| hca_offers_clarity_around_42_cfr_part_2_confidentiality_requirements | HCA Offers Clarity Around 42 CFR Part 2 Confidentiality Requirements | Advocacy | Shared_Content/News/Membership_Memo/20190710/hca_offers_clarity_around_42_cfr_part_2_confidentiality_requirements | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="Sharing Substance Use Disorder Information logo" src="/images/News/Sharing-SUD-645x425px.jpg" class="pull-right" />
</div>
<h5>
July 10, 2019
</h5>
<h2>HCA Offers Clarity Around 42 CFR Part 2 Confidentiality Requirements</h2>
<p>Substance use disorder treatment information is subject to stringent regulations in 42 Code of Federal Regulations Part 2. In response to physician and provider requests for clarity around the confidentiality requirements, the Health Care Authority now offers <a href="https://www.hca.wa.gov/assets/billers-and-providers/60-0015-sharing-substance-use-disorder-information-guide.pdf" target="_blank">Sharing Substance Use Disorder Information: A Guide for Washington State</a>. Developed with input from the WSMA, the guidance helps promote a common understanding of Part 2 and applicable laws, and offers common scenarios in which substance use disorder information sharing is needed. The resource also includes additional provider and patient resources, such as a sample Part 2 compliant consent form.</p>
</div> | 7/8/2019 11:25:13 AM | 7/10/2019 12:00:00 AM |
| medical_commission_license_renewal_fee_increase_still_under_consideration | Physician/PA License Renewal Fee Increase Rulemaking Still Active | Advocacy | Shared_Content/News/Membership_Memo/20190710/medical_commission_license_renewal_fee_increase_still_under_consideration | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/Stethoscope-on-table-645x425px.jpg" class="pull-right" />
</div>
<h5>
July 10, 2019
</h5>
<h2>Physician/PA License Renewal Fee Increase Rulemaking Still Active</h2>
<p>In May, the WSMA <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190424/last_chance_to_act_medical_commission_releases_rulemaking_for_license_renewal_fee_increase">called on members to act</a> in response to the Washington Medical Commission's release of proposed rulemaking raising license renewal fees for allopathic physicians (from $657 to $1,012) and physician assistants (from $202 to $396). While the Medical Commission reported then that the public commenting period would close on May 7 and the rule adopted on May 17, the WSMA has confirmed that the fee increase proposal is still an active rule—and commenting is still available. If you continue to have concerns, please share your comments with the Medical Commission at <a href="mailto:Medical.Rules@wmc.wa.gov">Medical.Rules@wmc.wa.gov</a>. For reference, see WSMA's formal response to the <a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/WMC_Fee_Increase_CR-102_Comment_Letter_May_2019.pdf]" name="proposed CR-102 rule"><a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/WMC_Fee_Increase_CR-102_Comment_Letter_May_2019.pdf]">proposed CR-102 rule</a> </a> that details our concerns regarding the commission's justifications for the fee increases. We will continue to provide updates and share any opportunities for advocacy as the rulemaking proceeds.</p>
</div> | 7/8/2019 11:25:07 AM | 7/10/2019 12:00:00 AM |
| updates_to_apple_health_opioid_prescribing_policy | Updates to Apple Health Opioid Prescribing Policy | Advocacy | Shared_Content/News/Membership_Memo/20190710/updates_to_apple_health_opioid_prescribing_policy | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="Physician inspecting prescription medicine bottle" src="/images/News/Rx_bottle_doctor_laptop_645x425.jpg" class="pull-right" />
</div>
<h5>
July 10, 2019
</h5>
<h2>Updates to Apple Health Opioid Prescribing Policy</h2>
<p>The Health Care Authority <a href="https://www.hca.wa.gov/about-hca/apple-health-medicaid/support-act#Changes">recently announced</a> updates to its Apple Health (Medicaid) opioid clinical policy to align with the <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20181010/new_opioid_bill_passes_congress_with_bipartisan_support">federal SUPPORT Act passed in 2018</a>. The policy's requirements remain largely the same as when first issued by the HCA in October of last year (and endorsed by the WSMA and the Washington State Hospital Association in return for an <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2018/multi_pronged_efforts_seek_to_make_a_difference_in_opioid_epidemic">agreement by the HCA to include expedited prior authorization</a>). Changes include an attestation that chronic pain best practices are being followed when prescribing more than the acute policy limit within a 90-day period, and prior authorization on claims that exceed the 120 morphine milligram equivalent (MME) limit. Visit <a href="https://www.hca.wa.gov/about-hca/apple-health-medicaid/support-act#Changes">the HCA website</a> to review the changes, effective Oct. 1.</p>
</div> | 7/8/2019 11:25:10 AM | 7/10/2019 12:00:00 AM |
| wsma_supports_federal_bill_eliminating_cost_sharing_for_ccm | WSMA Supports Federal Bill Eliminating Cost Sharing for CCM | Advocacy | Shared_Content/News/Membership_Memo/20190710/wsma_supports_federal_bill_eliminating_cost_sharing_for_ccm | <div class="col-md-12">
<h5>
July 10, 2019
</h5>
<h2>WSMA Supports Federal Bill Eliminating Cost Sharing for CCM</h2>
<p>Rep. Suzan Delbene's (D-Wash.) office recently reached out to the WSMA for feedback and support for the Improving Chronic Care Management Act (H.R. 3436). If signed into law, this measure would eliminate the 20 percent beneficiary cost-sharing requirement for chronic care management services, with Medicare paying for 100 percent of the service cost.</p>
