Medical Society of Virginia Making Change Happen: Advancing - - PowerPoint PPT Presentation

Medical Society of Virginia

CLARK BARRINEAU AVP OF GOVERNMENT AFFAIRS

Making Change Happen: Advancing Patient-Centered Health Care in Virginia

The Medical Society of Virginia

Vision Virginia is the best place in which to practice medicine and receive care. Purpose To advance quality health care throughout Virginia with the support and active voices

• f physicians, PAs, and

medical students.

Advocacy and Policy

With the support of members, MSV has helped legislators understand the challenges and opportunities facing the medical profession. Policymakers tell us that involvement is key to advocacy success and they want to hear from you. We make it easy for you to be part of influencing the future of medicine in Virginia.

Critical Legislative Priorities

COPN

• Governor Northam convened a workgroup this summer, made

up of CEO’s from several health care interests, including MSV, Anthem, Mary Washington Hospital, Sentara, HCA, The Commonwealth Institute, VCU Health, and many others.

• The CEO group has five 8-hour meetings this summer—

discussing conditions, process and services all related to COPN.

• The goal is to get the entire room to consensus and, if that

doesn’t happen, have as many groups as possible support whatever comes out of the workgroup with the Governor’s backing.

Prior Authorization

MSV’s key legislation for the 2019 session which:

• allows patients who switch health insurance

carriers to have any previously covered medication covered by their new plan for 30 days,

• clarifies that emergency prior auth requests

must be replied to within 24 hours, including weekends,

• prohibits use of prior auth for dosage changes

for any medication, other than opioids, as long as it aligns with FDA guidelines,

• requires plans to honor a previously issued prior

auth for a medication when a patient switches insurance within the same carrier,

• requires plans to provide at least one option for

medication assisted treatment that does not require prior auth,

• and, requires that during a surgery or invasive

procedure, if the physician must perform an additional or more complex procedure that is medically necessary, the health plan must reimburse for that procedure.

Went into effect 7/1

Surprise/Balance Billing

• Last year, MSV supported SB 1763 (Sturtevant), which would

have prohibited balance billing for emergency care and required physicians be paid the regional commercial average payment

• directly. It would have strengthened the prudent layperson

standard by requiring the plans to cover the emergency care, regardless of the final diagnosis.

• Despite unified support from the physician, hospital, and

patient communities, SB 1763 (Sturtevant) was killed due to health plan opposition and lobbying.

• We will continue to work on this issue next session.

Medicaid Reimbursement Rates

• In 2019, the General Assembly approved a budget that

includes a provision to raise Medicaid reimbursement rates to 70% of Medicare rates - impacting primary/preventive care related billing codes, as well as emergency codes.

• There is also a provision that will raise Medicaid rates for

mental health providers up to 100% of Medicare rates.

• Last month, MSV sent a letter to Governor Northam asking

for increased Medicaid rates to be a part of his budget.

Physician Loan Repayment Program

• Last month, MSV sent a letter to Governor Northam asking

for the creation of a physician loan repayment program to be a part of his budget.

• The program would provide financial assistance to physicians

who move and work in rural Virginia. Compensation would increase along with their years of service.

Scope of Practice

• Pharmacists are hoping to be given the power to diagnose

and prescribe.

• Optometrists are hoping to take on some of the out-patient

surgical responsibilities of ophthalmologists.

• Naturopaths want to equate their work with the practice of

medicine.

• The only way to stop these bills is to make your voice heard!

MSV Advocacy and Policy Process

MSV Advocacy and Policy

Define Position October

MSV’s House of Delegates is where policy decisions are made. Policy drives year-round advocacy efforts.

MSV’s House of Delegates (HOD)

Delegates vote on issues brought forward by resolutions. Resolutions craft MSV policy and position on issues. You can be a delegate! Be an MSV member, register for Annual Meeting Any MSV member can submit a resolution. Adopted resolutions become official MSV Policy in the Policy Compendium.

Choose Action April-September

Advocacy actions are driven by policy developed at MSV HOD Advocacy proposals drive MSV action for the year and the future.

Advocacy Proposals

Presented at the Advocacy Summit Reviewed by:

• Specialty Advisory Council
• Advocacy Committee

Approved by the board to set the plan

Take Action All Year

Taking action all year creates the greatest impact for positive change There are many ways you can take action

Serve on a committee or work group Talk to your legislator – they will listen Attend advocacy events Provide virtual comments

• n our website

Share your ideas– MSV can help! Attend the General Assembly session lobby day/s

Get Involved – Advocacy and Policy

White Coats on Call 365

• Visit your legislators
• Schedule a practice tour
• Attend General Assembly Lobby Days (not scheduled

yet)

Reminder – MSV Annual Meeting Oct 18-20, 2019

• Members can submit a resolution to set policy
• Members can serve as a delegate

Get Involved - MSVPAC

Participate with MSVPAC Help elect pro-medicine legislators!

• Contribute
• Attend a legislator’s

fundraiser on behalf of MSVPAC

• Host an event
• www.msv.org/PAC