| call_to_action_demand_a_better_federal_balance_billing_solution | Call to Action: Demand a Better Federal Balance Billing Solution | Latest_News | Shared_Content/News/Membership_Memo/20191211/call_to_action_demand_a_better_federal_balance_billing_solution | <div class="col-md-12">
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December 11, 2019
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<h2>
Call to Action: Demand a Better Federal Balance Billing Solution
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<a href="https://www.modernhealthcare.com/politics-policy/surprise-billing-tweaks-fail-win-provider-support">News broke this week</a> of a potential compromise in Congress on federal legislation banning balance billing. The proposal, while protecting patients from surprise bills, would set initial reimbursement from insurance carriers at the median in-network rate paid for the service in the geographic area. A similar proposal in here in Washington was opposed by the WSMA due to concerns about the power that would shift to carriers in contract negotiations. The legislation under consideration also sets a $750 threshold for independent dispute resolution and does not allow for claims bundling - therefore eliminating recourse for any payment from carriers that's below $750.
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Details of the legislation are still being negotiated, and as of the time of this writing, Sen. Patty Murray (the lead Democrat on the Senate committee where the bill is being considered) has not yet lent her support. If this issue is important to you and your practice, contact your congressional representatives today. The primary concerns of the physician community in the draft compromise bill are the rate-setting provision and the threshold for independent dispute resolution.
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Contact Sen. Murray and other members of your congressional delegation using the <a href="https://www.senate.gov/general/contact_information/senators_cfm.cfm">Senate</a> and <a href="https://www.house.gov/representatives">House</a> websites or the <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%252fcampaigns%252f67405%252frespond%253futm_source%253dAction%252520Alert%2526utm_medium%253dPGN%2526utm_campaign%253dSurprise%252520Billing%2526utm_content%253dSurprise%252520Billing">AMA Grassroots Action Center</a>. When sending a message, be sure to reference Washington's balance billing legislation, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1065&amp;Year=2019&amp;Initiative=false">House Bill 1065</a>, as a model. Learn more about that bill <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2019/weekly_rounds_apr_15_2019_taking_action_makes_a_difference">here</a>.
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</div> | 12/11/2019 12:00:00 AM | 1/1/0001 12:00:00 AM |
| practice_impact_new_laws_taking_effect_jan_1 | Practice Impact: New Laws Taking Effect Jan. 1 | Latest_News | Shared_Content/News/Membership_Memo/20191211/practice_impact_new_laws_taking_effect_jan_1 | <div class="col-md-12">
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December 11, 2019
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<h2>
Practice Impact: New Laws Taking Effect Jan. 1
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WSMA advocacy, with your support, makes a tangible difference for physicians, patients, and the practice of medicine in our state. The following is a look at legislation enacted in 2019 that goes into effect Jan. 1, and that may impact your practice or organization.
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More information on these new laws is provided where indicated. Contact the WSMA's new policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a> if you have questions. <em>HB = House Bill; SB = Senate Bill</em>
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<strong>Balance billing, HB 1065</strong>
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Bans balance billing in our state, requires health insurers to reimburse out-of-network physicians at a commercially reasonable rate, and creates an independent dispute resolution process. <a href="[@]Shared_Content/News/Membership_Memo/20191211/washingtons_balance_billing_ban_what_you_need_to_know.aspx">Here's what you need to know about this new law prior to implementation</a>.
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<strong>B&amp;O tax increase, HB 2158</strong>
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Imposes a 20% surcharge on the business and occupation (B&amp;O) tax paid by independent (i.e. non-hospital affiliated) physician practices, among other service businesses. The WSMA strongly opposed this targeted tax increase and will advocate for its repeal during the 2020 legislative session. Learn more about the issue on <a href="[@]WSMA/Advocacy/Legislative___Regulatory/No_to_B_and_O/WSMA/Advocacy/Legislative_Regulatory/No_to_B_and_O/no_to_b_and_o_.aspx?hkey=d5807781-a824-4b2c-a8f4-70ed597ddfa8">the WSMA website</a>. For latest developments, see <a href="[@]Shared_Content/News/Membership_Memo/20191211/sen_oban_announces_bill_to_repeal_b_and_o_tax_increase_on_health_care.aspx">this article in today's Membership Memo</a> .