<p>CCM codes, including the cost-sharing element for non-face-to-face components, can be confusing and burdensome for patients and physicians and a barrier to important services. The WSMA urges Congress to improve access to chronic care management by passing this bill. Email Jeb Shepard, WSMA director of policy, at <a href="mailto:jeb@wsma.org">jeb@wsma.org</a>&nbsp;with questions or comments.</p>
</div> | 7/8/2019 11:25:17 AM | 7/10/2019 12:00:00 AM |
| ama_welcomes_first_female_african_american_president_other_news_from_ama_annual_meeting | AMA Welcomes First Female African American President; Other News from AMA Annual Meeting | Advocacy | Shared_Content/News/Membership_Memo/20190626/ama_welcomes_first_female_african_american_president_other_news_from_ama_annual_meeting | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/HeadShots/Patrice-Harris-MD-Circle-645x425px.png" class="pull-right" />
</div>
<h5>
June 26, 2019
</h5>
<h2>AMA Welcomes First Female African American President; Other News from AMA Annual Meeting</h2>
<p>Patrice Harris, MD, was sworn in as the American Medical Association's 174th president at the AMA's annual House of Delegates meeting in Chicago earlier this month. Dr. Harris is the first African American woman to hold the office and only the fifth female president in the organization's history.</p>
<p>Watch the live broadcast of Dr. Harris' historic inauguration <a href="https://www.facebook.com/AmericanMedicalAssociation/videos/853283701704193/?notif_id=1559682244507710&amp;notif_t=live_video_schedule_broadcaster">here</a> (her swearing in and inaugural address begin at timestamp 48:45) and read <a href="https://www.medpagetoday.com/publichealthpolicy/generalprofessionalissues/80573?trw=no">a Q&amp;A with the new AMA president</a> to learn more about her goals for the AMA in the coming year.</p>
<p>In other news from the meeting, AMA delegates narrowly voted to continue its opposition to a single-payer health system, adopting new policy instead to push for universal coverage by supporting improvements to the Affordable Care Act, including:</p>
<ul>
<li>Eliminating the subsidy "cliff," thereby expanding eligibility for premium tax credits beyond 400 percent of the federal poverty level.</li>
<li>Increasing the generosity of premium tax credits.</li>
<li>Expanding eligibility of cost-sharing reductions.</li>
</ul>
<p>See <a href="https://www.ama-assn.org/house-delegates/annual-meeting/highlights-2019-ama-annual-meeting">this AMA report</a> for more highlights from the meeting. As they do every year, the WSMA's AMA delegation, comprised of four WSMA members representing the interests of Washington physicians and patients, brought forward several issues during the meeting, including:</p>
<ul>
<li>The concept of offering state employee health plans to every state resident and making the federal employee health benefits program health insurance plans available to everyone (referred for further study).</li>
<li>Alignment of federal privacy law and regulations with HIPAA for the purposes of treatment, payment, and health operations, while ensuring protections are in place against the use of "Part 2" substance use disorder records in criminal proceedings (amended to reference applicable state laws).</li>
<li>Universal access for essential public health services (alternative language adopted).</li>
<li>An AMA study and report on the conditions under which our country could successfully eliminate the manufacture, distribution, and sale of combustible cigarettes and other combustible tobacco products (referred for decision).</li>
</ul>
</div> | 6/26/2019 9:15:29 AM | 6/26/2019 12:00:00 AM |
| balance_billing_debate_and_wsma_advocacy_shifts_to_dc | Balance Billing Debate and WSMA Advocacy Shifts to D.C. | Advocacy | Shared_Content/News/Membership_Memo/20190626/balance_billing_debate_and_wsma_advocacy_shifts_to_dc | <div class="col-md-12">
<h5>
June 26, 2019
</h5>
<h2>Balance Billing Debate and WSMA Advocacy Shifts to D.C.</h2>
<p>After years of negotiation on balance billing in the Washington state legislature, the debate has moved to the federal level as Congress considers multiple approaches to protect patients from surprise bills. A <a href="https://www.modernhealthcare.com/politics-policy/senate-health-bill-includes-pay-cap-surprise-bill-disputes">recently released bipartisan Senate health care bill</a> would, among many provisions, ban balance billing and risk disrupting incentives to contract for insurance carriers. This week, Seattle anesthesiologist James Burkman, MD, and WSMA's Sean Graham traveled to Washington, D.C. to share the physician perspective on this issue with Sen. Patty Murray, the lead Democrat on the Senate Health, Education, Labor and Pension Committee, where the bill is currently being considered.</p>
<p>The Senate bill would reimburse physicians at an insurer's median contracted rate for care delivered under the bill. Importantly, unlike <a href="https://app.leg.wa.gov/billsummary?BillNumber=1065&amp;Year=2019&amp;Initiative=false">House Bill 1065</a>, the balance billing legislation passed in by the state Legislature earlier this year, the Senate bill does not include an arbitration process to allow physicians to seek additional reimbursement from insurers when their initial payment is insufficient. The arbitration component of the state bill was intended to maintain incentives to contract for both insurance carriers and physicians, to encourage the two parties to voluntarily reach an agreement on an acceptable reimbursement rate. Allowing carriers to use internal methodology to determine reimbursement will lead to fewer in-network providers, jeopardizing access to care for patients in some circumstances.</p>
