| building_a_stronger_more_inclusive_and_responsive_wsma | Building a Stronger, More Inclusive and Responsive WSMA | Advocacy | Shared_Content/News/Membership_Memo/2021/July_23/building_a_stronger_more_inclusive_and_responsive_wsma | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/am-201910263-645x425px.jpg" class="pull-right" alt="WSMA Annual Meeting room with attendees" />
</div>
<h5>July 23, 2021</h5>
<h2>Building a Stronger, More Inclusive and Responsive WSMA</h2>
<p>This fall at the WSMA Annual Meeting, delegates will consider a proposal to modernize and streamline the policymaking bodies of your WSMA. Prompted by a resolution passed by delegates in 2019 and reflecting months of diligence by the board of trustees and bylaws committee, the proposal seeks to make the House of Delegates stronger, giving all WSMA members an opportunity to have their voices heard during our policymaking process.</p>
<p>The WSMA is <em>your</em> WSMA - and now's your chance to make your voice heard by weighing in on these proposed changes.</p>
<h3>Why change WSMA's governing structure now?</h3>
<p>To help inform this work, the WSMA engaged an external association strategy consulting firm to explore organizational directives, concerns, best practices, and market benchmarking. The following key drivers were identified:</p>
<ul>
<li>Attendance, participation, and engagement in the House of Delegates have declined in recent years.</li>
<li>Intentional efforts are required to overcome systemic bias and help ensure more voices are at the table to effectively address inequities in health care.</li>
<li>A streamlined and more representative House and board of trustees will be better positioned to meet the challenges posed by a rapidly changing health care environment.</li>
</ul>
<p><strong>Topline takeaway</strong>: The governance structure of an association is a key factor in its ability to achieve its mission. WSMA's current governance structure reflects what has existed for decades across many health care organizations and medical associations. While it may have served the organization well in the past, fundamental changes are needed to ensure that a variety of voices are represented in WSMA's policymaking setting.</p>
<h3>Overview of proposed governance changes</h3>
<p>These governance changes would be implemented through a set of proposed bylaws amendments which will go before the House of Delegates this fall at their annual meeting. Taken together, the proposed bylaws amendments would streamline the board and the House while expanding opportunities for diverse representation, allowing for a more nimble and diverse policymaking body.</p>
<ul>
<li><strong>WSMA board of trustees</strong> - The size of the WSMA board would be reduced from 44 to 29 members. Reducing the size of the board is needed to improve its ability to be nimble and responsive.</li>
</ul>
<ul>
<li><strong>WSMA at-large delegates</strong> - WSMA members would be able to elect 14 at-large delegates to the House of Delegates. These new positions are intended to give more members a voice and to increase diversity in the House. These delegates would be voted on by the entire WSMA membership. A diversity, equity, and inclusion committee would be established to review at-large delegate candidates and provide candidate information to the membership. The DEI committee would also serve in other advisory capacities at the WSMA.</li>
</ul>
<ul>
<li><strong>County medical societies</strong> - Component societies that meet the definition of being a functioning society will have one delegate and one alternate for every 100 WSMA members in the county, rather than one delegate and one alternate for every 50 WSMA members in the county. To be considered functioning, a component county society should conduct a business meeting at least once per year and have an elected governing body.</li>
</ul>
<p>Reducing delegate apportioning for county societies better reflects their historical participation in the House. Requiring societies to be functioning as defined helps ensure that delegates are representing active counties that have a process in place to select delegates.</p>
<ul>
<li><strong>Specialty delegates</strong> - No changes. Each specialty would remain as is with one delegate and one alternate per society.</li>
</ul>
