Archive for Advocacy

What if No One was On Call?

2021 Legislative Recap

After the 2020 Session was cut short by the COVID-19 pandemic, it was widely expected that health care would be a hot topic for the 2021 Session. Those forecasts proved to be true, with roughly 20 percent of bills and resolutions filed during the 2021 Session relating to health care!

Had the Medical Association not been “on call” during the 2021 Session, problematic bills for physicians and bills dangerous to patients could have become law.  

*Click the button below to download a pdf version*

Moving Medicine Forward in 2021

While preventing dangerous and problematic proposals from becoming law consumes much of the Association’s advocacy efforts, at the same time the Association is trying to move medicine forward each session. The 2021 Session saw continued success for the Association in two top-priority funding requests (MMRC and BMSA) as well as the enactment of legislation to further access to physician-led, team-based care for patients in Alabama. 

If no one was on call . . . physicians, their staff, and their practices would have no protection from COVID-19 frivolous lawsuits. The Association worked with both Sen. Arthur Orr (R-Decatur) and a coalition of other organizations on legislation providing liability protection to businesses but also to physicians for care whose provision to patients was affected or impacted by COVID-19 and/or the state’s response to the pandemic. This bill was one of the first to become law in 2021.

If no one was on call . . . the Maternal Mortality Review Committee (MMRC) could not have received vital funding for the second year in a row. In 2019, the Association spearheaded a coalition of stakeholders – which included March of Dimes, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and Johnson & Johnson – to bring awareness to the issue of increasing maternal mortality rates in Alabama and spotlight the impact this committee could have to reverse that trend if properly staffed and resourced. As she did in 2020, Gov. Ivey again supported funding for the MMRC in her initial 2022 budget request and legislators maintained that funding in the final budget.

If no one was on call . . . the MMRC’s inaugural report outlining its findings and initial recommendations would not have been recognized. To raise awareness of this important work, the Association worked with Sen. Linda Coleman-Madison on a legislative resolution (SJR106) and joined several legislators at a press conference event in April. 

If no one was on call . . . the Board of Medical Scholarship Awards could not have maintained its significant funding increase in the coming fiscal year. As she did in 2020, Gov. Ivey recommended maintaining the additional $500,000 increase for the BMSA. The legislature agreed, and the total amount for physician-student-loans for 2022 remains at $1.9 million, allowing roughly 10 medical school tuition loans to be granted annually to physicians willing to set up practice in medically underserved areas of Alabama. This program remains one of the best mechanisms for expanding access to quality care.

If no one was on call . . . necessary physician-supported updates to Alabama’s athletic trainer statute as it relates to supervision and care continuity wouldnot have become lawThe Association worked closely with the Athletic Trainers Association and several medical specialty societies in drafting legislation to better define the practice of athletic training, ensure appropriate physician supervision, and allow joint-promulgation of athletic trainer rules between the professions’ respective licensure boards.

If no one was on call … the creation of a new physician-led program to utilize paramedics to reach at-risk patients in communities across the state would not have become law. The Association worked closely with the Alabama Chapter of the American College of Emergency Physicians on the legislation.

If no one was on call … the medical community’s voice and needs of physicians as it relates to expanding broadband in Alabama would not have been heard. The legislation that passed creates a digital expansion authority to expand access to the internet in all 67 counties and will undoubtedly help patients connect with their physicians via telehealth.

If no one was on call … awareness of the need to expand Medicaid would not have grown as much as it did. The Association, as part of Cover Alabama – a coalition of more than 100 organizations supporting Medicaid expansion – continues to advocate for those caught in the coverage gap. 

Fighting “Scope Creep”

(the Replacing of Education with Legislation)

Many people would like to be a physician, but few are willing to endure medical school, residency, and all the other various education and training requirements to become an M.D. or D.O. Instead of pursuing higher education, some non-physician organizations pursue legislative changes as an end-around-means to practice medicine, endangering quality care for patients.

If no one was on call . . . the physician referral requirement for physical therapy could have been abolished. As introduced, the legislation (sponsored by Sen. Jim McClendon) would have abolished the need for a medical diagnosis before a physical therapist could begin providing therapy to a patient. 

If no one was on call . . . podiatrists could have been granted the ability to perform surgery on the ankle and lower leg. The legislation (co-sponsored by Sen. Jim McClendon) would have allowed podiatrists who have completed as few as 2-years of podiatry residency (significantly less than either a general orthopaedist or an orthopaedic surgeon specializing in the ankle) to perform ankle surgery.

If no one was on call . . . optometrists could have begun performing eye surgeries using scalpels and lasers as well as eye injections. The legislation (pushed by Sen. Jim McClendon) would have allowed optometrists, who do not undergo any surgical residencies anywhere in the U.S., to perform surgeries and injections on the eye and would also have given the Alabama Board of Optometry the sole power to define and regulate what is considered to be the practice of optometry, taking all authority away from the Legislature to define it. 

