Alabama medical experts ask for $478,000 to investigate pregnancy-related deaths

Medical Association and Specialties Begin Work on 2020 Legislative Agenda

Earlier this month, the Medical Association hosted a legislative roundtable with leaders from the various physician specialties. The event included a discussion of the prior legislative session and our past priorities, as well as an open forum for specialty delegates to discuss items and issues important to their physicians.

Each legislative session presents new and unique issues, and we rely heavily on the guidance of physicians and society leaders to advise the Association’s Board X regularly on the appropriate course of action to take on legislation.

Thank you to those physicians and specialty leaders who attended our roundtable. To further guide the Association’s Board in developing the 2020 Legislative Agenda, we have created a survey for all members to weigh in on our priorities.

If you have yet to take the survey, you can do so at this link or by simply clicking the button below. Don’t wait! Take the survey today!

ALAPAC Ends FY2019 on a High Note

Over the past few months, ALAPAC has been in the midst of its summer fundraising campaign, seeking to raise $75k in 75 days. This week, both the summer campaign and the 2019 giving cycle came to a close.

First and foremost, thank you to all the physicians who chose to contribute to ALAPAC this year! We cannot succeed without your continued support.

Although we missed our summer goal by just $10,000, ALAPAC raised over $19,000 in the last month alone. Moreover, physician-giving made it possible for ALAPAC to positively impact special elections this year, with both ALAPAC-supported candidates (Charlotte Meadows and Van Smith) winning their primaries and advancing to the general election.

In the coming weeks, we will recognize all ALAPAC contributors and those individuals who went above and beyond. Also, we will provide a snapshot of the top specialties whose physicians donated to ALAPAC.

For now, we simply want to say THANK YOU!

Send Us Examples of Misleading Health Advertising

In 2019, the Medical Association drafted and supported, and will be supporting again in 2020, specific “truth in advertising” legislation in Alabama to prohibit misleading health care advertising and require all licensed health professionals to clearly communicate their credentials to patients.  These are critical elements to increasing patient education.  

Thanks to those who’ve already submitted examples of health care advertising in Alabama that is misleading.  To reinforce the need for this legislation, the Association is asking all its members to send examples of misleading health care advertising anywhere they see it.  

Want to help? 

Email a link to the misleading health advertising to cflack@alamedical.org

– or – 

Email a screenshot of the misleading health advertising to cflack@alamedical.org. 

Congress is Tackling Surprise Billing Legislation

12th hour negotiations are taking place in Congress to get Surprise Billing legislation passed before the end of the year. The Medical Association has been engaged on this issue since the beginning of the year advocating for a fair independent dispute resolution process to resolve out of network payment disputes. However the insurance industry has been pushing to set a benchmark for out of network payments to physicians at or below Medicare rates.

Several bi-partisan proposals on the subject have been introduced and are working their way thru the legislative process. Legislation by Sens. Lamar Alexander (R –Tenn) and Patty Murry (D-Wash) has been approved by the Senate Health and Labor Committee and a bill by Reps. Frank Pallone (d-NJ) and Greg Walden (R-Ore) has been approved by the House Energy and Commerce Committee.

The House Ways and Means Committee and the House Education and Labor committees are expected to begin their work on the legislation once Congress returns to Washington. Differences in the competing versions of the legislation exist and mainly surround the issue of how to calculate insurance payments to out of network physicians and hospitals that prevent patients from being stuck with high medical bills.

The Medical Association of the State of Alabama, the AMA, and most national physician specialty organizations are supporting an Independent Dispute Resolution (IDR) as a fair and transparent method of determining the appropriate reimbursement without burdening the patient.

The health insurance industry is pushing back on that approach and supporting a proposal that would set out of network rates at the median in-network rate. Under this method, health insurance companies and the federal government would be setting reimbursement rates for both in-network providers and out of network providers which is a flawed approach and should be opposed.

The Medical Association has sent out several alerts in previous weeks to the membership encouraging physicians to contact Congress in support of the IDR solution. We continue to encourage physicians to make those contacts through our Advocacy Portal.

The Medical Association has also partnered with the Alabama State Society of Anesthesiology to author an op-ed piece that can be found here.

Op-ed: Congress Must End Surprise Medical Billing by Aimee Walsh, M.D.

Congress Must End Surprise Medical Billing

By

Aimee Walsh, M.D.

Counselor, House of Delegates

Medical Association of the State of Alabama

Past President, Alabama State Society of Anesthesiology

Past President, Mobile County Medical Society

Far too often, Mobile residents receive an unwelcome surprise in the form of an unexpected, costly medical bill. Patients who think they are covered suddenly find themselves saddled with hefty bills for lab work, x-rays, facility charges or providers’ services.

This problem is found across Alabama and much of the country—and it is within Congress’s power to fix it. But they must do so the right way.

Earlier this year, Congress began to debate legislation aimed at addressing surprise medical bills, but progress stalled this summer. When lawmakers return from their August recess, they should redouble their efforts and take action this year to ensure that no patient ever again receives a surprise medical bill.

The first step of any solution should be to take patients completely out of the equation. Payment disputes should be resolved between medical providers and insurers, without the patient being caught in the middle.

When surprise medical bills arrive, patients are often recovering from an injury or illness. They should not have their suffering compounded by out-of-pocket costs that exceed what they expected to pay for in-network coverage. In addition, surprise bills and fear of additional costs can undermine patient-physician relationships, threatening the quality of care. This core problem for patients will be eliminated if Congress prohibits sending patients surprise balance bills reflecting unexpected out-of-network costs.

With the patient removed from the payment dispute, Congress must next establish fair rules for insurers and medical providers to resolve out-of-network payment disputes. Neither side—nor should the government— be able to dictate prices, especially through the so-called “bench marking” approach, which would under compensate providers, resulting in reduced access to care for patients.

Instead, third-party data and analysis should be used to establish fair payments through a process known as Independent Dispute Resolution (IDR). IDR will be neutral, fair and cost-efficient. It will never involve patients or add further costs to them. It will also be supported by increasingly robust technology and data analysis, making the process efficient.

Any legislative solution must first and foremost establish a fair process for insurers and providers to resolve disputes without mandating fixed prices. But Congress can take additional steps as well to prevent payment disputes in the first place.

The problem of surprise bills arises in part because of changes and exclusions in health insurers’ networks. Patients may not realize that a secondary specialist—for instance, a radiologist reading an x-ray—is not part of an insurer’s network. In an emergency—where a patient is rushed to the nearest hospital and sees the first available doctor—there may be no opportunity to check coverage or travel to a more distant hospital.

It is simply wrong for emergencies to result in high-dollar, out-of-network surprise bills. Congress can also help address this issue by encouraging insurers to build and maintain robust networks.

Local U.S. Representative Bradley Byrne has made a welcome commitment to lowering healthcare costs for American families. He can help fulfill this promise by working with others in Congress to pass legislation that stops surprise medical bills—the right way.