<ul>
<li><strong>Sections</strong> - With the proposed bylaws changes, both the senior section and osteopathic section delegates would be removed. Senior and osteopathic physicians and physician assistants are already sufficiently distributed and served throughout the delegate makeup of the House and board in both their current and proposed iterations.</li>
</ul>
<ul>
<li><strong>Proposed resolution sponsorship</strong> - Proposed resolutions would need to be sponsored by two members of the House of Delegates instead of one. This change would help ensure proposed policy to the House is meaningful and actionable.</li>
</ul>
<ul>
<li><strong>Proposed notification change</strong> - Reduce number of days required for resolutions to be furnished to delegates from 30 to 20 days prior to the annual meeting of the House. This change would allow adequate time for processing resolutions.</li>
</ul>
<h3>How to review these proposed governance changes and provide feedback</h3>
<p>To review the bylaws amendments in full and discuss them with your WSMA member colleagues, visit virtual reference committee B in the <a href="[@]WSMA/Membership/Discussion_Forums/Virtual_Reference_Committees/WSMA/Membership/Discussion_Forums/virtual_reference_committees.aspx?hkey=d674a5ae-4fb5-48d6-b969-16aab9b63647">WSMA virtual reference committee forums</a>. These private, secure forums require sign-in and will remain available for member discussions in the runup to the 2021 Annual Meeting on Sept. 25-26 in Bellevue. All feedback posted in the forums will be collated and provided to the in-person reference committees during the meeting. If you'd like to attend the in-person reference committees, register for the Annual Meeting <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">on the WSMA website</a>.</p>
</div> | 7/22/2021 12:41:40 PM | 7/23/2021 12:00:00 AM |
| cms_releases_2022_medicare_fee_schedule | CMS Releases 2022 Medicare Fee Schedule | Advocacy | Shared_Content/News/Membership_Memo/2021/July_23/cms_releases_2022_medicare_fee_schedule | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/medicare-barcode-645px.jpg" class="pull-right" alt="Medicare barcode graphic" />
</div>
<h5>July 23, 2021</h5>
<h2>CMS Releases 2022 Medicare Fee Schedule</h2>
<p>The Centers for Medicare &amp; Medicaid Services has released its 2022 Medicare Physician Fee Schedule and Quality Payment Program proposed rule. The rule includes updates to payment rates for physicians and other health care professionals, expands the use of telehealth, clarifies evaluation and management (E/M) policies, proposes policies for the 2022 performance year of the Quality Payment Program, and includes many other provisions.</p>
<p>Notably, the 2022 Medicare conversion factor would be reduced by approximately 3.89% from $34.8931 to $33.5848. This is largely a result of the expiration of a 3.75% increase to the conversion factor at the end of calendar year 2021. WSMA is still reviewing the proposal, however, we will strongly advocate that Congress stop this significant cut and extend the 3.75% increase for 2022.</p>
</div> | 7/22/2021 3:24:18 PM | 7/23/2021 12:00:00 AM |
| washington_medical_commission_clinical_support_program_workshop_aug_9 | Washington Medical Commission Clinical Support Program Workshop Aug. 9 | Advocacy | Shared_Content/News/Membership_Memo/2021/July_23/washington_medical_commission_clinical_support_program_workshop_aug_9 | <div class="col-md-12">
<h5>July 23, 2021</h5>
<h2>Washington Medical Commission Clinical Support Program Workshop Aug. 9 </h2>
<p>The Washington Medical Commission has resumed <a href="https://wmc.wa.gov/rule_making_2018/proposed-clinical-support-program">rulemaking</a> that would establish a clinical support program intended to assist practitioners in improving "practice deficiencies" that do not rise to the level of disciplinary action.</p>
<p>The current draft rule addresses many of WSMA's concerns about the program as outlined in a previous iteration of the rule (see our <a href="https://wsma.org/doc_library/news/wsma-comment-clinical-support-program-01072020.pdf" target="_blank">comment letter</a> for details on those concerns). However, the WSMA maintains concerns regarding the voluntary nature of the program and its potential use as another punitive measure in an already challenging disciplinary process.</p>