If no one was on call . . . a newly-created state board could have unilaterally set the scope of practice for imaging technologists and significantly increased costs to medical practices utilizing medical imaging. Working with the Alabama Academy of Radiology, the Alabama Academy of Family Physicians and other medical specialty societies, the Association was able to reach a consensus with the technologists on their legislation.

If no one was on call . . . the State Board of Nursing could have gained jurisdiction over, along with the ability to charge licensure fees to, medical assistants working in physician offices. Working with a coalition of partners, the problems with the legislation were resolved. 

If no one was on call … various “interstate compacts” for non-physicians could have enabled “scope creep” far beyond what Alabama law allows.   

Beating Back the Lawsuit Industry

Plaintiff lawyers are constantly seeking new opportunities to sue physicians. Alabama’s medical liability laws have long been recognized for ensuring a stable legal climate and fostering fairness in the courtroom. But those laws come in jeopardy every session and the Association must defend against allowing more frivolous lawsuits to be filed against physicians.

If no one was on call … new vaccine-related lawsuits against physician-employers and medical practices could have become law.

If no one was on call … physicians accepting Medicaid could have been subject to whistleblower lawsuits for honest billing mistakes, costing $5,500-$11,000 per billing mistake plus triple damages under a Medicaid fraud bill (sponsored by Sen. Jim McClendon). The Association, along with a coalition of health care associations, offered a substitute bill the sponsor rejected. 

If no one was on call … physicians treating prisoners who are pregnant could have been exposed to new liability for others’ actions. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call … physicians treating survivors of sexual assaults could have been exposed to new liability and requirements for new statutory standards of care. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call . . . physicians could have been held liable for emergency medical treatment decisions of individuals believed to be a threat to themselves or others. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call . . . physicians could have been held liable for school system employees’ deviations from DNR orders made portable for minors in schools. The Association worked with the bill sponsor and bill proponents to remove the problematic language.  

If no one was on call . . . physicians could have been held liable for the actions of school system employees if the physician helped create a “seizure action plan” for his or her minor child patient with a seizure disorder. The Association worked with the bill sponsor to remove the problematic language.  

If no one was on call … legislation to criminalize female genital mutilation could have unintentionally created new liability issues for physicians. The Association worked with the bill sponsor and the Alabama Section of the American College of Obstetricians and Gynecologists to ensure the bill adhered to ACOG guidelines and that no new physician liability was created.   

Other Health-Related Legislation of Interest

If no one was on call . . . the Board of Medical Examiners and Medical Licensure Commission would have been abolished. The legislation (sponsored by Sen. Jim McClendon) would have banned physicians who were members of county, state or national medical and specialty societies from participating in regulating their profession. The proposed structure in the legislation would also have ensured little diversity amongst the physicians serving on the reconstituted BME and would likely have prevented rural physicians from being represented as well. 

If no one was on call … the State Health Officer and the State Committee of Public Health would have been abolished. The legislation (sponsored by Sen. Jim McClendon) would have allowed for a non-physician to head the Health Department and would have replaced most of the physicians on the committee with an optometrist and other non-physicians.Instead of making drastic changes to ADPH midstream, the legislature and the governor agreed to a full-spectrum study of the state’s COVID-19 response efforts between now and the beginning of the 2022 Session to identify areas for improvement moving forward.

Legislation was enacted to enable cannabis for medicinal use ifapproved by a physician certified by the state to recommend it to patients. The bill provides for the regulation by the state, from “seed to sale”, of cannabis for medicinal use and creates a new commission to oversee all aspects (other than physician regulation) of cannabis.  The new law allows physicians to become “certifying physicians” and allows patients who are approved by a certifying physician to access medical cannabis at a state approved dispensary. In 2019, the Medical Association did an in-depth survey of its members to gauge Alabama physicians’ opinions on the topic. While opinions amongst individual physicians on cannabis for medicinal use differed then and still do, there was broad support amongst physicians for – IF cannabis for medicinal use were legalized in Alabama – that the state would regulate and inspect the products. As well, there was also broad support for keeping all regulation of physicians who choose to recommend cannabis to patients under the Board of Medical Examiners and not moved under the purview of the new Cannabis Commission or the Agriculture Department. Those areas and others of strong support identified via the 2019 survey, as well as several others, became the basis for the Association’s advocacy efforts on the legislation. As a result, those areas of broad agreement were included in the final bill that passed.

Legislation was enacted that would prevent practices of pharmacy benefit managers relating to patient steering to use mail-order pharmacies and would prevent price discrimination. It would also require the PBM to act as a fiduciary to clients and would prevent them from stopping pharmacists from disclosing prices.