<p>Members of Congress need to hear from you on this important issue. Visit the <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fcampaigns%2f66880%2frespond">AMA Physician Grassroots Network</a> for more details on the federal bills and for a link to message your members of Congress. When sending a message, be sure to reference Washington's balance billing legislation 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>.</p>
</div> | 6/26/2019 9:15:25 AM | 6/26/2019 12:00:00 AM |
| mmr_exemption_update_updated_form_and_new_webinar | MMR Exemption Update: Updated Form and New Webinar | Advocacy | Shared_Content/News/Membership_Memo/20190626/mmr_exemption_update_updated_form_and_new_webinar | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/2019-HB-1638-Signing-645x425px.jpg" class="pull-right" />
</div>
<h5>
June 26, 2019
</h5>
<h2>MMR Exemption Update: Updated Form and New Webinar</h2>
<p><a href="https://app.leg.wa.gov/billsummary?BillNumber=1638&amp;Year=2019&amp;Initiative=false">House Bill 1638</a>, WSMA-backed legislation eliminating the personal and philosophical exemption for the measles, mumps, and rubella (MMR) vaccine, takes effect July 28. Make sure you're prepared with the following new resources.</p>
<p>The Department of Health recently released an updated certificate of exemption form for school, childcare, and preschool immunization requirements. Download the new form from the Department of Health's <a href="https://www.doh.wa.gov/YouandYourFamily/Immunization/FormsandPublications/Forms">Immunizations Forms page</a>.</p>
<p>Important: Several WSMA members have contacted us regarding the new certificate of exemption form. With the elimination of the personal and philosophical exemption for the MMR vaccine, you may notice an uptick in the number of parents claiming a religious exemption to the vaccine. For the form to be valid, a physician or other authorized provider must sign the document attesting they have "…discussed the benefits and risks of immunizations with the parent/legal guardian as a condition for exempting their child." By signing the form, you are indicating that you have discussed the benefits and risks of immunizations. You are not affirming the validity of their religious beliefs.</p>
<p>According to the Department of Health, there is nothing in state statute that requires a physician to sign the form. However, a physician may open themselves up to discrimination claims if they attempt to evaluate the validity of a patient's religion or religious claims prior to signing the form. While the risk for litigation may be lower, this warning extends to physicians who refuse to sign any religious exemptions at all. The WSMA recommends consulting with legal counsel before making any decisions about whether or not to sign these exemption forms.</p>
<p>If you have additional questions about the exemption policy and the new immunization law, the Department of Health and Washington Chapter of the American Academy of Pediatricians are hosting a joint webinar this Friday, June 28 from 7-8 a.m. <a href="https://register.gotowebinar.com/register/7809027748702815235">Pre-register for the free webinar here</a>. If you are unable to attend the webinar, you can send follow-up questions to Billie Dickinson, WSMA policy analyst, at <a href="mailto:billie@wsma.org">billie@wsma.org</a>.</p>
<p><em>Photo: WSMA member Alan Melnick, MD, right, with Gov. Inslee as he signs House Bill 1638, removing the personal/philosophical exemption for the MMR vaccine.</em></p>
</div> | 6/26/2019 9:15:18 AM | 6/26/2019 12:00:00 AM |
| wsma_signs_on_to_support_federal_vaccines_act_legislation | WSMA Signs on to Support Federal VACCINES Act Legislation | Advocacy | Shared_Content/News/Membership_Memo/20190626/wsma_signs_on_to_support_federal_vaccines_act_legislation | <div class="col-md-12">
<h5>
June 26, 2019
</h5>
<h2>WSMA Signs on to Support Federal VACCINES Act Legislation</h2>
<p>The WSMA has joined a sign-on letter in support of the federal Vaccine Awareness Campaign to Champion Immunization and Enhance Safety (VACCINES) Act. The bill, developed by Washington State Secretary of Health John Wiesman and Congresswoman Kim Schrier, MD, would provide necessary tools to increase vaccine rates and reduce vaccine misinformation.</p>
<p>Among its provisions, the bill would:</p>
<ul>
<li>Provide grants for research to learn more about the factors that drive vaccine hesitancy and barriers to immunization.</li>
<li>Require the CDC to track where there are changes in vaccination confidence, coverage, and refusal rates to assist public health agencies.</li>
<li>Support an evidence-based public awareness campaign on the importance of vaccinations, which will include culturally and linguistically competent resources tailored for communities with high rates of unvaccinated individuals.</li>
<li>Authorize grants to state, local, and tribal public health departments.</li>
</ul>
<p>To learn more, read the <a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/VACCINES-Act.pdf]">bill language</a> for the VACCINES Act. A <a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/VACCINES-One-Pager.pdf]">one-pager</a> on the bill is also available.</p>
</div> | 6/26/2019 9:15:22 AM | 6/26/2019 12:00:00 AM |
| 2019_wsma_annual_meeting_how_to_propose_policy_serve_as_delegate | 2019 WSMA Annual Meeting: How to Propose Policy, Serve as Delegate | Advocacy | Shared_Content/News/Membership_Memo/20190612/2019_wsma_annual_meeting_how_to_propose_policy_serve_as_delegate | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/AM_2018.10.308-645x425px.jpg" class="pull-right" />
</div>
<h5>
June 12, 2019
</h5>
<h2>2019 WSMA Annual Meeting: How to Propose Policy, Serve as Delegate</h2>
<p>
If you are interested in proposing policy or serving as a delegate at the 2019 Annual Meeting of the WSMA House of Delegates, Oct. 12 and 13 at the Hilton Seattle Airport &amp; Conference Center, be sure to take note of the following guidance and key dates.
