Posts Tagged legislate

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

Posted in: Advocacy

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Three Simple Steps for Increasing Medicine’s Influence

Three Simple Steps for Increasing Medicine’s Influence

From the outside looking in, the political process likely seems as inviting as a shark tank, as navigable as a corn maze, as predictable as the Kentucky Derby. Intimidating, confusing and frustrating are often used by citizens to describe advocacy-related interactions with government and frankly, this isn’t surprising given most citizens’ level of understanding of the political process.

In his Gettysburg Address, President Abraham Lincoln famously opined our nation’s form of government — “of the people, by the people, for the people” — would long endure. Unlike the direct democracy of 5th century Athens, Americans live in a representative democracy, electing individuals from city councilmen to the President to make decisions for them.

Representative democracy eliminates the need for the citizenry to be involved in the minutiae of modern governance. The downside, however, can be a culture of complacency on the part of the electorate. Outcomes are typically directed by those choosing to engage government on issues important to them, and so government becomes “of the people, by the people, for the people [who choose to participate].” The citizenry is ultimately still responsible for holding government accountable, through either direct engagement with lawmakers or the electoral process (or both), though few understand how to do so.

By following the three simple steps below, physicians can increase their influence on issues important to them and the patients they serve.

Step 1: Join, join, join.

A significant portion of success is simply showing up, but most physicians don’t have the time to spend flying back and forth to Washington or driving to Montgomery for Congressional or legislative meetings, hearings and sessions. Laws and or regulations are constantly under consideration in either the nation’s or state’s capitol directly affecting medical care. A practicing physician can’t possibly make all the scheduled meetings and still see patients, much less attend to the necessary continual monitoring of legislative and regulatory bodies required of successful modern-day advocacy operations.

But when like-minded people pool their resources good things can happen. Advocacy organizations concerned with ensuring delivery of quality care and a positive practice and liability environment — from individual state and national specialty societies to the Medical Association of the State of Alabama — all deserve your support and membership.

They are all working for you and joining them gives these organizations the resources to hire qualified personnel to represent physicians and their patients before legislative and regulatory bodies.

Step 2: Get to know a few key people.

Physicians are responsible for a lot, and in today’s world especially, it’s easy to get into a routine and leave the job of representing the profession to someone else. After all, isn’t that what membership dues are for? Yes and no. While membership in organizations advocating for physicians helps fund advocacy operations, paying membership dues alone is not enough, not in the era of social media, 24-hour news and increased engagement by those on the other side of issues from organized medicine.

Perhaps surprisingly, getting to know a few key people is not difficult, even if only by phone or email. While those paid to represent physicians will know the members of the Legislature and Congress and try to convince them of medicine’s position, in lawmakers’ minds, there is no contact more important than one from a constituent.

Physicians should start locally, getting to know their State Representative and State Senator first, gradually working up to establishing relationships with their member of Congress and U.S. Senators. If they are doing their job well as an elected representative, these legislators and their staff will be glad to hear from a constituent and get his/her perspective. At the same time, don’t overlook the importance of encouraging fellow physicians to engage their local elected officials in meaningful dialogue as well so overall efforts will be amplified.

For more information on how to interact and communicate with lawmakers, check out the Medical Association’s ABCs of VIP.

Step 3: Put your money where your mouth is.

Medical and specialty society membership dollars cannot be legally used for elections purposes, and so separate political action committees or PACs must be established and funds raised each year to help elect candidates physicians can work with on important issues. Not surprisingly, numerous entities whose objectives are at odds with medical liability reform, meaningful health system reform and with ensuring the highest standards for medical care are eager to get their allies elected to office.

Just like their parent organizations, the PACs of specialty societies and the official political committee of the Medical Association of the State of Alabama (ALAPAC) are all worthy of your support. When it comes to PAC contributions, never underestimate the impact of even a small donation.

Choosing not to participate in the political process — when it’s known the decisions of lawmakers directly affect medicine — is akin to getting sued, consciously sitting out voir dire and letting the plaintiff’s lawyer pick the jury.

Summary

The future of medical care, in Alabama and the nation, rests not with elected lawmakers and appointed bureaucrats but with the men and women actually caring for patients every day. A representative democracy functions best when the electorate holds those elected to office accountable. Increasing medicine’s ability to successfully advocate for physicians and the patients they serve will require increased participation in the political process. It is incumbent upon physicians to join the organizations fighting for them, to get to know their elected officials and to contribute to PACs whose goals align with their own.

By Niko Corley
Director, Legislative Affairs
Deputy Director, Alabama Medical PAC (ALAPAC)

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