<p>You can find the current preproposal, or CR-101, draft language <a href="https://wmc.wa.gov/sites/default/files/public/CSP%20MD%20%26%20PA%20Draft%206.30.2021%20RT%20Edits.pdf" target="_blank" rel="noreferrer">here</a>. This draft <a href="https://wmc.wa.gov/sites/default/files/public/Draft%20Policy%20on%20the%20Use%20of%20Clinical%20Support%20Plans%205%2024%2021.pdf" target="_blank" rel="noreferrer">form</a> from the commission demonstrates what a clinical support plan might look like. The commission will be conducting an open public rules workshop Monday, Aug. 9, from 1-3 p.m. You can register <a href="https://register.gotowebinar.com/register/7665333690282480654">here</a>.</p>
</div> | 7/22/2021 3:46:46 PM | 7/23/2021 12:00:00 AM |
| wsma_joins_power_of_providers_covid_19_vaccine_initiative | WSMA Joins 'Power of Providers' COVID-19 Vaccine Initiative | Advocacy | Shared_Content/News/Membership_Memo/2021/July_23/wsma_joins_power_of_providers_covid_19_vaccine_initiative | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/doctor-patient-exam-room-645x425px.jpg" class="pull-right" alt="Doctor and patient in exam room" />
</div>
<h5>July 23, 2021</h5>
<h2>WSMA Joins 'Power of Providers' COVID-19 Vaccine Initiative</h2>
<p>As the state's leading physician association, the WSMA was pleased to lend its signature and weight behind Washington's new Power of Providers COVID-19 vaccine initiative announced by Gov. Jay Inslee and Secretary of Health Umair A. Shah, MD, last week. The new initiative encourages physicians from all specialties and health care providers throughout the state to proactively reach out and talk to their patients about COVID-19 vaccination.</p>
<p>In their announcement, Gov. Inslee and Secretary Shah asked all physicians and providers to sign the <a href="https://fortress.wa.gov/doh/opinio/s?s=POP">Power of Providers initiative</a> and make the Power of Providers commitment to take four simple steps with each patient:</p>
<ul>
<li><strong>Seek.</strong> Proactively reach out to your patients or clients to find out if they have received COVID-19 vaccination and invite them to do so if they have not.</li>
<li><strong>Ask/educate.</strong> Ask patients at every visit if they are vaccinated or check their immunization records. If the patient is not vaccinated, <a href="https://www.doh.wa.gov/Emergencies/COVID19/HealthcareProviders/VaccineInformationforHealthcareProviders">provide information and education</a> on the COVID-19 vaccine, recommend it, and offer it.</li>
<li><strong>Vaccinate.</strong> If the patient is interested, provide vaccination right then or give them a referral to a COVID-19 vaccine location using <a href="https://vaccinelocator.doh.wa.gov/">vaccinelocator.doh.wa.gov</a> or by calling 833.VAX.HELP.</li>
<li><strong>Empower.</strong> Empower vaccinated patients to share their vaccination status with friends, family, and others they know. Order free stickers and buttons from the Washington State Department of Health to give to vaccinated patients. Empower staff to talk with patients and people in their own lives about the importance of vaccines and their vaccination status.</li>
</ul>
<p>If a patient isn't ready to get vaccinated, the DOH encourages physicians and providers to share trustworthy resources and encourage the patient to review them later to learn more. DOH is also asking providers to continue supporting equitable access to vaccination by using <a href="https://www.doh.wa.gov/Emergencies/COVID19/VaccineInformation/Engagement">community-specific resources for outreach and engagement</a>.</p>
</div> | 7/22/2021 12:41:43 PM | 7/23/2021 12:00:00 AM |
| A_closer_look__Gun_violence_policies_adopted_by_WSMA_House_of_Delegates | A closer look: Gun violence policies adopted by WSMA House of Delegates | Advocacy | Shared_Content/News/Membership_Memo/20181114/A_closer_look__Gun_violence_policies_adopted_by_WSMA_House_of_Delegates | <div class="col-md-12">
<div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/gun_storage_645x425.jpg" class="pull-right" />
</div>
<h5>
November 14, 2018
</h5>
<h2>A closer look: Gun violence policies adopted by WSMA House of Delegates</h2>