</p>
<h3>Deadlines for submitting resolutions</h3>
<p>
Resolutions, one of the key policy drivers for the association, are considered for adoption by the House of Delegates at its annual meeting each fall. Resolutions must be sponsored by a WSMA delegate, alternate delegate or member of the board of trustees. If you are interested in authoring a resolution but are not a delegate or board member, the WSMA will work with you to develop your resolution idea and help find a sponsor. <a href="https://wsma.org/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">Learn more about resolutions on the WSMA website</a> and be sure to mark your calendar for the following dates:
</p>
<p>
<strong>Aug. 16</strong> – Deadline to submit your resolution for publication in the delegate handbook, the compilation of resolutions and other business to be considered by the House of Delegates.<br />
<strong>Aug. 30</strong> – Delegate handbook will be available from the WSMA website for download.<br />
<strong>Sept. 13</strong> – Final deadline to submit your resolution. Resolutions received after this date must have consent of two-thirds of the House at the opening session to be considered.</p>
<h3>How to serve as a delegate</h3>
<p>The House of Delegates is composed of WSMA members who represent, and are designated by, their respective county society or specialty society, as well as representatives of WSMA's special sections and board of trustees. If you would like to serve as a delegate at the 2019 WSMA Annual Meeting, please contact your local county society or state specialty society.
</p>
</div> | 6/12/2019 11:31:59 AM | 6/12/2019 12:00:00 AM |
| ama_urges_physician_action_in_response_to_federal_balance_billing_efforts | AMA Urges Physician Action in Response to Federal Balance Billing Efforts | Advocacy | Shared_Content/News/Membership_Memo/20190612/ama_urges_physician_action_in_response_to_federal_balance_billing_efforts | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/Stock.image_2017.US.Capitol.Building.bright-645x425px.jpg" class="pull-right" />
</div>
<h5>
June 12, 2019
</h5>
<h2>AMA Urges Physician Action in Response to Federal Balance Billing Efforts</h2>
<p>
This week, the AMA is calling on physicians across the country to contact their Congressional representatives and urge support of physician- and patient-friendly balance billing legislation, in anticipation of the issue being taken up by Congress in the upcoming weeks. With Washington state having passed one of the most physician-friendly balance billing bills in the nation this past session, WSMA members are encouraged to contact their representatives in Congress to help ensure potential federal efforts achieve the same standard—and don't negatively impact the progress made in our state.
</p>
<p>
For details on the AMA call to action and to send a message to your Congressional representatives, visit the <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fcampaigns%2f66880%2frespond">AMA Physician Grassroots Network</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>.
</p>
</div> | 6/12/2019 1:07:51 PM | 6/12/2019 12:00:00 AM |
| free_webinar_on_washington_states_new_public_option_and_balance_billing_legislation | Free Webinar on Washington State's New Public Option and Balance Billing Legislation | Advocacy | Shared_Content/News/Membership_Memo/20190612/free_webinar_on_washington_states_new_public_option_and_balance_billing_legislation | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Events/BB-PublicOption-Webinar-June2019.jpg" class="pull-right" />
</div>
<h5>
June 12, 2019
</h5>
<h2>Free Webinar on Washington State's New Public Option and Balance Billing Legislation</h2>
<p>
Register for a one-hour lunchtime webinar on Wednesday, June 19, co-presented with the Washington State Hospital Association, where we'll update you on two significant bills passed during session: Senate Bill 5526 establishing a public option health insurance plan ("Cascade Care") and House Bill 1065 prohibiting balance billing. We'll provide you with an overview of these two bills and how they may impact your medical practice or hospital.
</p>
<p>
Webinar presenters include:
</p>
<ul>
<li>Shirley Prasad, policy director, government affairs (WSHA)</li>
<li>Andrew Busz, policy director, finance (WSHA)</li>
<li>Sean Graham, director, legislative and political affairs (WSMA)</li>
</ul>
<p>
Join us Wednesday, June 19, noon-1 p.m. for this informative session. <a href="https://attendee.gototraining.com/r/4211360830636094466">Register online</a>.
