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Alabama Physicians Represented at AMA Annual Meeting

Alabama Physicians Represented at AMA Annual Meeting

CHICAGO – Physicians from Alabama were well represented at the American Medical Association’s meeting last week where discussions ranged from physician and medical student suicide to transparency in drug pricing.

Jorge Alsip, M.D., Delegation Chair, said the Medical Association’s members were represented by its eight-member delegation as well as by representatives from the state’s Medical Student Section, Resident Fellow Section, Young Physician Section, and Senior Physicians Section along with physician representatives from several specialty medical societies.

“During the five-day meeting, our delegation reviewed more than 250 reports and resolutions and offered testimony on issues of particular interest to Alabama physicians.” Dr. Alsip said.

Among the policies adopted or reaffirmed during the meeting were:

  • Eliminating the barriers to appropriate pain management created by insurers and pharmacy benefit managers, which make it more difficult for physicians to provide appropriate care to patients living with pain
  • Reaffirmation of the AMA’s strong opposition to physician-assisted suicide after the House of Delegates rejected a proposal by supporters of physician-assisted suicide to change AMA policy and have the organization take a neutral stance on the issue
  • A report calling for the AMA to conduct a study to identify the systemic patterns and risk factors that lead to burnout, depression and suicide among physicians, residents, and medical students and ultimately help prevent it.
  • New policy to improve the Affordable Care Act (ACA) while reaffirming the Association’s strong opposition to a single-payer approach to health system reform.
  • Strengthened the AMA’s long-standing support for transparency in drug pricing by adopting new policy to support the active regulation of PBMs under state departments of insurance and increased PBM transparency, including utilization, rebates and discounts, and financial incentives.
  • The need for the AMA to work with relevant stakeholders to support the extension of Medicaid coverage to 12 months postpartum to help address the rising maternal mortality rate.

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How Can You Help Students and Young Physicians in Debt?

How Can You Help Students and Young Physicians in Debt?

For most medical students, residents and even young physicians, debt continues to be a significant burden. According to a recent Analysis in Brief, 76% of students graduate with debt. While that percentage has decreased in the last few years, those who borrow for medical school face enormous loans: the median debt was $200,000 in 2018. At private schools, 21% of students have debt of $300,000 or more. The average four-year cost for public school students is $243,902 and $322,767 for private school students.

YOU CAN HELP! A bill was recently introduced in Congress that directly affects medical students and residents, and we need YOUR HELP to garner more support to secure its passage.

Introduced by Dr. Brian Babin (R-TX), HR 1554 (Resident Education Deferred Interest Act, or REDI Act) would allow physicians and dentists to obtain interest-free student loan deferment while training in residency. The bill is picking up steam and now has 32 co-sponsors split almost evenly between Republicans and Democrats. Simply put, this bill would be an across the board win for residents.

We encourage you to take action by asking your representatives for their support of HR 1554. A sample message is already composed for your convenience and you can reach your representatives by simply entering your contact information in the space provided.

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Federal Judge Rules FDA Acted Illegally in Delaying Required Review of E-Cigarettes, Cigars

Federal Judge Rules FDA Acted Illegally in Delaying Required Review of E-Cigarettes, Cigars

WASHINGTON, D.C. – In a major victory for America’s kids and public health, a federal judge has ruled that, in August 2017, the U.S. Food and Drug Administration acted illegally by allowing e-cigarettes to remain on the market until 2022 before applying for FDA authorization and by permitting products to remain on the market indefinitely during review.

In March 2018, several public health and medical organizations, and many individual pediatricians filed suit in federal court challenging this FDA decision. The lawsuit argued the FDA’s decision was unlawful, put kids at risk and harmed public health. The FDA’s delay allowed e-cigarettes – including candy, fruit, mint and menthol-flavored products that clearly appeal to kids – to stay on the market for years without a review of their public health impact. The FDA also delayed the deadline for cigar manufacturers to file such applications until 2021.

On Wednesday, U.S. District Judge Paul W. Grimm of the U.S. District Court for the District of Maryland found the FDA had exceeded its legal authority and the FDA’s delay had played a role in the skyrocketing youth use of e-cigarettes. Judge Grimm ruled the FDA’s delay gave “manufacturers responsible for the public harm a holiday from meeting the obligations of the law.”