<p>In the wake of two horrific mass shooting events - the killing of twelve people by a gunman in Thousand Oaks, Calif. and the massacre by a gunman of 11 congregants at a Pittsburgh synagogue - it's worth pausing a moment to consider the physicians and providers who have a front-row seat to the carnage created by gun violence. Physicians work tirelessly to reduce the impact of gun violence on bodies, and here in Washington state, they are also working to reduce the frequency of gun violence by seeking policy changes at the federal, state, and local level.</p>
<p>During last month's WSMA Annual Meeting, the WSMA House of Delegates adopted a total of 10 new policies related to gun violence (Resolutions C-9 through 14). They are: </p>
<ul>
<li>RESOLVED, that the WSMA advocate for measures to reduce gun violence. </li>
<li>RESOLVED, that the WSMA support the elimination of laws intruding on physicians’ and patients’ rights to discuss gun violence. </li>
<li>RESOLVED, that the WSMA support encouraging physicians and health care workers to discuss safe storage of guns and the association of guns with risk of homicide, accidental shooting, and suicide, and counsel about risk. </li>
<li>RESOLVED, that the WSMA support closing loopholes in gun purchases online and at unregulated gun shows. </li>
<li>RESOLVED, that the WSMA support policy that creates weapons-free zones for medical practice settings, allowing exceptions for law enforcement. </li>
<li>RESOLVED, that the WSMA support policy to address firearm-related violence and injury as a public health issue. </li>
<li>RESOLVED, that the WSMA support policy that provides for background checks and waiting periods for the purchase of firearms. </li>
<li>RESOLVED, that the WSMA support policy that will encourage and promote the safe storage of firearms in homes where those firearms are kept. </li>
<li>RESOLVED, that the WSMA support policy that raises the minimum age to purchase a firearm to 21 years of age. </li>
<li>RESOLVED, that the WSMA encourage its members to screen for risk factors of firearm injury and educate patients about prevention and safe storage. </li>
</ul>
<p>In addition to those new policies, WSMA delegates also reaffirmed existing policy that calls on the WSMA to support appropriate legislation that would restrict the sale and private ownership of large-clip, high-rate-of-fire automatic and semi-automatic firearms. Finally, WSMA delegates directed the WSMA to urge the state and federal government to fund research on the causes and prevention of firearm violence and injury and ensure that the databases and systems necessary for research and public health surveillance are available and publicly accessible.</p>
<p>Washington's citizens are acting too: during this year's midterm election, voters passed Initiative 1639, which appears to largely align with WSMA policy requiring safe storage and restricting the purchase of firearms under certain circumstances.</p>
<p>The creation of strong policy is at the heart of the WSMA's work, and reflects a commitment from Washington physicians to the health and welfare of patients and communities that extends beyond the exam room. Find all the new policies adopted by the 2018 WSMA House of Delegates on the <a href="[@]WSMA/About/Leadership/House_of_Delegates/House_of_Delegates.aspx">House of Delegates page</a>. For a comprehensive list of House of Delegates policy, review the WSMA Policy Compendium on our <a href="[@]WSMA/About/Policies/Policies.aspx">Policies page</a>.</p>
</div> | 11/9/2018 12:15:02 PM | 7/22/2021 3:21:58 PM |
| 2021_paying_for_value_survey_now_open | 2021 Paying for Value Survey Now Open | Advocacy | Shared_Content/News/Latest_News/2021/2021_paying_for_value_survey_now_open | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/physician-money-illustration-645x425px.png" class="pull-right" alt="Physician with money illustration" />
</div>
<h5>July 8, 2021</h5>
<h2>2021 Paying for Value Survey Now Open</h2>
<p>The Health Care Authority is requesting physician and provider participation in its latest survey on the use of value-based payments in Washington. This survey will provide valuable insight into the challenges that practitioners face as they consider adopting new payment arrangements.</p>
