House of Delegates

All legislative power of the WSMA is vested in the approximately 200 voting members of the WSMA House of Delegates.

For the compendium of all policies passed by the House of Delegates, visit our What’s Our Policy? page.

Official Actions of the 2021 House of Delegates

For policies adopted at the 2021 WSMA Annual Meeting, download the Official Actions of the 2021 WSMA House of Delegates.

Update on 2021 HOD actions

Official Actions of the 2021 House of Delegates progress report (updated April 2022)

For previous years' reports, contact the WSMA Seattle office at wsma@wsma.org or 206.441.9762.

About the House of Delegates

The WSMA House of Delegates is comprised of elected delegates from each county medical society, qualified state specialty societies, and members of the WSMA Board of Trustees. There is one resident delegate, one student delegate, and one young physician delegate. Each county society has one delegate for every 50 active WSMA members.

Each medical specialty society is entitled to elect or appoint one delegate and one alternate, provided that such specialty society has as members at least one hundred active members of the WSMA, or if the specialty society has fewer than 100 members, 50% of its members must belong to the WSMA.

How the House of Delegates Operates

The WSMA House of Delegates meets once a year, typically in September or October (learn more about the Annual Meeting of the WSMA House of Delegates). The House may also be called into special session at any time by the WSMA president on the written request of fifteen members of the House.

All business of the House is conducted according to parliamentary procedures as outlined in "The Standard Code of Parliamentary Procedure."

WSMA Governance Outside of the Annual House of Delegates Meeting

When the House of Delegates is not in session, the WSMA is governed by the board of trustees. The board meets quarterly and is responsible for carrying out the mandates and policies of the House. The board has all the powers of the House except amending the bylaws or establishing dues or assessments.

From the board of trustees, the WSMA president, president-elect, vice president, immediate past president, and secretary-treasurer form the executive committee. The committee meets monthly and acts for the board in implementing WSMA programs and establishing interim policy.

The WSMA president is the spokesperson for the association.

How to Impact Policymaking at WSMA Webinar

Policymaking is a central component of WSMA’s advocacy on behalf of physicians and physician assistants in Washington. Join WSMA’s policy team as they host a webinar covering the policymaking process at the WSMA, including an overview of the House of Delegates and how to draft, introduce, and successfully bring a resolution to fruition. The policy team also discusses how resolutions passed at the House of Delegates direct our advocacy. Originally held April 22, 2022.

Physician Leadership News

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weekly_rounds_august_5_2022_tuesdays_primary_elections_the_wave_that_wasnt

Weekly Rounds: August 5, 2022 - Tuesday's Primary Elections: The Wave that Wasn't?

Leadership

Shared_Content/News/Weekly_Rounds/2022/weekly_rounds_august_5_2022_tuesdays_primary_elections_the_wave_that_wasnt