“Instead of addressing public health concerns associated with tobacco use by minors and others, the August 2017 Guidance [which delayed the product review requirement] exacerbates the situation by stating, in essence, that manufacturers can continue to advertise and sell products that are addictive and that target a youth market … at a time when minors’ use of tobacco products like e-cigarettes is at an epidemic level and rising,” Judge Grimm wrote. “Arguably, the five-year compliance safe-harbor has allowed the manufacturers enough time to attract new, young users and get them addicted to nicotine before any of their products, labels, or flavors are pulled from the market, at which time the youth are likely to switch to one of the other thousands of tobacco products that are approved – results entirely contrary to the express purpose of the Tobacco Control Act.”

Judge Grimm gave the plaintiffs 14 days to explain what remedial action they want him to order and the FDA 14 days to respond. The FDA must take immediate action to protect our kids and require manufacturers to apply to the FDA if they want to keep their products on the market, including products like Juul that have fueled the youth e-cigarette epidemic.

Judge Grimm noted that manufacturers have had plenty of time to meet this requirement, writing that “manufacturers long have been on notice that they will have to file premarket approval applications, substantial equivalence reports, and exemption requests, and if they have chosen to delay their preparations to do so, then any hardship occasioned by their now having to comply is of their own making.”

The lawsuit was filed on March 27, 2018, by the American Academy of Pediatrics and its Maryland chapter, American Cancer Society Cancer Action Network, American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids, Truth Initiative and five individual pediatricians.

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A Review of Alabama’s Human Life Protection Act

A Review of Alabama’s Human Life Protection Act

UPDATE MAY 24, 2019: Lawsuit filed to block abortion ban. A federal lawsuit filed Friday, May 24, asks a judge to block Alabama’s law that outlaws almost all abortions, the most far-reaching attempt by a conservative state to seek new restrictions on the procedure. The American Civil Liberties Union and Planned Parenthood filed the lawsuit on behalf of abortion providers seeking to overturn the Alabama law that would make performing an abortion at any stage of pregnancy a felony punishable by up to 99 years or life in prison for the abortion provider. The only exception would be when the woman’s health is at serious risk. The law is set to take effect in November unless blocked by a judge.

Rep. Terri Collins, the bill’s sponsor, said this: “We not only expected a challenge to Alabama’s pro-life law from ultra-liberal groups like Planned Parenthood and the ACLU, we actually invited it. Our intent from the day this bill was drafted was to use it as a vehicle to challenge the constitutional abomination known as Roe v. Wade.”


 

MAY 17, 2019: The Human Life Protection Act, or House Bill 314, was enacted into law on May 15, 2019, (the “Act”). It is important to understand that this new law is likely to be legally challenged and unlikely to go into effect anytime soon. That being said, until a court stops the enforcement, physicians should be aware of what the Act prohibits:

  • The Act makes it a Class A felony (a penalty of 10 years up to 99 years in prison) for a physician to perform an abortion, or a Class C felony (a penalty of 1 year to 10 years in prison) for a physician to attempt to perform an abortion.
  • The Act contains limited exceptions for physicians to practice medicine. It is important to note that it is the physician who may be prosecuted under the Act and not the mother of the child.

What is an abortion under the Act?

The Act is centered upon the legal definition of what is a prohibited abortion. The Act requires that in order for it to be an abortion, the woman must be known to be pregnant, and there must be an intent to terminate that pregnancy. The Act has no requirement for “viability” of the fetus for its application. The definition of abortion used in the Act provides that an abortion is the use or prescription of any instrument, medicine, drug, or other substance or device with the intent to terminate the pregnancy of a woman known to be pregnant with knowledge that the termination by those means will with reasonable likelihood cause the death of the unborn child. “Unborn child” is defined broadly by the Act as “a human being, specifically including an unborn child in utero at any stage of development, regardless of viability.” In other words, this Act protects against any abortive procedures upon any unborn child regardless of viability. If a woman is three days pregnant and knows she is pregnant, it would be a prohibited abortion for a physician to terminate that pregnancy.

What is not an abortion under the Act?

If it is not an abortion, it is not prohibited. Specifically excluded from the definition of abortion are activities done with intent to save the life or preserve the health of an unborn child, remove a dead unborn child, to deliver the unborn child prematurely to avoid a serious health risk to the unborn child’s mother, or to preserve the health of her unborn child. These activities are not an abortion, and therefore not illegal. Abortion does not include a procedure or act to terminate the pregnancy of a woman with an ectopic pregnancy, nor does it include the procedure or act to terminate the pregnancy of a woman when the unborn child has a lethal anomaly.

