Medical Society of Virginia Making Change Happen: Advancing Patient-Centered Health Care in Virginia CLARK BARRINEAU AVP OF GOVERNMENT AFFAIRS
The Medical Society of Virginia Vision Purpose Virginia is the best place in To advance quality health which to practice medicine care throughout Virginia with and receive care. the support and active voices of 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 requires plans to honor a previously issued prior carriers to have any previously covered auth for a medication when a patient switches medication covered by their new plan for 30 insurance within the same carrier, • days, requires plans to provide at least one option for • clarifies that emergency prior auth requests medication assisted treatment that does not must be replied to within 24 hours, including require prior auth, • weekends, and, requires that during a surgery or invasive • prohibits use of prior auth for dosage changes procedure, if the physician must perform an for any medication, other than opioids, as long additional or more complex procedure that is as it aligns with FDA guidelines, 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 drives year-round policy decisions are made . advocacy efforts. MSV’s House of Delegates (HOD) Delegates vote on issues You can be a delegate! brought forward by Be an MSV member, register for Annual resolutions. Meeting Resolutions craft MSV Any MSV member can submit a resolution. policy and position on Adopted resolutions become official MSV issues. Policy in the Policy Compendium.
Choose Action April-September Advocacy actions are driven by Advocacy proposals drive MSV policy developed at MSV HOD action for the year and the future. Presented at the Advocacy Summit Reviewed by: • Advocacy Proposals Specialty Advisory Council • Advocacy Committee Approved by the board to set the plan
Take Action All Year Taking action all year creates the There are many ways you can take greatest impact for positive change action Provide virtual comments Serve on a committee or on our website work group Share your ideas – MSV Talk to your legislator – can help! they will listen Attend the General Assembly Attend advocacy events 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
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