<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/weekly-rounds-article-graphic-alex-645x425px.png" class="pull-right" alt="Weekly Rounds logo with Alex Wehinger" /></div> <h5>August 5, 2022</h5> <h2>Tuesday's Primary Elections: The Wave that Wasn't?</h2> <p> Alex Wehinger, WSMA Associate Director of Legislative and Political Affairs </p> <p> With so many factors at play heading into Tuesday's primary elections, even political insiders were reluctant to make predictions. With no shortage of offices up for election, including 123 state legislative positions, all 10 of the state's congressional House seats, and the U.S. Senate seat held by Sen. Patty Murray, both political parties are expecting primary results to forecast their respective chances in November's general elections. Regardless of the outcome, these elections will have a significant influence over the state's political landscape, impacting the future of health care policy in Washington. </p> <p> The <a href="https://results.vote.wa.gov/results/20220802/">secretary of state's elections website</a> is tracking election returns while hundreds of thousands of ballots continue to be counted in the coming days and weeks due to Washington's vote-by-mail system. As such, the takeaways discussed below are preliminary and some results may shift substantially by the time results are finalized and the primary election is certified. </p> <p> At the congressional level, all the state's incumbents appear to be advancing to the November ballot in Washington's "top two" primary system. Issaquah pediatrician Rep. Kim Schrier performed well, garnering just shy of 50% of her district's votes, though the race will remain competitive. It's too soon to tell who Schrier will face in November, with the top Republican challengers separated by less than 1,000 votes. Embattled congressional Republicans who voted for former President Donald Trump's impeachment look to be advancing to the general, with Rep. Jaime Herrera Beutler and Rep. Dan Newhouse surviving conservative challengers. And Sen. Patty Murray bested a crowded field of almost 20 challengers, sailing to a primary victory that portends being repeated in the general. </p> <p> Early results from state legislative races seem to buck conventional wisdom that the president's political party typically loses seats during midterm election years. Going into the primary, Republicans forecasted a "red wave" with campaigns centered on inflation, high gas prices, and public safety. On the other hand, Democrats signaled they were playing defense to retain seats they'd gained since 2018 that looked to once again be competitive. Leaning into the progressive policy wins of recent years, they focused their messaging on abortion access and addressing climate change. </p> <p> Before diving into the details, the open seat race in North Seattle's 46th Legislative District is of particular relevance for the physician community. Lelach Rave, a pediatrician who worked at The Everett Clinic, is leading a crowded primary field, and the other physician in the race, family physician Nancy Connolly, is currently finishing third. There may be shifts in the coming weeks, but at least one physician will be on the ballot for this seat in November, creating an opportunity to see a physician in the state Legislature for the first time in almost a decade. </p> <p> As things stand, Democrats look poised to maintain strong majorities in both the House and Senate, while Republicans are recalibrating expectations and asking themselves what happened. Almost every district that was considered a tossup, or even those targeted as potentially competitive, were handily won by Democrats, including: </p> <ul> <li>10th Legislative District (La Conner): Democrats are performing strongly in both legislative races, with a Democratic challenger on target to potentially knock off a Republican House incumbent.</li> <li>26th Legislative District (Gig Harbor): In what is considered the most competitive Senate race of the year, the Democrat incumbent garnered around 52% of the vote. A Democrat is also ahead in the open seat House race.</li> <li>30th Legislative District (Federal Way): Both Democrat incumbents are winning their races, and a Democrat is also leading the votes for the open seat.</li> <li>44th Legislative District (Mill Creek) and 47th Legislative District (Kent): Between the two districts, all six seats look likely to remain in Democratic control.</li> </ul> <p> Based on preliminary primary returns, the only swing district where Republicans performed particularly well is Whatcom County's 42nd Legislative District. If these numbers hold, there will be lots of speculation in the coming weeks attempting to explain the lack of a Republican wave. There may be several factors, the most obvious being the Supreme Court's decision to overturn Roe v. Wade, which helped galvanize and energize many progressive voters, especially in key Puget Sound swing districts. </p> <p> As you would expect, Democrats are doing victory laps extolling the early returns, while Republicans warn that there are still lots of ballots left to be counted. But barring significant shifts in the primary results as ballots continue to be counted, or political winds shifting between now and November, a Democratic-controlled Legislature looks all but certain to continue in 2023. </p> <p> The general election is on Tuesday, Nov. 8. If you are interested in learning more about campaigns or getting connected with the work of <a href="[@]WSMA/Advocacy/WAMPAC/WSMA/Advocacy/WAMPAC/WAMPAC.aspx">WAMPAC</a>, WSMA's political action committee, please contact Alex Wehinger, WSMA's associate director of legislative and political affairs, at <a href="mailto:alex@wsma.org">alex@wsma.org</a>. </p> </div>

8/5/2022 12:00:00 AM

1/1/0001 12:00:00 AM

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Weekly Rounds: July 29, 2022 - 5 Things You May Have Missed

Leadership

Shared_Content/News/Weekly_Rounds/2022/weekly_rounds_july_29_2022_5_things_you_may_have_missed