An ectopic pregnancy is defined as a pregnancy resulting from either a fertilized egg that has implanted or attached outside the uterus or a fertilized egg implanted inside the cornu of the uterus. A lethal anomaly is defined as a condition from which an unborn child would die after birth or shortly thereafter or be stillborn. Both pregnancies resulting from an ectopic pregnancy and pregnancies in which the unborn child has a lethal anomaly are not included in the definition of an abortion, and therefore, procedures involving either are not prohibited under the Act.

What is a serious health risk to the mother?

As provided above, an act performed by a physician in order to avoid a serious health risk to the unborn child’s mother is not an abortion and not illegal. A serious health risk to the mother may be based upon either

  1. a physical condition or
  2. an emotional or a mental illness, both of which are discussed below.

A serious health risk to the unborn child’s mother, is defined as:

In reasonable medical judgment, the child’s mother has a condition that so complicates her medical condition that it necessitates the termination of her pregnancy to avert her death or to avert serious risk of substantial physical impairment of a major bodily function. This term does not include a condition based on a claim that the woman is suffering from an emotional condition or a mental illness which will cause her to engage in conduct that intends to result in her death or the death of her unborn child. However, the condition may exist if a second physician who is licensed in Alabama as a psychiatrist, with a minimum of three years of clinical experience, examines the woman and documents that the woman has a diagnosed serious mental illness and because of it, there is reasonable medical judgment that she will engage in conduct that could result in her death or the death of her unborn child. If the mental health diagnosis and likelihood of conduct is confirmed as provided in this act, and it is determined that a termination of her pregnancy is medically necessary to avoid the conduct, the termination may be performed and shall be only performed by a physician licensed in Alabama in a hospital as defined in the Alabama Administrative Code and to which he or she has admitting privileges.

Under the Act can a physical condition of the mother be a serious health risk to the unborn child’s mother?

Yes, a physical condition may be a serious health risk to the unborn child’s mother when the mother is facing death or a serious risk of physical impairment of a major bodily function. Except in cases of a medical emergency, a physician who determines that a woman has a serious health risk must confirm his or her determination in writing by a second physician. The second physician attesting to such is immune from any civil or criminal liability. A physician has 180 days in order to obtain this determination by a second physician. Therefore, a procedure to terminate a pregnancy on a woman who has a physical condition that qualifies as a serious health risk will not be considered an abortion, and thus not prohibited by the Act.

Under the Act can a mental or emotional condition of the mother be a serious health risk to the unborn child’s mother?

Generally emotional conditions and mental illnesses may not qualify for this condition, and therefore neither will be part of an exclusion to the definition of abortion. In other words, generally a procedure to terminate the pregnancy of a woman with an emotional condition or mental health issue, with nothing else, will still be a prohibited abortion. However, if a qualified psychiatrist documents that the woman has a serious mental illness and in his or her medical judgment that she will engage in conduct that will result in her death or the death of her child, then a procedure to terminate the pregnancy may be performed in a hospital. Saying it differently, there is a limited mechanism under the Act allowing for a physician to terminate a suicidal patient’s pregnancy, or the pregnancy of a woman who will engage in conduct that will cause the death of the fetus, when a psychiatrist confirms and documents

  1. the mental health diagnosis,
  2. the likelihood of the conduct, and
  3. the medical necessity of the termination of the pregnancy.

When does this Act go into effect?

The Act shall become effective six months after it was approved by the Governor, or November 15, 2019. However, opponents have pledged to file a lawsuit to enjoin (stop) any enforcement of the Act, until the Court can make a final determination on the constitutionality of the new law.

What happens if this Act is enjoined?

The Act has a specific provision recognizing that all existing laws shall remain in effect while the new Act is being challenged in the Courts.

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For the First Time, Employed Physicians Outnumber Self-Employed

For the First Time, Employed Physicians Outnumber Self-Employed

CHICAGO — For the first time in the United States, employed physicians outnumber self-employed physicians, according to a newly updated study on physician practice arrangements by the American Medical Association. This milestone marks the continuation of a long-term trend that has slowly shifted the distribution of physicians away from ownership of private practices.

