
  • Encouraging competition through rapid entry to market of generics and biosimilars; and
  • Lowering patient out-of-pocket expenses.

The Blueprint proposes a broad number of changes to prescription drug programs in several federal health care programs – such as Medicare, Medicaid and other safety net programs – as well as Food and Drug Administration policies that should impact commercial and federal health care program access to affordable prescription drugs.

While some of these proposals can be undertaken through immediate regulatory or subregulatory actions, others are still on the drawing boards at the U.S. Department of Health and Human Services and some will require congressional action to implement. The Blueprint proposes a select number of programmatic and design changes, yet the Administration is seeking feedback for a large number of lingering questions.

Initial review appears to show an increased access to lower-cost alternative generics. But closer review is needed on proposed changes to the Medicare Part D Prescription Drug Benefit Program and the Part B drug reimbursement methods to alleviate concerns the changes may limit patient access to medically necessary alternative brand or specialty treatments and result in additional administrative burdens on physicians and patients. The proposal may also eliminate the requirement that Part D plans include a minimum of two drugs proven to be effective in each therapeutic category or pharmacologic class, if available.

The Medical Association will be closely monitoring the Administration’s “American Patients First” Blueprint and will keep our members updated on any new developments as they become available.

Posted in: Advocacy

Leave a Comment (0) →

What’s the Future for Physicians without Net Neutrality?

What’s the Future for Physicians without Net Neutrality?

Net neutrality has changed the digital landscape for millions of Americans, specifically physicians and health care professionals, but that could all change on June 11. In December, the Federal Communications Commission voted to repeal the net neutrality rules set in place by the Obama Administration, and on June 11 the repeal of net neutrality is set to take effect. Many professionals are unaware of the positive impact net neutrality has had in areas of the health care profession, such as telemedicine and technology education since it passed in 2015. Despite these technological advancements, many doctors still do not understand net neutrality, or the potential effect the repeal will have on their practice.

What is net neutrality?

Net neutrality is the concept that Internet Service Providers (ISPs) like Verizon, Comcast and Spectrum are required to handle all data equally. Meaning ISPs cannot slow down some websites and speed up others. Net neutrality operates all websites loading at equal speeds and treats all content online fairly. Also, it protects the consumer from paying more money for slower internet speeds. Net neutrality keeps everyone on a level playing field with everyone having the same rights to the equally fast internet, and all websites are available at the same speed and quality.

Life without net neutrality

Without net neutrality, non-profit and educational websites and databases run the risk of being de-prioritized for commercial websites, meaning the importance of educational materials and research is left up to the internet service providers. Allowing ISPs the ability to decide the importance of internet content leaves the potential for the medical and academic community to suffer. Additionally, we can expect slower internet speeds affecting the ability to live-stream, upload and download promptly. Overall, a divide will be created between those who can afford faster internet service and those who are stuck with the slower bandwidth.

What does this mean for physicians? 

For physicians and health care professionals, the repeal of net neutrality could be detrimental. First, professionals run the risk of paying significantly more for high-speed internet capable of downloading, uploading, sending and receiving digital medical records. Also, all the advancements made in telemedicine recently could become stagnant. Despite the recent advancements, the future of telemedicine remains uncertain because even if the doctor can afford the high-speed internet to treat patients, many patients may not be able to afford the high-speed internet capable of live-streaming with their doctor.

Likewise, the education of doctors will be impacted significantly. For medical students, there is potential for an increase in tuition since it will cost more for high-speed internet capable of downloading and uploading medical books and research vital to their education. For doctors, it will become harder to stay up-to-date on the most recent research and studies in their field. Educational and non-profit websites will be overshadowed by commercial websites paying ISPs, making it harder to access scholarly research. Finally, the competition created between commercial websites and educational and non-profit websites will hinder and slow-down research. Overall, net neutrality has created a level playing field on the World Wide Web. It has made possible technological advancements that empower physicians with the education and tools they need to best care for their patients.

How can you make a difference?