</p>
</div> | 6/12/2019 1:02:22 PM | 6/12/2019 12:00:00 AM |
| washington_prescribers_can_soon_access_rx_data_across_state_lines | Washington Prescribers Can Soon Access Rx Data Across State Lines | Advocacy | Shared_Content/News/Membership_Memo/20190612/washington_prescribers_can_soon_access_rx_data_across_state_lines | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/Rx_bottle_doctor_laptop_645x425.jpg" class="pull-right" />
</div>
<h5>
June 12, 2019
</h5>
<h2>Washington Prescribers Can Soon Access Rx Data Across State Lines</h2>
<p>
As the result of persistent WSMA advocacy with state lawmakers and at the Department of Health, physicians in Washington will now have access to prescribing data in nearly every other state. The DOH has <a href="https://www.doh.wa.gov/Newsroom/2019NewsReleases/19059PMPDataSharingNewsRelease">announced a new data-sharing agreement</a>, under which it will now share prescription monitoring program data with nearly all states and the District of Columbia through two key hubs, <a href="https://www.pdmpassist.org/content/rx-check">RxCheck</a> and <a href="https://nabp.pharmacy/initiatives/pmp-interconnect/">PMP InterConnect</a>.
</p>
<p>
Washington was one of the first states to connect with RxCheck in 2018. Expanding to connect to the 51 jurisdictions participating in PMP InterConnect gives prescribers in Washington more options for checking prescribing data for patients and access to more information. Prescribers can connect to these hubs using secure web-access portals.
</p>
<p>
Accessing prescription data across state lines will be particularly helpful to physicians practicing near the border with neighboring states. The WSMA will keep members updated as to when access to the cross-state data will be available.
</p>
</div> | 6/12/2019 11:32:03 AM | 6/12/2019 12:00:00 AM |
| wsma_in_the_media_as_public_option_gains_national_attention | WSMA in the Media as Public Option Gains National Attention | Advocacy | Shared_Content/News/Membership_Memo/20190522/wsma_in_the_media_as_public_option_gains_national_attention | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/steth_warm-background_645x425.jpg" class="pull-right" />
</div>
<h5>
May 22, 2019
</h5>
<h2>WSMA in the Media as "Public Option" Gains National Attention</h2>
<p>
Washington state's <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190508/public_option_bill_passes_with_rate_setting_provision">new public option legislation</a> is garnering national media attention as health care reform continues to dominate presidential and congressional politics. Several recent reports are worth noting, with the WSMA offering comment on the adverse impact of the proposed health plans on Washington's physicians and health care providers:
</p>
<p>
<a href="https://news.bloomberglaw.com/health-law-and-business/blue-states-taking-health-care-into-their-own-hands">Blue States Taking Health Care Into Their Own Hands</a>, Bloomberg Law, May 13. Subscription required, key excerpt: <em>"…'Artificially capping provider reimbursement rates at a percentage of Medicare will jeopardize provider participation in the plan, resulting in health plans with extremely limited provider options,' the medical association's president, Tom Schaaf, said in an email."</em>
</p>
<p>
<a href="https://www.cnn.com/2019/05/18/politics/washington-state-public-option-health-insurance/index.html">Washington Pioneers Public Health Care Option, But Controlling Costs Remains Tricky</a>, CNN, Saturday, May 18, features quotes from both the WSMA and the Washington State Hospital Association on the legislation's rate-setting provision.
</p>
<p>
Also, see DJ Wilson's May 17 <a href="https://stateofreform.com/featured/2019/05/four-important-things-you-may-have-missed-about-washington-states-public-option-bill/?utm_source=State+of+Reform&amp;utm_campaign=9bc2768cc3-5+Things+WA+July+2_COPY_01&amp;utm_medium=email&amp;utm_term=0_37897a186e-9bc2768cc3-273246485">State of Reform newsletter on the public option legislation</a>. While we disagree with his assessment of the bill's impact, the author makes two points worth highlighting:
</p>
<p>
Wilson discusses how the bill establishes a framework for future price management by making "moving from 160% of Medicare to 140% or 120% or 100% of Medicare in the future…a relatively easy legislative change." This subjecting of rate-setting to shifting political winds and the removal of a physician's ability to negotiate with a carrier perfectly illustrates why the WSMA opposed—and remains opposed—to setting rates in statute.
</p>
<p>
And while we can quibble with the full quote, Wilson does credit the WSMA for staying "engaged throughout…and ultimately were at the table at the end to earn changes to the rate setting element."
</p>
<p>
Engagement is key to WSMA's work on behalf of physicians and the practice of medicine in Washington state. Our work on this issue and others is far from over, and we will continue to stay engaged—and seek our members' engagement—in the months ahead, as we gear up for the next state legislative session in January 2020.
</p>
</div> | 5/22/2019 11:35:49 AM | 5/22/2019 12:00:00 AM |
| challenges_and_gains_mark_2019_legislative_session | Challenges and Gains Mark 2019 Legislative Session | Advocacy | Shared_Content/News/Membership_Memo/20190508/challenges_and_gains_mark_2019_legislative_session | <div class="col-md-12">
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</div>
<h5>
May 8, 2019
</h5>
<h2>Challenges and Gains Mark 2019 Legislative Session</h2>
<p>
The 2019 state legislative session was gaveled to a close on Sunday, April 28, marking the end of one of the most challenging sessions in memory for the physician community. While there were bright spots, they were overshadowed by several high-priority issues that will adversely impact the bottom line of physicians, particularly those in independent practice.
