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Medical Association Announces 2019 State and Federal Agendas

Medical Association Announces 2019 State and Federal Agendas

The Medical Association Board of Censors has met and approved the Association’s 2019 State and Federal Agendas. These agendas were developed with guidance from the House of Delegates and input from individual physicians. As the Alabama Legislature and U.S. Congress begin their work for 2019, additional items affecting physicians, medical practices and patients may be added to this list.

2019 STATE AGENDA

The Medical Association supports:

  • Legislation prohibiting deceptive health care advertising and requiring all health care professionals to clearly identify their type of license to patients
  • Reforming the “certificate of need” process to increase physician ownership of equipment and facilities and expand access to quality, affordable care
    • The recommendations of the Rural Health Taskforce:
    • Increased in funding for the Board of Medical Scholarship Awards (BMSA),
    • Broaden the rural physician tax credit,
    • Promote continued support for the Rural Medical Program and the Rural Medical Scholars Program
    • Expansion of the model Huntsville Rural Premedical Internship program to other medical school campuses
    • Increased funding for the Alabama Area Health Education Center (AHEC) program
  • Medicaid expansion
  • Increasing physician Medicaid payments to Medicare levels for all specialties of medicine
  • Increased funding for the Prescription Drug Monitoring Program to continue transforming it into a useful tool for physician monitoring of patients at risk for drug interactions and overdose potential
  • Requirements for vaccine registry review prior to administration and uploading patient vaccine information into the database
  • Strengthening existing tort reforms and ensuring liability system stability
  • Continued physician compounding, dispensing of drugs
  • The same standards and reimbursements for telehealth and face-to-face visits
  • Reforming the “certificate of need” process to increase physician ownership of equipment and facilities and expand access to quality, affordable care

The Medical Association opposes:

  • Any scope of practice expansion which could lower quality of care for or increase costs for patients including, but not limited to, eliminating the referral requirement for physical therapy; allowing optometrists to perform eye surgery and injections; expanding podiatric surgical allowances; and, abolishing collaborative practice, supervisory agreements and/or supervision requirements between physicians and nurse practitioners, physician assistants and nurse anesthetists.
  • Legislation or other initiatives that could increase lawsuits against physicians
  • Non-physicians setting standards for medical care delivery
  • Tax increases disproportionately affecting physicians
  • Expanding Prescription Drug Monitoring Program access for law enforcement
  • Statutory requirements for mandatory Prescription Drug Monitoring Program checks
  • Expansion of Maintenance of Certification (MOC) requirements
  • Changes to workers’ compensation laws negatively affecting treatment of injured workers and medical practices
  • Biologic substitution legislation containing insufficient quality and notification requirements and which increases administrative burdens on physicians

 

2019 FEDERAL AGENDA 

The Medical Association supports:

  • Meaningful tort reforms that maintain existing state protections
  • Reducing administrative and regulatory burdens on physicians and medical practices
  • Repeal of the Affordable Care Act and replacement with a system that:
    • Includes meaningful tort reforms that maintain existing state protections
    • Preserves employer-based health insurance
    • Protects coverage for patients with pre-existing conditions and for dependents under age 26
    • With proper oversight, allows the sale of health insurance across state lines
    • Allows for deducting individual health insurance expenses on tax returns
    • Increases allowed contributions to health savings accounts
    • Ensures access for vulnerable populations and does not increase uncompensated care
    • Ensures universal, catastrophic coverage
    • Does not require adherence with insurance requirements until insurance reimbursement begins
    • Reduces administrative and regulatory burdens
  • Overhauling federal fraud and abuse programs and reforming the RAC program
  • Prescription drug abuse education, prevention and treatment initiatives
  • Allowing patient private contracting in Medicare and expanding veterans’ access to non-VA physicians
  • Reducing escalating prescription drug costs
  • A patient-centered MACRA framework, including non-punitive and flexible implementation of new MIPS, PQRS and MU requirements
  • Better interstate Prescription Drug Monitoring Program connectivity
  • Eliminating “pain” as the fifth vital sign
  • Requiring all VA facilities, methadone clinics and suboxone clinics to input prescription data into state PDMPs where they are located

The Medical Association opposes:

  • Non-physicians setting standards for medical care delivery
  • Publication of Medicare physician payment data
  • National medical licensure that supersedes state licensure
  • Legislation/initiatives increasing lawsuits against physicians

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Medical Association’s 2018 State and Federal Agendas

Medical Association’s 2018 State and Federal Agendas

The Medical Association Board of Censors has met and approved the Association’s 2018 State and Federal Agendas. These agendas were developed with guidance from the House of Delegates and input from individual physicians. As the Alabama Legislature and U.S. Congress begin their work for 2018, additional items affecting physicians, medical practices and patients may be added to this list.