A resolution was enacted to establish the chronic weight management and type 2 diabetes task force. The task force will study the health implications of chronic weight management and type 2 diabetes, the costs associated with the diseases, and the various health treatments available to reduce the epidemic in this state caused by those diseases. The task force is also tasked with making recommendations for improving the health of Alabamians. The Association has an appointment to the task force.

Legislation was filed to require all vaccine providers to check the state vaccine registry (ImmPrint) before administering a vaccine and also to input vaccine-recipient information into the database. The legislation was amended to exclude flu shots for those 19 and older from falling under the legislation. The bill did not pass.

Legislation was filed to ban transgender therapy. It would have criminalized counseling, prescribing and performing surgery if the intent of any of the preceding was to assist and/or affirm in transitioning a patient to a gender different than the one listed on the patient’s birth certificate. The legislation was amended to remove “counseling” from the list of banned therapies for treating transgender patients. The bill did not pass.

Legislation was filed to change the way county health officers issued countywide public health orders. Various bills were filed related to county health orders. Some would have established an advisory panel to weigh in on countywide health orders before implementation while others would have prohibited a county health officer from issuing an order that relates to pandemic or outbreak unless it was approved by the State Health Officer. These bills did not pass.

Legislation was filed to change how statewide public health orders are issued and also to curtail the emergency declaration powers of the governor. These bills did not pass.

Multiple pieces of legislation were filed related to abortion. The topics ranged in focus from requiring information be provided to patients about possible reversal of chemical abortion medications, to banning chemical abortions altogether, to banning the public funding of abortions, to requiring that babies born alive after an abortion in a reproductive health center be provided the same life-sustaining treatment than if the baby were born elsewhere. Of these, the “born alive” bill passed in the final legislative day.

Multiple pieces of legislation were filed related to banning vaccine passports.  The bill that passed on the final legislative day leaves in place existing immunization requirements for students (and also allows exceptions for religious or medical reasons) but bans the issuance of vaccine passports in Alabama by the state or any other governmental body. It also prevents businesses from being able to require proof of vaccination for entry into a business or as a condition for provision of a good or service to a customer. 

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Medical Association Supports Continued Funding for Maternal Death Investigations

Medical Association Supports Continued Funding for Maternal Death Investigations

‘Shocking’ Nearly 70% of Deaths Are Preventable, Experts Say      

MONTGOMERY – The Medical Association of the State of Alabama today joined Alabama legislators in calling for continued state funding to investigate why Alabama mothers die from childbirth and pregnancy complications at more than double the rate of women nationally.

The funding for this research, which was first appropriated by Governor Kay Ivey and the Alabama Legislature just last year, enables the Alabama Maternal Mortality Review Committee (AL-MMRC) to pay for additional autopsies and costs associated with compiling case files and reviewing medical records of Alabama mothers who died up to a year after giving birth. While the AL-MMRC was launched in 2018, it relied solely on the work of volunteers to undertake such reviews until last year.

Appearing at a press conference in Montgomery today, Aruna Arora, MD, MPH, President of the Medical Association, applauded Senator Linda Coleman-Madison for sponsoring a resolution spotlighting the findings of the first AL-MMRC report and acknowledging continued funding of the program is critical to saving Alabama mothers.

“The recent report of the Maternal Mortality Review Committee was both shocking and informative,” said Dr. Arora. “That nearly 70 percent of the deaths could have possibly been prevented highlights the inequities of our current health system and underscores the need for the continued annual review to determine why these high numbers of deaths are occurring. Funding the review committee provides invaluable insight into the deaths of Alabama mothers and will enable the experts to develop specific strategies to save lives in the future.”

For its initial report, the AL-MMRC undertook a review of all maternal deaths in the state from 2016. Highlights from that report include:

  • 36 mothers lost their lives within one year of the end of pregnancy and 36 percent of those deaths were directly related to the pregnancy.
  • Nearly 70 percent of deaths were determined to be preventable.
  • Mental health and substance use disorders were identified as key contributors in almost 50 percent of deaths.
  • 67 percent of deaths occurred 43 to 365 days after the end of pregnancy.

Additionally, the AL-MMRC also made more than 100 recommendations to improve maternal health. Chief among those recommendations is for the state to expand Medicaid. 

“Right now, amid a global pandemic, affordable and accessible health care is more important than ever,” continued Dr. Arora. “Just last week, new research found the risk of maternal mortality to be 22 times higher in women who tested positive for COVID-19 during pregnancy. Thus, with other research showing reduced maternal mortality rates and positive maternal health outcomes in states that expanded Medicaid, the decision to expand here in Alabama is abundantly clear.”

The Medical Association appreciates Governor Ivey’s recommendation for initial funding for the review committee for 2020-21 as well as the continued efforts from legislative leaders like Senator Coleman-Madison, Rep. Laura Hall, and others.                                                                                 

The Medical Association also launched an online social media effort aimed at increasing awareness of maternal health needs with #SaveAlMoms and a website:  www.alabamamedicine.org/SaveAlMoms/.