Employed physicians were 47.4 percent of all patient care physicians in 2018, up 6 percent points since 2012. In contrast, self-employed physicians were 45.9 percent of all patient care physicians in 2018, down 7 percentage points since 2012. Changes of this magnitude are not unprecedented. Older AMA surveys show the share of self-employed physicians fell 14 percentage points during a six-year span between 1988 and 1994.

Given the rate of change in the early 1990s, it appeared a point was imminent when employed physicians would outnumber self-employed physicians, but the shift took much longer than anticipated. The AMA’s research notes this example and suggests “caution should be taken in assuming current trends will continue indefinitely.”

The majority of patient care physicians (54.0 percent) worked in physician-owned practices in 2018 either as an owner, employee, or contractor. Although this share fell from 60.1 percent in 2012, the trend away from physician-owned practice appears to be slowing since more than half of the shift occurred between 2012 and 2014.

Concurrently, there was an increase in the share of physicians working directly for a hospital or in a practice at least partly owned by a hospital. Physicians working directly for a hospital were 8.0 percent of all patient care physicians, an increase from 5.6 percent in 2012. Physicians in hospital-owned practices were 26.7 percent of all patient care physicians, an increase from 23.4 percent in 2012. In the aggregate, 34.7 percent of physicians worked either directly for a hospital or in a practice at least partly owned by a hospital in 2018, up from 29.0 percent in 2012.

Younger physicians and women physicians are more likely to be employed. Nearly 70 percent of physicians under age 40 were employees in 2018, compared to 38.2 percent of physicians age 55 and over. Among female physicians, more were employees than practice owners (57.6 percent vs. 34.3 percent). The reverse is true for male physicians, more were practice owners than employees (52.1 percent vs. 41.9 percent).

“Transformational change continues in the delivery of health care and physicians are responding by reevaluating their practice arrangements,” said AMA President Barbara L. McAneny, M.D. “Physicians must assess many factors and carefully determine for themselves what settings they find professionally rewarding when considering independence or employment. The AMA stands ready to assist with valuable resources that can help physicians navigate their choice of practice options and offers innovative strategies and resources to ensure physicians in all practice sizes and settings can thrive in the changing health environment.”

As in past AMA studies, physicians’ employment status varied widely across medical specialties in 2018. The surgical subspecialties had the highest share of owners (64.5 percent) followed by obstetrics/gynecology (53.8 percent) and internal medicine subspecialties (51.7 percent). Emergency medicine had the lowest share of owners (26.2 percent) and the highest share of independent contractors (27.3 percent). Family practice was the specialty with the highest share of employed physicians (57.4 percent).

Despite challenges posed by a dynamic change in the health care landscape, most physicians still work in small practices. This share has fallen slowly but steadily since 2012. In 2018, 56.5 percent of physicians worked in practices with 10 or fewer physicians compared to 61.4 percent in 2012. This change has been predominantly driven by the shift away from very small practices, especially solo practices, in favor of very large practices of 50 or more physicians.

The new study is the latest addition to the AMA’s Policy Research Perspective series that examines long term changes in practice arrangements and payment methodologies. The new AMA study, as well as previous studies in the Policy Research Perspective series, is available to download from AMA website.

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An Update on Alabama’s Certificate of Need Program

An Update on Alabama’s Certificate of Need Program

Over the past few months, we have seen some changes and movement when it comes to the certificate of need (“CON”) program in the State of Alabama.

In February, Emily Marsal was appointed as the new Executive Director of the State Health Planning and Development Agency (“SHPDA”), the state agency overseeing the CON program. Emily comes to SHPDA after serving with the Alabama Department of Senior Services.

In addition, we have seen movement towards revising the State Health Plan (“SHP”). The State Health Coordinating Council (“SHCC”) is the regulatory body consisting of both providers and consumers that oversees the SHP. The SHP is used to help determine the need for certain services within the state based on a variety of factors, including data collected by SHPDA. To be approved, a CON application must be consistent with the SHP. Thus, if the SHP does not show a need for a particular service, a CON application for that service cannot be granted. If the SHP shows a need for a particular service, a CON application for that service must be consistent with the need shown in the SHP.