<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/Weekly%20Rounds/Weekly-Rounds-Article-Graphic-2022-645x425px.png" class="pull-right" alt="Weekly Rounds logo" /></div> <h5>July 29, 2022</h5> <h2>5 Things You May Have Missed</h2> <p>Jennifer Hanscom, CEO</p> <p> While for many the news cycle may appear to slow a bit in the summer months, that's rarely the case for physicians and health care. If you've been busy these past weeks, whether in your practice or (hopefully) on a much-needed vacation, here are several quick news updates to keep you abreast of the health care news cycle here in the Evergreen State. </p> <h3>Washington's hospitals and health systems face large financial losses</h3> <p> Last Thursday, the Washington State Hospital Association held a press briefing to announce the results of a statewide financial impact survey of Washington's hospitals. Hospitals representing 97% of all inpatient beds in Washington state responded to survey, which compared hospitals' financial performance of the first quarter of 2022 to the first quarter of 2021. The survey results paint a dire picture, with hospital operating revenues up 5%, operating expenses up 11% (driven by increased workforce, supply, and drug expenses), and total operating losses combined with investment losses resulting in a net loss of $929 million (a 13% net loss). All 52 urban hospitals and health systems reported negative margins, and account for 99% of losses statewide. Of the independent rural hospitals, 18 out of 34 reported negative margins. Reasons cited for these large losses include low Medicaid reimbursement, high inflation and labor shortages, employee compensation increases, temporary labor spending increases, more complex patients with costs of care higher than rates of reimbursement, especially patients on Medicaid and Medicare, and expenses related to the large and increasing number of patients ready for discharge unable to be transferred. </p> <p> In response to this financial shortfall, WSHA is asking the state to act to get difficult-to-discharge patients into appropriate settings to allow hospitals to focus on critical care, and it will seek long-term solutions from the Legislature in 2023, including an increase in Medicaid rates for hospitals, funding for new facilities for patients needing long-term care, and funding to address the behavioral health crisis, including more staffing, facilities, and upstream interventions. </p> <h3>WSMA seeking input for 2023 legislative agenda</h3> <p> Speaking of Medicaid rates, the WSMA will be pursuing raising Medicaid rates to Medicare levels for all physician services in 2023 (to include services performed by PAs and ARNPs). This is just one of the priorities topping our preliminary 2023 legislative agenda. Our team has surveyed WSMA's membership and leadership on the most pressing issues facing their practices and we will be using those results to outline what we plan to pursue in the 2023 session. You can get a preview of what issues are rising to the top of our agenda at our next Advocacy Council meeting on Aug. 16 at noon via Zoom. During the session, our government affairs team will also provide insights on the fall midterm elections and how they may affect our agenda in 2023. <a href="https://us06web.zoom.us/meeting/register/tZAsf-qqrD4uGdf1lsde7ItlaqVlUGqxCIRr">Register for the WSMA Advocacy Council meeting online</a>. </p> <h3>Registration is now open for the WSMA Annual Meeting</h3> <p> The WSMA is set to have our Annual Meeting Oct. 1 and 2 at the Davenport Hotel in Spokane. In preparing for the policy debate that takes place at the House of Delegates, our staff is collecting resolutions to set our policy or direct our action. If you have an idea you'd like to get before the House of Delegates, a resolution template and other frequently asked questions can be found <a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx?hkey=a22cd977-aaed-4445-9ee2-6fc4716a7136&amp;_zs=B3aFd1&amp;_zl=mhKU8">on the WSMA website</a>. To have your resolution included in the delegate handbook (a compilation of resolutions and other business to be considered by delegates at the Annual Meeting) you must submit it to <a href="mailto:hod@wsma.org">hod@wsma.org</a> by Aug. 12. All resolutions must be sponsored by two WSMA delegates. If you need help identifying sponsors or have additional questions on the House of Delegates or resolution drafting, email the WSMA Policy Department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <p> As soon as resolutions are finalized with a fiscal note and health equity note, they will be posted in our password-protected Virtual Reference Committees, where all members can share their thoughts and opinions. <a href="[@]WSMA/Membership/Discussion_Forums/Virtual_Reference_Committees/WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx?hkey=d674a5ae-4fb5-48d6-b969-16aab9b63647&amp;_zs=B3aFd1&amp;_zl=ohKU8">Bookmark the page to join the conversation</a>. </p> <h3>WSMA provides input on apprenticeship rulemaking to L&amp;I</h3> <p> The Department of Labor and Industries has initiated <a href="https://lni.wa.gov/rulemaking-activity/AO22-15/2215CR101.pdf" target="_blank" rel="noreferrer">rulemaking</a> on apprenticeships as a result of <a href="https://app.leg.wa.gov/billsummary?BillNumber=5600&amp;Year=2021&amp;Initiative=false">Senate Bill 5600</a>, which passed the Legislature in 2022 with the intent of sustaining and expanding the state's registered apprenticeship programs. The WSMA supported this legislation during session and will provide the same support throughout the rulemaking process. The WSMA submitted a <a href="https://wsma.informz.net/WSMA/data/images/Attachments/LI-Apprenticeships-WSMA-Letter.pdf" target="_blank" rel="noreferrer">comment letter</a> on June 24 requesting that L&amp;I consider an apprenticeship platform for medical assistants under the health care and behavioral health platform. Providing medical assistants an apprenticeship pathway will strengthen care teams, improve the quality of care patients receive, and help mitigate workforce issues facing our state. This rulemaking is still in the 101 phase, or Preproposal Statement of Inquiry. The WSMA will be sure to keep you apprised of updates as this rulemaking progresses. </p> <h3>Payers must post negotiated prices</h3> <p> The Centers for Medicare and Medicaid Services' <a href="https://www.beckerspayer.com/policy-updates/payers-must-post-negotiated-prices-starting-july-1-8-things-to-know.html#key-provisions">Transparency in Coverage final rule</a> took effect on July 1, requiring payers nationwide to publish the cost of nearly every health care service they've negotiated with physicians and health care professionals. The rule requires payers to disclose in-network physician and health care professional rates for covered items and services; out-of-network allowed amounts and billed charges for all covered items and services; and negotiated rates and historical net prices for covered prescription drugs administered by physicians and health care professionals. Payers not in compliance could face fines of up to $100 per day for each violation and for each individual affected by the violation. The rule provides accommodations for health plans using alternative reimbursement arrangements that cannot accurately provide a specific dollar amount until after services are rendered. If you have any questions about CMS' new rule you may contact our policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> <p> As always, thank you for all you do in caring for Washingtonians, and keeping our state healthy. </p> </div>