Download the Medical Association’s 2018 State and Federal Agendas (PDF)

 

2018 STATE AGENDA

 

The Medical Association supports:

  • Ensuring legislation “first do[es] no harm”
  • Extending the Medicaid payment bump for primary care to all specialties of medicine
  • Eliminating the health insurance-coverage gap for the working poor
  • Ensuring fair payment for patient care and reducing administrative burdens on physicians and medical practices
  • Strengthening existing tort reforms and ensuring liability system stability
  • Empowering patients and their doctors in making medical decisions
  • Continued physician compounding, dispensing of drugs
  • The same standards and reimbursements for telehealth and face-to-face visits
  • Training, education and licensing transparency of all individuals involved in patient care
  • Continued self-regulation of medicine over all areas of patient care
  • Increased state funding to upgrade the Prescription Drug Monitoring Program to a useful tool for physician monitoring patients at risk for drug interactions and overdose potential
  • Using data analytics to combat the drug abuse epidemic by strengthening research capabilities of pre-approved, de-identified prescription information
  • Maintaining the Alabama Department of Public Health as the repository for PDMP information to ensure continuity for prescribers and dispensers and security for patients
  • Standard opioid education in medical school so the physicians of tomorrow are prepared to face the realities and responsibilities of opioid prescribing

 

The Medical Association opposes:

  • The radical Patient Compensation System legislation
  • Legislation/initiatives increasing lawsuits against physicians
  • Non-physicians setting standards for medical care delivery
  • Tax increases disproportionately affecting physicians
  • Expanding access to the Prescription Drug Monitoring Program (PDMP) for law enforcement
  • Statutory requirements for mandatory PDMP checks
  • Further expansion of Maintenance of Certification (MOC) requirements
  • Changes to workers’ compensation laws negatively affecting treatment of injured workers and medical practices
  • Any scope of practice expansions that endanger patients or reduces quality of care
  • Biologic substitution legislation that allows lower standards in Alabama than those set by the FDA that doesn’t provide immediate notifications to patients and their physicians when a biologic is substituted, and that increases administrative burdens on physicians and medical practices

 

2018 FEDERAL AGENDA

 

The Medical Association supports:

  • Meaningful tort reforms that maintain existing state protections
  • Reducing administrative and regulatory burdens on physicians and medical practices
  • Repeal of the Affordable Care Act and replacement with a system that:
    • Includes meaningful tort reforms that maintain existing state protections
    • Preserves employer-based health insurance
    • Protects coverage for patients with pre-existing conditions
    • Protects coverage for dependents under age 26
    • With proper oversight, allows the sale of health insurance across state lines
    • Allows for deducting individual health insurance expenses on tax returns
    • Increases allowed contributions to health savings accounts
    • Ensures access for vulnerable populations
    • Ensures universal, catastrophic coverage
    • Does not increase uncompensated care
    • Does not require adherence with insurance requirements until insurance reimbursement begins
    • Reduces administrative and regulatory burdens
  • Overhauling federal fraud and abuse programs
  • Reforming the RAC program
  • Prescription drug abuse education, prevention and treatment initiatives
  • Allowing patient private contracting in Medicare
  • Expanding veterans’ access to non-VA physicians
  • Reducing escalating prescription drug costs
  • A patient-centered MACRA framework, including non-punitive and flexible implementation of new MIPS, PQRS and MU requirements
  • Congressional reauthorization of CHIP (Children’s Health Insurance Program) at the current enhanced funding level
  • Better interstate PDMP connectivity
  • Eliminating “pain” as the fifth vital sign
  • Repealing the “language interpreters” rule
  • Requiring all VA facilities, methadone clinics and suboxone clinics to input prescription data into state PDMPs where they are located

 

The Medical Association opposes:

  • Non-physicians setting standards for medical care delivery
  • Publication of Medicare physician payment data
  • National medical licensure that supersedes state licensure
  • Legislation/initiatives increasing lawsuits against physicians

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Medical Licensure Compact Goes Live

Medical Licensure Compact Goes Live

The Interstate Medical Licensure Compact, a pathway to expedite the licensing of physicians already licensed to practice in one state, who seek to practice medicine in multiple states, is officially live. Alabama became the seventh state to enact the Interstate Medical Licensure Compact and the final state necessary in order for the expedited pathway to licensure for board-certified physicians who have no history of disciplinary action against them to be made possible through the Compact.

The Compact creates a new pathway to expedite the licensing of physicians already licensed to practice in one state, who seek to practice medicine in multiple states. The Compact is designed to increase access to health care in underserved or rural areas and allow patients to more easily consult physicians through telemedicine technologies. The Compact will make it easier for physicians to obtain licenses to practice in multiple states and will strengthen public protection by facilitating state medical board sharing of investigative and disciplinary information that they cannot share now.

The Interstate Medical Licensure Compact is an agreement between 18 states and the 23 Medical and Osteopathic Boards in those states. Under this agreement licensed physicians can qualify to practice medicine across state lines within the Compact if they meet the agreed upon eligibility requirements. Approximately 80 percent of physicians meet the criteria for licensure through the IMLC.

Physicians can apply for an expedited license at https://imlcc.org/applynow/.

There are a few issues of special note:

  • As of now, seven of the 18 states (AL, ID, IA, KS, WV, WI, WY) in the Compact are ready to issue licenses through the Compact. The remaining 11 are working to clarify/verify that their state medical boards are authorized to conduct background checks as required by the Compact. Bills to clear up this issue appear to be moving quickly.
  • Fees
    1. For states – The Commission decided that there will be no cost to a state to participate in the Compact.
    2. For physicians – The cost to a physician to participate in the Compact is:
      1. Application Cost  = $700
        1. $400 of which will go to the Commission, and
        2. $300 of which will go to the physician’s State of Principal Licensure to cover the cost of verifying the physician’s credentials; PLUS
      2. License Cost – Each state in the Compact has the authority to establish the cost of the license received through the Compact. The costs range from $75-600. See the breakdown here.

The application fee may be changed in the future as licenses start being processed, and the amount of interest in getting a license through the Compact is better known.

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