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American Rescue Plan Offers $940 Million for Medicaid Expansion and Other Benefits for Healthcare

American Rescue Plan Offers $940 Million for Medicaid Expansion and Other Benefits for Healthcare

The American Rescue Plan Act of 2021, signed by President Biden on Thursday, includes a number of key provisions that strengthen both public and private health insurance coverage. Among its Medicaid and the Children’s Health Insurance Program (CHIP) provisions, the American Rescue Plan encourages states to finally take up the Medicaid expansion by offering even more favorable financial incentives than those already in place and allows states to provide longer postpartum health coverage for new mothers.

Right now, some 300,000 Alabamians living in the health coverage gap. They earn too much to qualify for Medicaid under the state’s stringent income limit but too little to qualify for subsidized ACA marketplace plans. If Alabama were to expand Medicaid and provide much-needed healthcare coverage for these individuals, the state would receive an estimated $940 million over two-years for doing so. 

A complete analysis of the Act and its potential impact is below. 

HEALTHCARE PROVISIONS

Additional Federal Funding to States that Newly Adopt the Medicaid Expansion

  • Newly expanding states would receive a 5-percentage-point increase in their FMAP for all non-expansion enrollees, who account for most of a state’s Medicaid enrollees and costs. The increase would begin the first day of the quarter that expansion begins and last for two years. Not only that, this increase is on top of the 6.2-percentage-point FMAP increase that all states will receive for the duration of the public health emergency under last year’s Families First Act, which will provide $86 billion in additional federal Medicaid dollars in 2020 and 2021. 
  • According to the Center for Budget and Policy Priorities (CBPP), Alabama would receive an estimated $940 million in federal funds for expanding. 

New Medicaid and CHIP Option for States to Extend Postpartum Coverage for 12 Months

  • The American Rescue Plan offers states a new “state plan” option to provide pregnancy-related Medicaid and CHIP coverage for one year after the end of pregnancy, extending coverage well beyond the current cutoff of 60 days. States can take up this option starting in the first calendar year quarter one year after enactment, which is April 1, 2022. The option, however, is temporary and will be available to states for five years unless Congress acts to extend it at a later time.
  • The Congressional Budget Office (CBO), for example, estimates that about 45 percent of women covered by Medicaid on the basis of pregnancy now become uninsured after the end of the 60-day postpartum coverage period. Alabama is no different, and this new option would directly help address our current maternal mortality statistics. 

Expansion of the State Medicaid Option for Coverage of COVID-19 Testing for the Uninsured to Include Coverage for COVID-19 Vaccines and Treatment

  • The Families First legislation included a Medicaid option for states to cover COVID-19 testing for the uninsured through the duration of the public health emergency. The federal government picks up 100 percent of the cost. The American Rescue Plan expands this fully federally-funded option to cover COVID-19 vaccines and their administration, and treatment, including prescription drugs, and treatment for conditions that complicate COVID-19 treatment.

Policies to Improve the Affordability and Access of Private Insurance Coverage

  • COBRA Coverage: Premiums for COBRA coverage for individuals who are laid off or leave their jobs because of the pandemic will be subsidized at 100% through September 30, 2021. The employer or health plan could claim a refundable tax credit against its Medicare payroll tax liability for the cost of the premiums.
  • Affordable Care Act (ACA) Marketplace Subsidies: Refundable credits for households with income between 100% to 400% of the federal poverty level (FPL). For 2021 and 2022, premiums for individuals with income at 150% of the FPL will be eliminated, while premiums for all other households will be capped at 8.5% of their income.
  • Health Insurance Marketplace: $20 million in grants to states to modernize and update health insurance marketplace systems, programs, or technology.

Public Health Provisions

  • $7.66 billion to expand the public health workforce, including grants to state, local, and territorial health departments that increase the number of contact tracers, social support specialists, community health workers, public health nurses, epidemiologists, lab personnel, disease intervention specialists and communications personnel.
  • $7.6 billion for testing and vaccinations at community health centers (CHCs).
  • $3 billion for block grant programs under the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide community mental health services and prevention and treatment of substance abuse.
  • $800 million for the National Health Service Corps, as well as $100 million reserved for state student loan repayment programs, $200 million for the Nurse Corps Loan Repayment program, and $330 million for teaching health centers that operate graduate medical education.
  • $250 million for states to establish “strike teams” that could be deployed at skilled nursing facilities (SNFs) with high rates of COVID-19.