On Wednesday, May 17, 2018, the Senate voted to reinstate the net neutrality rules repealed in December. The legislation is currently in the House where it is given little hope of advancing. Contact your district’s representative and express your concerns over the end of net neutrality and the effects it will have on physicians and healthcare professionals.

Posted in: Advocacy

Leave a Comment (0) →

What If No One Was On Call [at the Legislature]?

What If No One Was On Call [at the Legislature]?

2018 Recap of the Regular Session of the Alabama Legislature

In times of illness, injury and emergency, patients depend on their physicians. But what if no one was on call? Public health would be in jeopardy.  However, the same holds true for the Legislature. During the 2018 session alone, if the Medical Association had not been on call advocating for you and your patients, unnecessary and costly standards of care would have been written into law, lawsuit opportunities against physicians would have increased and poorly thought out “solutions” to the drug abuse epidemic ─ that could’ve made the problem worse ─ would have become law. Keep reading to find out more.

Moving Medicine Forward

The 2018 Legislative Session is over, but continued success in the legislative arena takes constant vigilance. Click here to download our 2018 Agenda.

If no one was on call…increased state funding for upgrading the Prescription Drug Monitoring Program (PDMP) would not have occurred. Working with the Governor’s Opioid Task Force, the Medical Association proposed increased funding for the PDMP, to allow it to be an effective tool for physicians. As a result, the Task Force made the request its number one recommendation to the Governor and the 2019 budget for the Alabama Department of Public Health (the PDMP administrator) has a $1 million increase for making a long-overdue upgrade to the user-friendliness of the drug database.

If no one was on call…legislation helping veterans at-risk for drug abuse get the care they need and also leverage technology to combat the drug abuse epidemic would not have occurred. Through enactment of SB 200, the prescription information of VA patients will be shared between the VA and non-VA physicians and pharmacists who are outside the VA system, the same kind of information sharing of prescription data that exists for almost all other patients. Passage of SB 200 also establishes a mechanism for vetting requests for release of completely de-identified PDMP information that can be used to spot drug abuse trends and help state officials better allocate resources in combatting this epidemic. The proposals that resulted in the drafting of SB 200 originated with a recommendation from the Governor’s Opioid Task Force, one the Medical Association supported.

If no one was on call…the concerns of physicians regarding the current state of affairs surrounding the Maintenance of Certification program would not have been heard. A formal recommendation from the Medical Association’s MOC Study Committee resulted in the enactment of SJR 62 by Senators Tim Melson, M.D., Larry Stutts, M.D., and the entire Alabama Senate. The resolution was signed by Gov. Kay Ivey. SJR 62 vocalizes Alabama physicians’ frustrations with MOC and urges the American Board of Medical Specialties to honor its commitment to help reduce the burden and cost of MOC. Pursuit of a legislative resolution was just one of several recommendations from the Association’s MOC Study Committee this year.

If no one was on call…the Board of Medical Scholarship Awards could have seen its funding reduced but instead, the program retained its funding level of $1.4 million for 2019. The BMSA grants medical school loans to medical students and accepts as payment for the loan that student’s locating to a rural area to practice medicine. The BMSA is a critical tool for recruiting medical students to commit to practice in rural areas. As well, the economic footprint of every physician is at least $1 million, which improves both community health and local economies.

If no one was on call…Medicaid cuts could have been severe, possibly reducing access for patients within an already fragile system in which less than 20 percent of Alabama physicians participate. The 2019 budget has sufficient funds available for Medicaid without scheduled cuts to physicians. However, increasing Medicaid reimbursements to Medicare levels could further increase access to care for Medicaid patients and remains a Medical Association priority.

Beating Back the Lawsuit Industry

While Alabama’s medical liability laws have fostered fairness in the courtroom and improved the legal climate, each year personal injury attorneys seek to undo parts of the very law that helps keep “jackpot justice” and frivolous suits in check.