</p>
<p>
The WSMA was particularly disappointed with the passage of the following proposals:
</p>
<ul>
<li><a href="https://wsma.org/Shared_Content/News/Latest_News/2019/April/vulnerable_patient_health_care_jeopardized_by_proposed_b_and_o_tax_increase">A tax bill</a> that imposes a 20 percent surcharge on the business &amp; occupation (B&amp;O) tax paid by independent physician practices and clinics. The bill spares hospital systems from the tax increase. </li>
<li><a href="[@]Shared_Content/News/Membership_Memo/20190508/public_option_bill_passes_with_rate_setting_provision.aspx">A "public option" health insurance plan for Washington state</a> with physician reimbursement rates capped at 160 percent of Medicare, a precedential move by the state to limit reimbursement in a commercial health care plan. </li>
<li><a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190424/wrongful_death_bill_passes_legislature_heads_to_governor_for_signing">Legislation expanding wrongful death liability</a>, exposing physicians and other entities to more lawsuits and higher awards.</li>
<li><a href="[@]Shared_Content/News/Membership_Memo/20190508/the_good_and_bad_of_new_opioid_legislative_policy.aspx">Costly IT mandates on physician practices and health care facilities</a> , including a mandate to integrate with the state's prescription drug monitoring program and a mandate to use an electronic prescribing system.</li>
</ul>
<p>
There were also, thankfully, important victories achieved this session for <a href="[@]Shared_Content/News/Membership_Memo/20190508/session_ends_with_landmark_public_health_wins.aspx">public health</a> , the state's <a href="[@]Shared_Content/News/Membership_Memo/20190508/state_budget_includes_mental_health_investments_b_and_o_increase_passes.aspx">mental and behavioral health system</a> , and for <a href="[@]Shared_Content/News/Membership_Memo/20190508/more_wins_whistleblower_protections_fee_setting_transparency_advance_directives.aspx">WSMA-initiated bills</a> , covered separately in this issue of the Membership Memo (and be sure to watch the final <a href="https://vimeo.com/334209068">episode in our legislative update video series featuring WSMA's own Katie Kolan, JD, and Sean Graham</a>). For a more in-depth look at new policies impacting medicine, register to attend our lunchtime <a href="https://wsma.org/WSMA/Events/WSMA_Legislative_Wrap_Up_Webinar/WSMA/Events/wsma_legislative_wrap_up_webinar.aspx?hkey=9e9d7843-853f-47d0-bae4-7d2595f5c86b">session wrap-up webinar</a> on Wednesday, May 15, and keep an eye out for our yearly publication, the WSMA Legislative Report, mailed to members this summer.
</p>
<h3>What's next?</h3>
<p>
As we all know, the legislative process is a long game—good (and bad) policies are often the result of many years of hard work in, and outside of, the Legislature. There will be opportunities to amend laws we are concerned with and opportunities to repeal wrongheaded policies like the B&amp;O tax increase. Our work is far from over, and we will continue to need the engagement of our members and the physician community as we gear up for the next state legislative session in January 2020.
</p>
<p>
As we prepare for our conversations with legislators during the interim (the time during which the Washington State Legislature is not in session), we will remain focused on developing and advocating for policies that will positively impact the bottom lines of physician practices, while continuing to highlight the importance of access to care for patients. After all, physicians can only deliver care if they can keep their doors open—an "on-the-ground" reality that legislators need to develop a better understanding of, and a message the WSMA will continue to hammer home through every available means (see this <a href="https://www.seattletimes.com/opinion/public-health-wins-but-physician-practices-lose-in-2019-legislative-session/">Seattle Times opinion column from WSMA CEO Jennifer Hanscom</a> as the latest example). As your premier statewide physician professional association, our resolve has never been stronger, as we fight for policies to make Washington a better state to practice medicine and increase the influence of the physician voice in Olympia and beyond.
</p>
</div> | 5/8/2019 9:21:10 AM | 5/8/2019 12:00:00 AM |
| legislative_compromise_reached_on_balance_billing | Legislative Compromise Reached on Balance Billing | Advocacy | Shared_Content/News/Membership_Memo/20190508/legislative_compromise_reached_on_balance_billing | <div class="col-md-12">
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</div>
<h5>
May 8, 2019
</h5>
<h2>Legislative Compromise Reached on Balance Billing </h2>
<p>
Another bright spot this legislative session was the successful conclusion of a multi-year effort to address the challenging issues that can result from balance billing. After many years of negotiation, WSMA reached an agreement on balance billing legislation, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1065&amp;Initiative=false&amp;Year=2019">House Bill 1065</a>, that protects patients from unexpected bills and is fair for the physician community. The bill requires insurance carriers to reimburse out-of-network physicians at a commercially reasonable rate, with a physician-friendly dispute resolution process in the event of disagreement over acceptable compensation. It also requires carriers to pay physicians directly (rather than routing payment through patients) and strengthens carriers' network adequacy requirements. Read more about this bill in the <a href="https://wsma.org/Shared_Content/News/Weekly_Rounds/2019/weekly_rounds_apr_15_2019_taking_action_makes_a_difference">April 15 issue of Weekly Rounds</a>, WSMA CEO Jennifer Hanscom's e-newsletter.