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Stutts, Melson Defend “Physician-Led” ADPH in Committee Hearing

Stutts, Melson Defend “Physician-Led” ADPH in Committee Hearing

A bill (SB 240) by optometrist and Senate Health Committee Chairman Jim McClendon (R-Springville) to abolish the position of state health officer and overhaul the entire Alabama Department of Public Health and all county health departments in the state passed committee on an 8-3 vote this week.  The opposing votes came from Sens. Larry Stutts (R-Tuscumbia) and Tim Melson (R-Florence), both physicians, and also from Sen. Dan Roberts (R-Mountain Brook). 

Sen. McClendon told the audience that the State Committee of Public Health, which appoints the state health officer, was just “a private club” of doctors, and that he aimed to change that.  While current law provides that the State Committee of Public Health (12 physicians and four other members) appoints the state health officer, SB 240 would instead have the governor appoint a “secretary of health” who would not be required to be a physician in the proposed legislation.

Senators Larry Stutts, M.D. and Tim Melson, M.D, both took issue with McClendon’s explanation of the bill and with the bill itself.  Stutts said he believes the timing of the bill is wrong.

“The tail end of a pandemic is not the time to do this.  I respect Dr. Harris and his objectivity and expertise.  I haven’t always agreed with all the decisions made, but I don’t want the state health officer to be political appointment,” Stutts said. 

Melson agreed.

“I want the state health officer accountable to other doctors,” Melson said.  “I don’t want to make [it] a political position…I think the system may need a tune-up but not an overhaul, not what’s in this bill.”

Sen. Billy Beasley (D-Clayton), a pharmacist, said he thinks State Health Officer Dr. Scott Harris should be “commended” for his work during the pandemic, adding “I think the state health officer needs to be a doctor.”

Those voting in favor of the bill in committee were Sens. Jim McClendon, Billy Beasley, Tom Whatley, Jack Williams, Sam Givhan, Donnie Chesteen, Garlan Gudger, and Linda Coleman-Madison. 

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2021 Legislative Session

2021 Legislative Session

Scope of Practice

  • ATHLETIC TRAINERS: This bill (SB73) provides for the licensing and regulation of athletic trainers relationship with a supervising physician, creates a joint committee of the two state boards, and expands the ability of athletic trainers to treat injuries sustained by physically active individuals. The Association worked with the ATs prior to the session and are supporting these bills. SB73 was signed by the Governor. 
  • OPTOMETRY: These bills (SB174 & HB402) would have allowed optometrists (who do not undergo any surgical residencies anywhere in the U.S.) to perform surgeries and injections on the eye. This legislation was being pushed by Senator Jim McClendon, the chairman of the Senate Health Committee and an optometrist himself. You may recall the controversy surrounding similar legislation last year when Sen. McClendon rammed the bill through committee without calling a proper vote (video). We stood opposed to these bills. Thank you for reaching out to your legislators! These bills did not pass.
  • PODIATRY: These bills (HB291 & SB371) would have allowed podiatrists who have completed as few as 2 years of podiatric residency (significantly less than a general orthopaedist and orthopaedic surgeon) to perform surgery on the foot and ankle. The same legislation was introduced last year but failed to receive a vote. We worked with the Alabama Orthopaedic Society to oppose this legislation.  Thank you for reaching out to your legislators! These bills did not pass.
  • PHYSICAL THERAPY:  This bill (SB237) was brought by Sen. Jim McClendon and expands the services a licensed physical therapist can render without a prescription or referral in two ways: (1) it extends the current time limit for which services can be provided from 90 days to 120 days; and (2)  it allows physical therapists to treat patients without referral upon their determination that the patient is “medically stable” and “deemed suited to receive physical therapy.” We believe that a medical diagnosis is important and should always come before treatment. This bill did not pass.