If no one was on call…bill language that could have pulled physicians into new lawsuits targeting opioid drug makers and opioid wholesale drug distributors could have been included in the final version of the legislation, whose subject matter was originally limited to placing new criminal penalties on unlawful possession, distribution and trafficking of Fentanyl. After the liability language was added on the House floor, a committee of the House and Senate removed the new cause of action language that could have affected physicians. Additionally, an unsuccessful attempt was made to amend this same bill to give law enforcement the authority to determine what is the unlawful “prescribing” or “dispensing” of prescription drugs. The final bill that passed contained neither of these elements that would have been problematic for physicians.

If no one was on call…physicians and medical practices could have been forced to provide warranty and replacement coverage for “assistive medical devices.” As originally drafted in the bill, the term “assistive medical devices” was broadly defined to include any device that improves a person’s quality of life including those implanted, sold or furnished by physicians and medical practices like joint or cochlear implants, pacemakers, hearing aids, etc. However, the Medical Association successfully sought an amendment to remove physicians, their staff and medical practices from having any new warranty or assistive device replacement responsibility under the act, and the final version doesn’t expand liability on doctors.

If no one was on call…legislation granting nurse practitioners and nurse midwives new signature authority outside of a collaborative practice and for some items prohibited under federal law – thereby significantly expanding liability for collaborating physicians – could have become law. The Medical Association successfully sought to ensure that all new signature authority granted to CRNPs and CNMs was subject to an active collaborative agreement and all additional forms or authorizations granted were consistent with federal law, protecting collaborating physicians from new liability exposure. The final bill was favorably amended with this language.

If no one was on call…physicians could have been held legally responsible for others’ mistakes including individuals following or failing to follow DNR orders on minors. The language of the final bill does not expand liability for physicians.

Protecting Public Health and Access to Quality Care

Every session, various pieces of legislation aimed at improving the health of Alabamians are proposed. At the same time however, many bills are also introduced that endanger public health and safety, like those where the Legislature attempts to set standards for medical care, which force physicians and their staffs to adhere to non-medically established criteria, wasting health care dollars, wasting patients’ and physicians’ time and exposing physicians to new liability concerns.

If no one was on callcollaborative practice in Alabama between nurse practitioners, nurse midwives and physicians could have been abolished. The legislation did not pass. Read the joint statement on the bill from the Medical Association and allied medical specialties here. The bill may return next session.

If no one was on call…legislation to give law enforcement the authority to determine what is the unlawful “prescribing” or “dispensing” of controlled substances (and making violations a Class B Felony) could have become law. The Medical Association sought changes to the bill to require prosecutors to have to prove beyond a reasonable doubt that a physician knowingly or intentionally prescribed controlled substances for other than a legitimate medical purpose and outside the usual course of his or her professional practice, and also to ensure sufficient qualifications for expert witnesses. The sponsor however – arguing that expert witness testimony for prosecuting a physician should not be required – asked the bill not be passed and instead “indefinitely postponed it,” killing the bill for the 2018 session. The bill will return next session.

If no one was on callmarriage and family therapists could have been allowed unprecedented authority to diagnose and treat mental illnesses without restriction. The legislation would also have deleted numerous prohibitions in current law including prescribing drugs, using electroconvulsive therapy, admitting to a hospital and treating inpatients without medical supervision, among other things. The Medical Association offered a substitute bill that (1) ensures all diagnoses and treatment plans made by MFTs are within the MFT treatment context; (2) ensures MFTs cannot practice outside the boundaries of MFT services; (3) prohibits MFTs from practicing medicine; and, (4) ensures all the current prohibitions in state law regarding prescribing of drugs, electroconvulsive therapy and inpatient treatment remain intact. The final bill that is now law contains all of these elements.

If no one was on call…legislation creating a new state board with unprecedented authority over medical imaging could have passed. The legislation would have required x-ray operators, magnetic resonance technologists, nuclear medicine technologists, radiation therapists, radiographers and radiologist assistants to acquire a new license from a new state board, a board granted total control over the scope of practice for each licensee. Quality and access to care concerns abounded with this legislation that many saw as unnecessary. The legislation did not pass, but is likely to return next session.