The SHCC is currently in the process of updating several sections of the SHP. For some services (e.g., SCALF beds), once revised, it is anticipated that the SHP will show a need where it has not shown a need in the past, opening the door for CON applications for such services to be filed. For other services (e.g., in-home hospice), it is anticipated that we may see a new, more detailed need methodology where one has not historically been present.

Thus, physicians and other providers who are interested in venturing outside the traditional physician office into other lines of business should pay attention to the proposed revisions to the SHP and the resulting changes in the need methodology for certain services. For those areas opening the door for CON applications to be filed, we expect that a number of applicants will move quickly in attempts to meet such need. Once a CON application is granted by SHPDA to meet the need reflected in the SHP, the need is no longer present in the SHP and future CON applications cannot be approved, absent a regulatory procedure to adjust the need or amend the SHP. Thus, we suspect that, in certain areas for certain services, time will be of the essence once the revised SHP is implemented.

Additional information on the SHCC meetings the SHP revisions is available on the SHPDA website at http://shpda.state.al.us/.

Kelli Fleming is a partner at Burr & Forman LLP practicing in the firm’s Health Care Industry Group. Burr & Forman LLP is an official partner with the Medical Association. 

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Legislation Introduced to Tackle Doctor Shortages

Legislation Introduced to Tackle Doctor Shortages

WASHINGTON, D.C. – U.S. Reps. Terri Sewell (D-AL) and John Katko (R-NY) have introduced legislation that would take critical steps towards reducing nationwide physician shortages by boosting the number of Medicare-supported residency positions. The Resident Physician Shortage Act (H.R. 1763) would support an additional 3,000 positions each year for the next five years, for a total of 15,000 residency positions.

“This week, medical students across the country will celebrate their match into physician residency programs, but many of their peers will be left without a residency due to the gap between students applying and the number of funded positions. At the same time, the United States faces a projected shortage of up to 120,000 physicians by 2030. We need to act now to train more qualified doctors,” Sewell said. “Increasing the number of Medicare-supported residency positions means increasing the number of trained doctors to meet growing demand. It also means giving hospitals and health centers the tools they need to increase access, lower wait times for patients and create a pipeline of qualified medical professionals to serve Americans’ health needs.”

To become a practicing doctor in the U.S., medical school graduates must complete a residency program. However, for the past two decades, an artificial cap on the number of residents funded by Medicare – which is the primary source of payment for residents – has limited the expansion of training programs and the number of trainees.

According to the Association of American Medical Colleges, the United States will face a physician shortage of between 42,600 and 121,300 physicians by 2030. As the American population grows older, the demand for physicians and other medical professionals will increase.

Earlier this year, the Medical Association empaneled the Manpower Shortage Task Force to develop and restore adequate health care manpower in all geographic areas in order to provide quality local health care for all Alabama citizens. Members of the task force have discussed a number of issues including fully funding the Board of Medical Scholarship Awards, scope of practice, physician pipeline programs, education and the possibility of GME expansion, recruitment and retention of physicians through meaningful tax credits and rural community support, and start-up business models.

“Naturally, there are a lot of concerns about health care shortages in rural areas, but our goal with the task force is a long-term solution,” said Medical Association Executive Director Mark Jackson. “The task force and the resolution stand as a reminder that Alabama ranks in the last five of 50 states in health status categories, and while primary care medicine is effective in raising health status, supporting hospitals and improving the economic status of disadvantaged communities, the state’s aging population is causing an escalation in need for primary care physicians. The Association would like to thank Rep. Sewell for introducing the bill and will work closely with her and her staff to help ensure its passage.”

Read the Resident Physician Shortage Act

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Medical Association Signs on to Letter Targeting PA Requirements

Medical Association Signs on to Letter Targeting PA Requirements

The Medical Association recently joined the American Medical Association and 85 other national medical groups and state medical associations in sending a letter to the Centers for Medicare & Medicaid  Services to urge CMS to provide guidance to Medicare Advantage plans on prior authorization processes through its 2020 Call Letter. In the jointly signed letter, the groups call upon CMS to require MA plans to selectively apply PA requirements and provide examples of criteria to be used for programs such as ordering/prescribing patterns that align with evidence-based guidelines and historically high PA approval rates. Citing the CMS Patients Over Paperwork initiative, the letter stresses this new guidance will promote safe, timely and affordable access to care for patients; enhance efficiency; and reduce administrative burden on physician practices.