Public Health

  • EMERGENCY TIMEFRAME & AUTHORITY: This bill (SB97) limited the timeframe for which a state of emergency can be declared (by the State Health Officer or Governor) to only 14 days. The bill also gave the Legislature the sole authority to extend such declarations. This bill did not pass.
  • COUNTY HEALTH OFFICERS: These bills (SB184 and HB168) would prohibit a county health officer from issuing orders or directives during an epidemic or disease outbreak if the State Health Officer has issued one already. The bill also applies to orders or directives on the county level that are more protective than the state’s guidance. The Association supports County Health Officers and believes local physicians are best suited to make decisions for their local population. These bills did not pass.
  • ABOLISHING MLC & RESTRUCTURING BME: This bill (SB239) was brought by Sen. Jim McClendon and would abolish the Medical Licensure Commission, have the Board of Medical Examiners take on the duties of the Commission, and forbid leaders of any physician specialty organization from serving on the “new” board. By consolidating two, separate agencies into a single regulatory body, this legislation overhauls the current congressional representation requirements, revokes the appointment powers of the Lt. Governor and Speaker of the House, and decreases the board composition by more than half. The amount of issues the Association has with this legislation are lengthier than the bill itself. The bill was defeated by a vote of 8-3 in committee. Thank you to everyone who contacted their Senator and told them to oppose the bill!
  • ABOLISHING & RESTRUCTURING STATE BOARD OF HEALTH: This bill (SB240) was brought by Sen. Jim McClendon and would abolish the State Board of Health, the State Committee of Public Health, the County Boards of Health, and the position of the State Health Officer (among other things). With the two boards and physician oversight no longer existing, the bill creates a new State Health Advisory Board made up of a laundry list of individuals who have some type of relationship to healthcare. County Boards of Health are instantly gone, too, turning such over to the determination of the County Commission. Strangely enough, the State Health Officer position would not exist, but two roles take its place, with the highest (termed “Secretary of the Alabama Department of Public Health”) now appointed by the governor with no requirement that he/she be a physician. We support our state and local boards of health, we support our State Health Officer, and we will vehemently oppose this bill. Thank you for reaching out to your legislators! This bill did not pass. 
  • IMMUNIZATION REGISTRY (ImmPrint): This bill (HB184) by Rep. Paul Lee would require health care providers to report immunization data to the ImmPrint registry and to review the registry before a vaccine is administered. Annual influenza vaccinations are exempt from the review requirement for adults, but are still required to be reported. The Association worked with members of our President’s Council and other specialties in support of this bill. This bill did not pass.
  • COMMUNITY PARAMEDICINE: These bills (HB141 & SB115) would authorize ADPH to establish and administer a community paramedicine program that allows paramedics to provide certain services to patients. The Association worked ACEP and other specialties in drafting the bill. HB141 was signed by the Governor.
  • MEDICAL MARIJUANA: This bill (SB46) by Sen. Tim Melson, M.D. (R—Florence) would authorize medical marijuana in the state. The House Judiciary Committee, the first of two House committees expected to vet the bill, conducted a public hearing Wednesday. Rep. Mike Ball (R—Madison), a Judiciary Committee member and retired law enforcement officer, is shepherding the bill in the House. SB46 was signed by the Governor.
  • SEXUAL ASSAULT SURVIVORS BILL OF RIGHTS: This bill (HB137) creates the Sexual Assault Survivors Bill of Rights and provides certain rights to all victims of sexual assault. The bill also creates a task force responsible for developing recommendations for improving the coordination of the dissemination and implementation of best practices and protocols to hospital administrators, physicians, forensic examiners, and other medical associations and leaders in the medical community. The Association worked with the bill sponsor to amend the bill and ensure physician liability was not expanded. HB137 was sent to the Governor.
  • PHARMACY BENEFIT MANAGERS: This bill (SB227) would prevent practices of pharmacy benefit managers relating to patient steering to use mail-order pharmacies and would prevent price discrimination. It would also require the PBM to act as a fiduciary to clients and would prevent them from stopping pharmacists from disclosing prices. SB227 was signed by the Governor.

Lawsuits & Liability

  • COVID-19 LIABILITY PROTECTION: This bill (SB30) provides liability protection to physicians, health facilities, and businesses from claims arising from COVID-19 and the state’s response to the pandemic. The Medical Association, with the help of Starnes, Davis, Florie, LLP, worked with Sen. Arthur Orr in drafting this bill. SB30 was signed by the Governor. 
  • GENDER CHANGE THERAPY:  These bills (HB1 & SB10) would make it a felony for doctors to treat transgender youth with hormonal therapy and puberty blockers to help their transition. More specifically, the bills would prohibit the use of puberty-blocking drugs, hormonal therapy and surgery to treat transgender minors. Violators could face up to 10 years in prison. A House Judiciary committee amendment was added to narrow the focus of the bill and remove “counseling” a patient and “dispensing” medication to a patient from the list of prohibited activities. Read more on these bills at AL Daily News, AL.com, and KFF. These bills did not pass.
  • BORN ALIVE ABORTION: This bill (HB237) would make it a Class A felony if a physician does not exercise reasonable care to preserve the life of a child born alive after an abortion or attempted abortion in an abortion or reproductive health center. HB237 was sent to the Governor.
  • CHEMICAL ABORTION: This bill (HB317) expands a physician’s standard of care to mandate three types of required patient disclosures when performing or attempting to perform chemical abortions or abortions due to a medical emergency. A physician performing or attempting to perform an abortion who violates these rules recklessly or knowingly is guilty of a Class C felony, and does not have a medical emergency exception authorizing abortion to be “a claim or diagnosis that the woman will engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function.” This bill did not pass.
  • CHEMICAL ABORTION PROHIBITION ACT: This bill (HB377) would prohibit the manufacture, distribution, prescription, dispensing, sale, or transfer any type of generic or non-generic abortifacient medication in Alabama. HB377 has a public hearing in the House Judiciary Committee next week. We oppose. This bill did not pass.
  • GENITAL MUTILATION: This bill (HB252) creates the crime of “genital mutilation” as a Class B Felony in Alabama. Although the list of acts that constitute “genital mutilation” is long, nothing in the bill applies to procedures medically necessary procedures or procedures performed during labor. The legislation adheres to the ACOG position on genital mutilation and also contains Medical Association language explicitly stating that nothing shall be construed to establish a standard of care for hospitals or physicians. This bill did not pass.
  • MEDICAID FALSE CLAIMS ACT: This bill (SB241) was brought by Sen. Jim McClendon and prohibits certain fraudulent activities affecting the Alabama Medicaid program. Furthermore, liability for violations of these prohibitions includes (1) a civil penalty of $5,500-$11,000 per claim, and (2) treble damages. These prohibitions and penalties are different and much more drastic than what currently Medicaid and Medicare law provides, creating very serious liability and monetary concerns for physicians. This bill did not pass.
  • MINOR DNAR: This bill (HB224) would require physicians to obtain consent of parent or legal guardian of a minor prior to entering “do not attempt resuscitation” order. HB224 was sent to the Governor.
  • VACCINE PASSPORTS: This bill (SB267) as substituted would prohibit state and local government entities from requiring an individual to receive an immunization to receive certain government benefits. It would also prohibit businesses from refusing service based on immunization status. SB267 was sent to the Governor.