If no one was on call…proposals to move the PDMP away from the Alabama Department of Public Health and instead under the authority of some other state agency or even to a private non-profit organization could have been successful. In working with the Governor’s Opioid Task Force, the Medical Association stressed the Health Department was the proper home for the PDMP and the Task Force did not recommend that the PDMP be moved elsewhere.

If no one was on call…legislation to place new requirements on and increase civil liability exposure on referring physicians under the Women’s Right to Know Act could have become law. The legislation aimed to provide a woman seeking an abortion with notice that she can change her mind at any time and be entitled to a full refund for not going through with the abortion. The Medical Association sought to fix a longstanding problem that places information-provision requirements on referring physicians under the Women’s Right to Know law. While the Association’s language was adopted, the bill failed to pass. The bill is expected to return next session.

If no one was on call…state law could have been changed to require mandatory PDMP checks on every prescription. Attempts to change this are expected in 2019.

If no one was on call…law enforcement could have been granted unfettered access to the prescriptions records of all Alabamians. Attempts to change this are expected in 2019.

Other Bills of Interest

Rural physician tax credits…legislation to increase rural physician tax credits and thereby increase access to care for rural Alabamians did not pass but will be reintroduced next session.

Infectious Disease Elimination…legislation to establish infectious disease elimination pilot programs to mitigate the spread of certain diseases failed to garner enough support to pass this session.

Data breach notification…relating to consumer protection, is known as the “data breach bill.” In the event of a data breach by a HIPAA-covered entity, as long as the entity follows HIPAA guidelines for data breaches and notifies the attorney general if the breach affects more than 1,000 people, the HIPAA-covered entity is exempt from any penalties. Now, only North Dakota lacks a “data breach” notification statute. The bill was signed by the Governor.

School-based vaccine program…a Senate Joint Resolution urging the State Department of Education and the Alabama Department of Public Health to encourage all schools to participate in a school-based vaccine program passed in 2018. The Medical Association, Alabama Academy of Pediatrics and Alabama Academy of Family Physicians issued a joint statement in opposition to the resolution.

While we remain committed to increasing vaccine rates in Alabama for the very reasons outlined in the “Whereases” of the resolution, we are very concerned about the potential disruption that a widespread school-based program could bring to local practices and the likelihood of detrimental effects of adolescents not visiting the doctor-their medical home–during the critical teen years,” the joint statement from the medical societies reads.

While Gov. Ivey did not sign the resolution, it was ratified under state law without her signature.

Workers comp…legislation to penalize an individual from obtaining workers comp benefits by fraudulent means was introduced this session. The Medical Association successfully sought an amendment to require notice to the physician of termination of a worker’s benefits and to ensure continued payment of claims submitted by a physician until that notice is received. The bill failed to see any action this session.

Genital mutilation…legislation criminalizing the genital mutilation of a minor female was introduced this session. The Medical Association successfully sought an amendment to exclude emergency situations and procedures. The bill died in the Senate during the last days of the session. It is expected to return next year.

If the Medical Association was not on call at the Legislature, countless bills expanding doctors’ liability, placing standards of care into state law, lowering the quality of care provided and diminishing the practice of medicine could have passed. At the same time, positive strides in public health – like new funding for a much-needed PDMP upgrade, better data-sharing with VA facilities and the resolution on MOC – would not have occurred. The Medical Association is Alabama physicians’ greatest resource in advocating for the practice of medicine and the patients they serve.

Questions? For more information contact Niko Corley at ncorley@alamedical.org

Posted in: Advocacy

Leave a Comment (0) →

MOC UPDATE: Working to Solve Problems with Certifications

MOC UPDATE: Working to Solve Problems with Certifications

UPDATE APRIL 20, 2018:  The Continuing Board Certification: Vision for the Future Commission is continuing its quest  to bring together physicians, medical organization, state medical societies, hospitals, health systems, patients and the ABMS to investigate the future of board certification and recently hosted its first in-person meeting in March in Washington, D.C. Commission members heard testimony on continuing certification from stakeholders who provided their perspectives and experiences with continuing certification, the challenges they currently face, and their thoughts about opportunities about the future. The presentation components of the meeting were open to the public and video streamed for all to view live.