<p>The 2021 Paying for Value survey is designed to be filled out by an administrative leader, with consultation from clinicians as necessary. HCA is seeking only one response per organization. The survey should take no more than 30-45 minutes to complete. Surveys must be complete by 5 p.m. PDT, Friday, Aug. 31.</p>
<p><a href="https://hca.servicenowservices.com/assessment_take2.do?sysparm_assessable_type=63e8e1d71b343810a6f9628ae54bcb37">Take the 2021 Paying for Value survey</a>.</p>
<p>This survey helps inform HCA's strategic direction toward its goal of 90% of state-financed health care and 50% of the commercial market in value-based purchasing arrangements by the end of 2021. <a href="https://www.hca.wa.gov/about-hca/value-based-purchasing/tracking-success">More information and past survey results are available on the HCA website</a>.</p>
</div> | 7/7/2021 12:00:17 PM | 7/8/2021 12:00:00 AM |
| cpt_codes_for_covid_19_vaccine_patient_conversations | CPT Codes for COVID-19 Vaccine Patient Conversations | Advocacy | Shared_Content/News/Latest_News/2021/cpt_codes_for_covid_19_vaccine_patient_conversations | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/istock-1296415706-645x425px.jpg" class="pull-right" alt="Masked physician talking to patients" />
</div>
<h5>July 8, 2021</h5>
<h2>CPT Codes for COVID-19 Vaccine Patient Conversations </h2>
<p>Since Washington state announced a provider-based approach to its COVID-19 vaccine outreach, the WSMA has advocated for physicians and practices to be reimbursed for these important, and often necessary, conversations with their patients. On June 17, Gov. Jay Inslee, in conjunction with Insurance Commissioner Mike Kreidler and the Health Care Authority, announced that CPT consultation codes will temporarily be available for direct patient outreach.</p>
<h3>About the billing codes</h3>
<p>The new CPT codes, established via emergency order and in effect only until Aug. 21, are intended to facilitate direct outreach to patients to discuss the importance of getting vaccinated, as well as the safety and efficacy of a vaccine:</p>
<ul>
<li>CPT code 99401 for in-person consultation, and available for audio and visual telehealth visits.</li>
<li>CPT code 99441 for audio-only (telephone) counseling for physicians.</li>
<li>CPT code 98966 for audio-only (telephone) counseling for non-physicians (medical assistants, nurses, etc.).</li>
</ul>
<h3>Yes, but…</h3>
<p>The emergency order does not dictate a reimbursement rate for these codes. The WSMA has reached out to the governor's office to confirm whether insurance carriers will be able to set their own payment rates and to clarify, if possible, the rates they are paying. We've made clear that without clarity on rates, it will be difficult for practices to determine if they have the resources to dedicate a provider to make this outreach.</p>
<p>State officials have clarified that carriers will negotiate rates individually with their contracted providers. The WSMA advises that your practice review arrangements with insurance carriers to understand the contracted rate for these new billing codes.</p>
<h3>For more information</h3>
<p>You can review the <a href="https://www.hca.wa.gov/assets/billers-and-providers/apple-health-covid-vaccine-policy.pdf" target="_blank" rel="noreferrer">Apple Health COVID-19 vaccine billing policy</a> (starting on page 3) and the <a href="https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-21-02_0.pdf?utm_content=&amp;utm_medium=email&amp;utm_name=&amp;utm_source=govdelivery&amp;utm_term=">OIC emergency order</a>&nbsp;for more information on the new CPT codes and what consulting conditions apply under this order.</p>
</div> | 7/7/2021 12:00:05 PM | 7/8/2021 12:00:00 AM |
| hca_prepares_guidelines_for_new_pmp_check_requirement | HCA Prepares Guidelines for New PMP-Check Requirement | Advocacy | Shared_Content/News/Latest_News/2021/hca_prepares_guidelines_for_new_pmp_check_requirement | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/pharmacist-stock-lores-645x425.jpg" class="pull-right" alt="Pharmacist filling prescription bottles" />
</div>
<h5>July 8, 2021</h5>
<h2>HCA Prepares Guidelines for New PMP-Check Requirement</h2>
<p>The Washington State Health Care Authority is finalizing guidelines for determining appropriate reviews of the state's prescription monitoring program consistent with federal SUPPORT Act requirements. As a reminder, starting Oct. 1 of this year, physicians must check an Apple Health (Medicaid) client's history in the PMP before prescribing controlled substances.</p>