Finance & Taxation

  • CARES ACT TAX EXCLUSION: These bills (SB98 & HB170) exclude any money received from the CARES Act or other similar COVID-related relief measures from Alabama income tax. “We are not going to tax any of the stimulus monies that came in for businesses, for individuals, for anyone,” said Senator Dan Roberts (R-Mountain Brook). HB170 was signed by the Governor.

Federal Legislation

  • MEDICAID EXPANSION: On March 11, 2021, President Biden signed the American Recovery Act of 2021. The legislation includes a short provision outlining that states, for a length of five years, can extend Medicaid eligibility to women for 12 months after giving birth. The bill also provides an incentive for states that newly expand Medicaid by temporarily increasing the state’s base FMAP by 5% for two years. Please join the Cover Alabama Coalition in supporting Medicaid expansion in Alabama.

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ALAPAC-Supported Kirk Hatcher wins Democratic nomination for Senate District 26

ALAPAC-Supported Kirk Hatcher wins Democratic nomination for Senate District 26

Former State Rep. Kirk Hatcher won the Democratic nomination for Senate District 26, defeating former Rep. John Knight in a runoff with 74% of the vote. Hatcher will face Rep. William Greene in a special general election on March 2.

A Montgomery native and former English educator with 17 years of experience, Hatcher currently is the director of Head Start in Montgomery County. To learn more about Kirk Hatcher, check out his campaign website or his profile in the Montgomery Advertiser.

Hatcher was elected in 2018 to represent District 78 in the House and though only serving a short time as a representative, he believes that he is ready and capable to serve the people of District 26 in the Senate.

Hatcher raised more than $123,000 for the race between Oct. 1 and Dec. 8 (Knight raised a little over $39,000) and has gotten the backing of the Alabama Democratic Conference, the Medical Association of the State of Alabama, the Alabama Association of Realtors and the Alabama Grocers Association. Hatcher said he hopes to use those endorsements to improve the district.

As the political action committee for the Medical Association, ALAPAC supports candidates who best represent the interests of physicians and their patients. This is why ALAPAC supported Kirk Hatcher for Senate District 26.

Posted in: Advocacy, ALAPAC

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ALAPAC Announces Support for April Weaver in Senate District 14

ALAPAC Announces Support for April Weaver in Senate District 14

Alabama Medical PAC (ALAPAC) is proud to announce its support of former State Representative April Weaver in the upcoming special election for Senate District 14.

The ALAPAC Board considers many factors in making campaign support decisions, including candidate-vetting meetings with ALAPAC staff and board members, electronic surveys of ALAPAC contributors, third-party polling data and outreach from local physician ALAPAC contributors voicing support. Regarding its decision to support Weaver, ALAPAC Board Chairman David Herrick, M.D. noted her previous role as Chair of the House Health Committee and the relationships Weaver has built with physicians in her area and across the state.

“Supporting April Weaver for Senate District 14 was an easy decision,” Herrick said. “From her previous roles in both the Alabama House of Representatives and HHS, Weaver has consistently been a leader in healthcare industry and an advocate of policies that move medicine forward. The overwhelming outreach and support from physicians in her area, as well as statewide, is a testament to the positive impact Weaver has made both personally and professionally.”

At a time when healthcare policy is so polarized, electing candidates who understand these issues and value physician input is a top priority. April Weaver is that type of candidate, and we encourage all physicians in Senate District 14 to support her campaign. The special primary election is Tuesday, March 30, 2021. Senate District 14 represents portions of Bibb, Chilton, Hale, Jefferson and Shelby counties.