The letter further explains how the prior authorization process has been found to be burdensome for health care providers, health plans and even patients and that physicians and insurers have agreed that these policy changes to eliminate PAs on those services for which there is low variation in care can promote greater transparency regarding services subject to PAs and protect patients to ensure PAs do not impact the continuity of care.

PA programs can create significant treatment barriers by delaying the start or continuation of necessary treatment, which may in turn adversely affect patient health outcomes. According to a 2018 AMA survey of 1,000 practicing physicians, 91 percent of physicians said PAs can delay a patient’s access to necessary care. These delays may have serious implications for patients and their health, as 75 percent of physicians reported that PA can lead to treatment abandonment, and 91 percent indicated that PA can have a negative impact on patient clinical outcomes. Most alarmingly, 28 percent of physicians indicated that PA has led to a serious adverse event (e.g., death, hospitalization, disability/permanent bodily damage) for a patient in their care.

Read the letter in its entirety

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Montgomery County Hosts AMA President

Montgomery County Hosts AMA President

Feb. 21, 2019 MONTGOMERY ─ The Medical Society of Montgomery County hosted Dr. Barbara L. McAneny, president of the American Medical Association as its keynote speaker for its regular quarterly meeting at the Alabama Department of Archives and History.

During the reception before her lecture, Dr. McAneny had the opportunity to speak one-on-one with many local physicians from a variety of different specialties about their concerns for medicine not only in Alabama, but also on the national stage.

Speaking to a packed house, Dr. McAneny spoke to more than 75 local physicians and guests highlighting some of the AMA’s recent advocacy work and strategic priorities, including issues with physician burnout, access to care, regulatory burdens, increased consolidation, the opioid epidemic, technology and the increasing cost of medical care.

While in Montgomery, MSMC President Stephen Suggs, M.D., and his wife, DeDe, had the opportunity to escort Dr. McAneny to some local landmarks, such as the Equal Justice Initiative’s Legacy Museum and National Memorial for Peace and Justice. Before she left Montgomery, Dr. McAneny also visited with the 42nd Medical Group at Maxwell Air Force Base for a mission briefing and tour of the campus.

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Third Party Task Force Hosts UnitedHealthcare Execs

Third Party Task Force Hosts UnitedHealthcare Execs

Feb. 19, 2019 MONTGOMERY ─ The Association’s Third Party Task Force hosted executives from UnitedHealthcare earlier this week as they made a presentation and answered questions from members of the Board of  Censors and Association staff. Chief Executive Officer, Gulf States Region, Joe Ochipinti, and Vice President of Provider Relations Mike Apple discussed topics ranging from the group’s expansion in Alabama to prior authorization issues and upcoming town hall meetings.

Task Force members questioned the UnitedHealthcare (UHC) representatives about the recent expansion from 300,000 to about 420,000 insureds in Alabama and how this will affect provider relations. UHC will host several town hall meetings across the state to provide educational opportunities for physicians in the area.

The announced town hall meetings include:

March 6-8
MGMA Alabama 2019 Winter Conference
Hyatt Regency Birmingham/The Wynfrey Hotel
Birmingham

March 19
Alabama Hospital Association
Mobile Service Center
Wynlakes Country Club
Montgomery

March 27
UHC Spring 2019 Provider Information Expo
Wynlakes Country Club ─ 9 a.m. – 3 p.m.
Montgomery

March 28
Baptist Montgomery
Link Computer Lab Training
Deboer Building (Brown Springs Road)
Montgomery

April 10
UHC Spring 2019 Provider Information Expo
Embassy Suites ─ 9 a.m. – 3 p.m.
Huntsville

April 24
Russell Medical Center Town Hall
Education Meeting Room
Alexander City

May 7
DCH Town Hall
Druid City Hospital
Willard Auditorium
Tuscaloosa

May 15
Baldwin County Town Hall
Mobile Infirmary
Mobile

May 16
Mobile County Town Hall
Springhill Memorial Hospital
Mobile

The Third-Party Task Force is a subcommittee of the Board of Censors that meets regularly to provide members with assistance in resolving issues and disputes with insurance companies, including Medicaid and Medicare. The Task Force is staffed by the Legal Department and helps members address hassles or other difficulties with policies and procedures of payors.

If you have questions or issues you would like the Association’s Third Party Task Force to address, please email your inquiry to Cheairs Porter.

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