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<strong>Non-competition clauses, HB 1450</strong>
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Limits the circumstances under which non-compete clauses may be used. Non-compete clauses will only be enforceable if: an employee earns more than $100,000 a year; an independent contractor earns $250,000 a year from the employer proposing a non-compete; the employer discloses terms of the non-compete at or prior to making an employment offer; the employer compensates employees who are laid off but still subject to non-compete agreements; and the non-compete agreement covers a period no longer than 18 months.
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<strong>Public option health plan (aka Cascade Care), SB 5526</strong>
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While effective this Jan. 1, the plans being developed by the state under SB 5526 won't be available until November 2020 for coverage beginning in 2021. <a href="[@]Shared_Content/News/Membership_Memo/20191211/preparing_for_cascade_care_free_webinar_for_physicians.aspx">Learn more about these plans and their cost-control mechanisms</a> (including statutory limits on reimbursement, which the WSMA opposes).
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<strong>Reproductive health care, SB 5602</strong>
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Prohibits discrimination based on an individual's gender identity or expression for reproductive health services purchased or contracted for by the Washington State Health Care Authority, including the use of automatic denials of coverage by managed care organizations. Effective Jan. 1, 2021, health plans and student health plans must provide coverage for certain reproductive treatments and services. Insurers must bill and collect payment with a single invoice that includes all covered benefits and services, and segregation plans must include a certification that the billing and payment processes meet the Office of the Insurance Commissioner's requirements.
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<strong>Substance and opioid use disorder, HB 5380</strong>
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While containing important provisions to improve the treatment of pain and increase access to medication-assisted treatment and naloxone, HB 5380 contains several notable provisions impacting medical practice:
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Requires insurance companies to cover, without prior authorization, at least one FDA-approved product for the treatment of opioid use disorder in the drug classes opioid agonists, opioid antagonists, and opioid partial agonists.
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Requires groups with 10 or more prescribers to integrate their certified electronic health record with the state's prescription monitoring program by 2021 and requires prescriptions for controlled substances to be communicated electronically beginning in 2021. The WSMA was able to obtain exemption processes for both mandates that consider economic hardship, technological limitations, or other exceptional circumstances. The WSMA will report to members when the Department of Health drafts rules outlining the exemption process.
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More information will be forthcoming from WSMA publications on these provisions.
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<strong>Workplace violence prevention, HB 1931</strong>
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Hospitals, ambulatory surgical centers, and other facilities such as home care agencies and psychiatric facilities must develop and implement a violence prevention plan every three years that outlines strategies focused on security considerations and risk of violence factors. A review of workplace violence incidents and issues must be conducted annually. Violence prevention training must be provided to employees, volunteers, and contracted security personnel by July 1, 2020. Records of violent acts must be kept for at least five years after the act reported.
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</div> | 12/11/2019 12:00:00 AM | 1/1/0001 12:00:00 AM |
| sen_oban_announces_bill_to_repeal_b_and_o_tax_increase_on_health_care | Sen. O'Ban Announces Bill to Repeal B&O Tax Increase on Health Care | Latest_News | Shared_Content/News/Membership_Memo/20191211/sen_oban_announces_bill_to_repeal_b_and_o_tax_increase_on_health_care | <div class="col-md-12">
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December 11, 2019
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<h2>Sen. O'Ban Announces Bill to Repeal B&amp;O Tax Increase on Health Care</h2>
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Repealing the B&amp;O tax surcharge on independent physician practices is a key priority for the WSMA as we look toward the 2020 state legislative session. To that end, we're pleased to report that Sen. Steve O'Ban (R-Pierce County) has announced a bill that he is sponsoring for the legislative session that would <a href="http://steveoban.src.wastateleg.org/oban-fights-repeal-business-tax-increase-health-care-providers/">repeal the tax surcharge</a>. The WSMA appreciates the support Sen. O'Ban has provided on this issue, which has included an excellent <a href="http://steveoban.src.wastateleg.org/watch-video-series-bo-tax-increase-will-affect-family-budget-health-care/">video interview series with WSMA members</a> on the impact of the tax increase on their patients and businesses. However, support for repeal will need to come from all corners of the Legislature; if you haven't yet done so, contact your senator and representatives this week and urge them to prioritize patient access to care and physician practice viability by exempting health care from this misguided tax increase when they return to work in 2020. <a href="https://takeaction.wsma.org/no-bo-tax-increase-on-health-care/">Send a message today</a>. #NoToBandO
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</div> | 12/11/2019 12:00:00 AM | 1/1/0001 12:00:00 AM |