HOW  CAN YOU PARTICIPATE? The Commission launched a stakeholder survey in February, which will remain open until May 11. Complete the survey, share the link with your colleagues, and urge them to participate as well. TAKE THE SURVEY

The next Commission meeting will be held May 30 – June 1. The meeting will feature sections open to the public and will be live video streamed. Details regarding the agenda and live streaming will be featured in next month’s update and posted on visioninitiative.org. Please make sure to bookmark the site for access to Commission meeting information, progress updates, and opportunities for your feedback and input, and remember to share this update with your colleagues and encourage them to become involved in the process as well.

 


The Medical Association continues to work with the American Board of Medical Specialties concerning physician frustrations with the current Maintenance of Certification process. Late last year, Association Executive Director Mark Jackson and Council on Medical Service member Jeff Rickert, M.D., joined representatives from other state medical societies and individual specialty boards for a meeting with the ABMS in Chicago, which included discussions about innovations the medical boards are working on to address continuous learning for physicians, many of which include input from various outside stakeholders and focus on greater consistency amongst the medical boards.

Following the Association’s Annual Governmental Affairs Meeting in Washington in February where Richard Hawkins, President and Chief Executive Officer of ABMS, was a guest speaker, the organization issued a statement as an update on the progress of issues of concern to physicians about Maintenance of Certification.

As a result of these meetings, and other meetings initiated by State Medical Societies, the Continuing Board Certification: Vision for the Future was formed as a collaborative effort bringing together physicians, medical organization, state medical societies, hospitals, health systems, patients and the ABMS to investigate the future of board certification.

The Commission invites input from all stakeholders. To participate in the discussion, you may provide comments to inform the future of board certification, learn how you can engage in the process, and sign up for monthly email updates from the Commission. LEARN MORE

Posted in: Advocacy

Leave a Comment (0) →

STUDY: Independent Practice Declines Due Partially to EHRs

STUDY: Independent Practice Declines Due Partially to EHRs

A new study conducted by the Trump Administration suggests electronic health records are currently failing at reducing the cost of billing for medical facilities, especially for independent practices.

“Small physicians’ groups and solo providers could not afford to purchase and maintain electronic medical records and comply with government reporting requirements,” the White House report stated. “As a result, hospital mergers are booming, leading to horizontal integration, and large hospitals are buying up physicians’ practices and outpatient service providers to form large, vertically integrated health care networks.”

A study published in the Journal of the American Medical Association shows that billing costs consumed significant chunks of revenue even at a large academic center with a fully implemented EHR system. They represented about 14.5 percent of costs of primary care visits and 13.4 percent of costs for ambulatory surgical procedures. “These findings suggest that significant investments in certified health information technology have not reduced high billing costs in the United States,” the authors state in the report.

Independent physicians have also commented on the burdens of the EHR system. Three out of four physicians believe electronic health records (EHRs) increase practice costs, outweighing any efficiency savings, and seven out of 10 think EHRs reduce their productivity, according to a Deloitte’s recent 2016 Survey of U.S. Physicians.

The results of the survey also indicate physician satisfaction with EHRs varies by practice characteristics. About 70 percent of employed physicians are more likely to think that EHRs support the exchange of clinical information and help improve clinical outcomes compared to 50 percent of independent physicians. The results also revealed 72 percent of independent physicians are more likely to think that EHRs reduce productivity compared to 57 percent of employed physicians. Additionally, 80 percent of independent physicians think that EHRs increase practice costs, compared to 63 percent of employed physicians.

The federal government has financial interests in making it easier for physicians to cope with EHR requirements, according to President Trump’s 2018 Economic Report. As part of its 2018 economic report, released Feb. 21, the White House drew a direct connection between physicians’ struggles to purchase and operate EHR systems and the increase in consolidation among hospitals.

Posted in: Advocacy

Leave a Comment (0) →
Page 1 of 5 12345