</p>
</div> | 5/8/2019 3:10:47 PM | 5/8/2019 12:00:00 AM |
| more_wins_whistleblower_protections_fee_setting_transparency_advance_directives | More Wins: Whistleblower Protections, Fee-Setting Transparency, Advance Directives | Advocacy | Shared_Content/News/Membership_Memo/20190508/more_wins_whistleblower_protections_fee_setting_transparency_advance_directives | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/News/HB1049-Signing-645x425px.jpg" class="pull-right" />
<div class="col-md-12 pull-right" style="text-align: center;"><em>Gov. Jay Inslee signs HB 1049 on April 19, 2019.</em></div>
</div>
<h5>
May 8, 2019
</h5>
<h2>More Wins: Whistleblower Protections, Fee-Setting Transparency, Advance Directives</h2>
<p>
The WSMA was pleased to see multiple bills we helped bring forward approved by the Legislature this year. <a href="https://wsma.org/Shared_Content/News/Advocacy_Report/2019/WSMA_Whistleblower_Bill_Passes_Senate__Heads_to_Governor_s_Desk">House Bill 1049</a> will expand and align whistleblower protections to non-employed health care professionals and apply these protections in the peer review setting. This legislation was prioritized by the WSMA pursuant to House of Delegates resolutions*. <a href="https://app.leg.wa.gov/billsummary?BillNumber=1753&amp;Initiative=false&amp;Year=2019">House Bill 1753</a> will add more transparency to the process of health professions increasing licensure fees, an apt proposal as the <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190424/last_chance_to_act_medical_commission_releases_rulemaking_for_license_renewal_fee_increase">Washington Medical Commission considers a hefty fee increase on MD and PA licensure renewals</a>. And <a href="https://app.leg.wa.gov/billsummary?BillNumber=1175&amp;Initiative=false&amp;Year=2019">House Bill 1175</a> will allow a Washington state health care directive to be notarized as an alternative to signing in the presence of witnesses—bringing state requirements in line with those of the durable power of attorney for health care, and making it easier for patients completing these advance care planning documents.
</p>
<p>
*As a WSMA member, you can help guide the direction of the association by authoring a "resolution," a proposal asking the WSMA to take a position or act on an issue. Resolutions are considered for adoption by the WSMA House of Delegates each fall during its annual meeting. Do you have an idea for a policy that you'd like the House of Delegates to adopt? <a href="https://wsma.org/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">Learn more about how to write and submit a resolution</a>.
</p>
</div> | 5/8/2019 3:12:26 PM | 5/8/2019 12:00:00 AM |
| public_option_bill_passes_with_rate_setting_provision | Public Option Bill Passes with Rate-Setting Provision | Advocacy | Shared_Content/News/Membership_Memo/20190508/public_option_bill_passes_with_rate_setting_provision | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Advocacy/Leg-Session-Updates-Graphic-645x425px.jpg" class="pull-right" />
</div>
<h5>
May 8, 2019
</h5>
<h2>"Public Option" Bill Passes with Rate-Setting Provision</h2>
<p>
One of the concerning policies passed this session is <a href="https://app.leg.wa.gov/billsummary?BillNumber=5526&amp;Year=2019&amp;Initiative=false">Senate Bill 5526</a>, priority legislation for Gov. Jay Inslee and majority-party Democrats that will establishes a "public option" health plan offered for sale on the state's health insurance exchange. The WSMA negotiated with legislators throughout session on the bill, <a href="https://wsma.org/WSMA/Shared_Content/News/Weekly_Rounds/2019/Weekly_Rounds__Mar._18__2019_-_A_Public_Option_that_Works_for_Patients_and_Physicians.aspx">strongly opposing</a> any plan option that used rate setting to establish physician reimbursement levels.
</p>
<p>
As originally introduced, SB 5526 would have reimbursed physicians at Medicare rates; the final version of the bill passed by the Legislature and currently awaiting the governor's signature caps reimbursement at 160 percent of Medicare, based on an insurance carrier's average contracted rates. The bill also directs a study of mandating physician participation in the plan (by making a provider's ability to treat state-employee plan enrollees contingent on contracting with the public option plan).
</p>
<p>
While affordability of health insurance is a real problem, a public option that relies on rate setting for establishing physician reimbursement is bad policy: bad for patients and bad for the medical community. Artificially capping provider reimbursement rates at a percentage of Medicare will jeopardize provider participation in the plan, resulting in health plans with extremely limited provider options. And the bill fails to holistically address the cost of health care, with only physicians and health care facilities being required to sacrifice to meet the goals of the plan and no restraints being put on insurance carriers, pharmaceutical manufacturers, or other stakeholders profiting off the plan. WSMA's guidance on public option advocacy was informed by the physicians participating in the WSMA's Health Care Reform Work Group, and we are grateful for their guidance and leadership.