Posted in: Advocacy, ALAPAC

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Discussions with Decisionmakers: Barry Moore

Discussions with Decisionmakers: Barry Moore
Discussions with Decisionmakers

1. Please tell us a little bit about yourself – Primary occupation? Interests? Hobbies?

I am Barry Moore from Enterprise, Alabama. I grew up on a farm in Coffee County. In 1992 I graduated from Auburn University with a degree in Agricultural Science. Since 1998, my wife Heather and I own and operate Hopper-Moore Inc., a waste-hauling and demolition company. I served in the Alabama House as District 91’s State Representative for 8 years. During that tenure I served as Chairman of Military and Veteran Affairs and several other committees. Heather and I have four children- Jeremy, Kathleen, Claudia and Jeb.

2. What first prompted you to consider running for your House District seat and how do you believe your background and experiences help you serve in the legislature?

I have four fundamentals that guide all aspects of my life: Faith, Family, Finance and Freedom. I felt this has been a calling from God and I have answered that call. Our nation must have leaders with the courage to stand and serve with humility. I am a veteran and the only veteran serving in the Alabama delegation. I ran for Congress in 2018 against an incumbent. It laid the ground-work for 2020 when Congresswoman Roby decided to retire. With much prayer I entered the race along with seven other candidates and by the grace of God, I won. My experience in the Alabama House gave me a track record of how I voted and my work ethic. I was voted the most conservative dependable vote and I will continue to serve my constituents in the same manner.

3. Can you tell us a little about some health-related issues important to your district and your constituents?

Right now, protecting our rural hospitals is very important to District 2. These hospitals are front line to so many different health care emergencies to include CoVid and Mental Health.

4. If you could change one thing about our current healthcare system, what would it be?

I would encourage more physician-patient confidentiality and keep the government out of the decision-making process that may place unnecessary pressure upon the patient or the physician. In other words, let our doctors do their job without the interference of the government.

5. How can the Medical Association – and physicians statewide – help you better address our state (and nation’s) current health challenges?

Continue to work together with an open line of communication and dialogue that effectively serves the people.

6. What’s the one thing you would like to say to physicians in your district?

Absolutely want to say a huge THANK YOU for the incredible job you are doing. The year 2020 has been a year like no other and without our physicians working the way they have, especially the front-line physicians, working directly with CoVid patients, our state would have suffered even greater. My office will always be grateful and open to MASA and look forward to working together.

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Discussions with Decisionmakers: Jerry Carl

Discussions with Decisionmakers: Jerry Carl
Discussions with Decisionmakers

1. Please tell us a little bit about yourself – Primary occupation? Interests? Hobbies?

I have spent most of my life creating and building small businesses, primary dealing with home healthcare equipment and specialty pharmacies. Presently, my wife and I own one pharmacy that serves hemophilia patients. In my spare time, I love being outdoors, hunting, fishing, and spending time with my grandkids.

2. What first prompted you to consider running for your House District seat and how do you believe your background and experiences help you serve in the legislature?

As a native of Mobile, I love everything about my district and have always been proud to call it home. I care about our area and want to do everything possible to help improve the lives of everyone who calls South Alabama home. I have no doubt my experience working with all levels of government as a county commissioner has prepared me well to serve as Congressman for the First District.

I felt prompted to run for Congress when my son, a Marine, came back from active duty in Afghanistan, and I saw the struggles he was having with the VA healthcare system. I knew with my business background and knowledge of the medical industry, I could help make a difference in the lives of our veterans.

3. Can you tell us a little about some health-related issues important to your district and your constituents?

The immediate issue facing our area is the Covid-19 pandemic. It will be key to work with local and state governments to continue limiting the spread of the virus, as well as distributing vaccines once they are available. Moving forward, we must refocus on the rising costs of healthcare, including prescription medication. I look forward to working closely with all levels of government and the AMA to help address these issues.

4. If you could change one thing about our current healthcare system, what would it be?

Our insurance markets need greater competition. I believe we need market-based insurance solutions rather than bloated government programs. This includes allowing individuals the ability to purchase their insurance across state lines and ensuring those with pre-existing conditions are protected.

5. How can the Medical Association – and physicians statewide – help you better address our state (and nation’s) current health challenges?

Overcoming the challenges our healthcare system faces is complex and will require hard work on all sides of the issue. Anytime the Association, physicians, and other medical stakeholders in our state have a concern or an idea, please reach out to me. The more I understand the challenges you face, the more likely we will be to find a solution together.

6. What’s the one thing you would like to say to physicians in your district?

Thank you for all you do for our community day in and day out, especially this year. Covid-19 has been difficult on every American. However, no one has felt this more than our physicians and healthcare workers. 2020 has reminded everyone just how important our physicians are, and I am grateful for the work you continue to do for the people of our district.

Posted in: Advocacy

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