7/29/2022 12:00:00 AM

1/1/0001 12:00:00 AM

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Aetna Rescinds Prior Authorization Requirement on Cataract Surgeries

Leadership

Shared_Content/News/Membership_Memo/2022/July_22/aetna_rescinds_prior_authorization_requirement_on_cataract_surgeries

<div class="col-md-12"> <div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/july/surgeon-645x425px.jpg" class="pull-right" alt="closeup photo of surgeon with headgear" /></div> <h5>July 22, 2022</h5> <h2>Aetna Rescinds Prior Authorization Requirement on Cataract Surgeries</h2> <p>Aetna recently <a href="https://www.aetna.com/content/dam/aetna/pdfs/olu/July-2022-olu-monthly-notice-final.pdf" target="_blank" rel="noreferrer">announced</a> that as of July 1, it will no longer require prior authorization for cataract surgery, with the exception of Florida and Georgia Medicare Advantage patients. This change follows advocacy by the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgery, and other members of the federation of medicine that highlighted the care delays, practice administrative burdens, and patient and public safety concerns associated with this policy. For an update on other prior authorization reform efforts, including federal legislation that would streamline prior authorization in Medicare Advantage plans, see this <a href="[@]Shared_Content/News/Weekly_Rounds/2022/weekly_rounds_april_29_2022_prior_authorization_plagues_us_all">recent Weekly Rounds issue</a>&nbsp;from WSMA CEO Jennifer Hanscom.</p> <p>The WSMA has worked hard to address prior authorization challenges in Washington state. You may recall that <a href="https://apps.leg.wa.gov/WAC/default.aspx?cite=284-43-2050">new rules</a> went into effect in 2018 that were intended to ease the administrative burden you face as you strive to meet the requirements of state-regulated insurers or their third-party administrators when seeking prior authorization of medical services. To help practices adjust workflows to accommodate the new requirements, the WSMA introduced the <a href="https://priorauth.wsma.org/">Prior Authorization Navigator</a>&nbsp;- a mobile-friendly "one-stop-shop" website for guidance on the new rules. There you'll find a <a href="https://priorauth.wsma.org/">one-minute bullet-point summary</a> of the new rules as well as in-depth guidance on the rules' provisions. You'll also find guidance on 2015 rules covering <a href="https://priorauth.wsma.org/prescription-drugs/">prior authorization of prescription drugs</a>.</p> <p>If you encounter an insurer or third-party administrator out of compliance with Office of the Insurance Commissioner's prior authorization requirements, you can easily file a complaint by utilizing the WSMA's Prior Authorization Navigator's <a href="https://priorauth.wsma.org/file-a-complaint/?_zs=B3aFd1&amp;_zl=IInK8">complaint form</a>. We urge you to take advantage of this tool.</p> </div>

7/22/2022 12:00:00 AM

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