</p>
</div> | 5/8/2019 2:43:51 PM | 5/8/2019 12:00:00 AM |
| session_ends_with_landmark_public_health_wins | Session Ends with Landmark Public Health Wins | Advocacy | Shared_Content/News/Membership_Memo/20190508/session_ends_with_landmark_public_health_wins | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Advocacy/Leg-Session-Updates-Graphic-645x425px.jpg" class="pull-right" />
</div>
<h5>
May 8, 2019
</h5>
<h2>Session Ends with Landmark Public Health Wins</h2>
<p>
Several important victories were achieved this session, including the passage of two landmark public health bills: <a href="https://wsma.org/Shared_Content/News/Latest_News/2019/March/Washington_State_Physicians_Praise_Lawmakers_for_Raising_Purchase_Age_of_Tobacco_and_Vaping_Products">House Bill 1074</a>, which will raise the purchase age for tobacco and vapor products to 21, and <a href="https://wsma.org/Shared_Content/News/Latest_News/2019/April/washingtons_health_care_community_applauds_state_legislature_for_passage_of_mmr_vaccine_bill">House Bill 1638</a>, which will remove the personal and philosophical exemption for the MMR vaccine. Both bills were WSMA priorities and will have the effect of saving lives and improving health outcomes for the people of our state. The WSMA thanks Rep. Paul Harris (R-Vancouver) for introducing both bills and championing them through the legislative process. Additionally, a tax increase on vapor products was enacted, with revenue going to fund foundational public health and cancer research.
</p>
</div> | 5/8/2019 3:08:51 PM | 5/8/2019 12:00:00 AM |
| state_budget_includes_mental_health_investments_b_and_o_increase_passes | State Budget Includes Mental Health Investments, B&O Increase Passes | Advocacy | Shared_Content/News/Membership_Memo/20190508/state_budget_includes_mental_health_investments_b_and_o_increase_passes | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Advocacy/Leg-Session-Updates-Graphic-645x425px.jpg" class="pull-right" />
</div>
<h5>
May 8, 2019
</h5>
<h2>State Budget Includes Mental Health Investments, B&amp;O Increase Passes</h2>
<p>
The final state budget adopted by Democrats at the conclusion of the legislative session raises state spending by 18 percent, appropriating $52.4 billion over the two-year period beginning July 1. The spending plan relies on nearly $1 billion in new taxes over the same timeframe, including a 20 percent business and occupation (B&amp;O) tax hike impacting our state's private and independent physician practices.
</p>
<p>
The 20 percent B&amp;O tax hike for independent physicians and other businesses in the "service" category (e.g. attorneys and architects) in <a href="https://app.leg.wa.gov/billsummary?BillNumber=2158&amp;Year=2019&amp;Initiative=false">House Bill 2158</a> was strongly <a href="https://wsma.org/Shared_Content/News/Latest_News/2019/April/vulnerable_patient_health_care_jeopardized_by_proposed_b_and_o_tax_increase">opposed by the WSMA and a coalition of health care partners</a>. The tax increase will create additional revenue earmarked for higher education, with proponents arguing that professions dependent on practitioners with advanced degrees should pay for the next generation of workforce. Elsewhere, the state's real estate excise tax was revised to apply in a more graduated fashion, and a much-discussed state capital gains tax proposal was ultimately scrapped.
</p>
<p>
Mental health and substance use treatment saw important gains in the final budget, with notable investments including funding to move more 90- and 180-day mental health commitments into the community. In the physician workforce realm, new psychiatric residency positions were created, and funding was continued for physician family practice residencies and health professional student loan repayment.
</p>
</div> | 5/8/2019 2:19:19 PM | 5/8/2019 12:00:00 AM |
| the_good_and_bad_of_new_opioid_legislative_policy | The Good and Bad of New Opioid Legislative Policy | Advocacy | Shared_Content/News/Membership_Memo/20190508/the_good_and_bad_of_new_opioid_legislative_policy | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/Generic_Rx_645px.jpg" class="pull-right" />
</div>
<h5>
May 8, 2019
</h5>
<h2>The Good and Bad of New Opioid Legislative Policy</h2>
<p>
Like in recent legislative sessions, policies to ameliorate the opioid epidemic were a prominent item of discussion in Olympia. Among its numerous provisions, <a href="https://app.leg.wa.gov/billsummary?BillNumber=5380&amp;Initiative=false&amp;Year=2019">Senate Bill 5380</a> mandates that, beginning in 2021, prescriptions for controlled substances be communicated electronically and that a practice's electronic health record system be integrated with the state's prescription monitoring program. WSMA strongly opposed these mandates due to the cost they will impose on practices; however, we were able to secure exemptions in the event the mandates pose a financial hardship to practices (a waiver process will be created through the state Department of Health). A positive component of the bill was a prohibition on health plans imposing prior authorization for medication-assisted treatment. Provisions relating to limiting safe-injection facilities were considered, but not included in the final bill.
</p>
</div> | 5/8/2019 3:15:51 PM | 5/8/2019 12:00:00 AM |