<p>This new requirement falls under sections <a href="https://www.congress.gov/bill/115th-congress/house-bill/6">subtitle E of the SUPPORT Act</a>, establishing the "Medicaid Providers Are Required to Note Experiences in Record Systems to Help In-need Patients Act" or the "Medicaid PARTNERSHIP Act." Physicians may delegate this task to anyone at the practice with authorization to access the PMP, so long as the physician reviews all of the client's prescriptions. The date and time of the retrieval and review of information must be documented in the patient record. Prior to writing and shortly after dispensing a prescription for a controlled substance to a Medicaid patient, providers will be expected to review the (most recent 12-month period) prescription drug history of a covered individual in the PMP for:</p>
<ul>
<li>The number and type of controlled substances prescribed and filled</li>
<li>Who prescribed a controlled substance</li>
</ul>
<p>Outpatient pharmacists will also be required to review the PMP before dispensing a controlled substance. The Health Care Authority's finalized guidelines will be reflected in the agency's Oct. 1 prescription drug program billing guide.</p>
</div> | 7/7/2021 12:00:02 PM | 7/8/2021 12:00:00 AM |
| july_16_deadline_to_weigh_in_on_scope_proposals | July 16 Deadline to Weigh in on Scope Proposals | Advocacy | Shared_Content/News/Latest_News/2021/july_16_deadline_to_weigh_in_on_scope_proposals | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/eye-exam-645x425px.jpg" class="pull-right" alt="Eye exam" />
</div>
<h5>July 8, 2021</h5>
<h2>July 16 Deadline to Weigh in on Scope Proposals</h2>
<p>We recently reported on three sunrise reviews underway at the Washington State Department of Health that propose changes to the scope of practice for several health professions in our state. The WSMA will be providing feedback to the department on each of the scope proposals, and we encourage all WSMA members to do so as well. They are:</p>
<ul>
<li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/SunriseRequest-Midwives.pdf" target="_blank" rel="noreferrer">proposal</a> from the Midwives Association of Washington to increase the midwifery scope of practice. Submit your comments on the MAW proposal by emailing <a href="mailto:mwsunrise@doh.wa.gov">mwsunrise@doh.wa.gov</a>. </li>
</ul>
<ul>
<li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/OptometrySunriseRequest.pdf" target="_blank" rel="noreferrer">proposal</a> from the Optometric Physicians of Washington to increase the optometrist scope of practice. Submit your comments on the OPW proposal by emailing <a href="mailto:optom-sunrise@doh.wa.gov">optom-sunrise@doh.wa.gov</a>. </li>
</ul>
<ul>
<li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/SunriseRequest-AnesthesAssistants.pdf" target="_blank" rel="noreferrer">proposal</a> from the Washington State Society of Anesthesiologists to create a license for anesthesiologist assistants. Submit your comments on the WSSA proposal by emailing <a href="mailto:anesthesiology-sunrise@doh.wa.gov">anesthesiology-sunrise@doh.wa.gov</a>. </li>
</ul>
<p>See this Membership Memo article <a href="[@]Shared_Content/News/Latest_News/2021/sunrise_reviews_on_the_horizon_midwifery_optometrists_and_anesthesiologist_assistants">more information on sunrise reviews and WSMA policy regarding scope of practice</a>. Comments on these proposals are due by July 16 at midnight and should be sent to the email addresses provided above. If you have already submitted your comments to <a href="mailto:sunrise@doh.wa.gov">sunrise@doh.wa.gov</a>, originally provided by your WSMA in the last Memo, you should resubmit your comments to the correct email address. If the WSMA can be of any assistance, email our policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
</div> | 7/7/2021 11:59:56 AM | 7/8/2021 12:00:00 AM |
| oic_responds_to_carrier_non_payment_of_new_ppe_cpt_code_99072 | OIC Responds to Carrier Non-Payment of New PPE CPT Code 99072 | Advocacy | Shared_Content/News/Latest_News/2021/oic_responds_to_carrier_non_payment_of_new_ppe_cpt_code_99072 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/July/mask-mika-baumeister-645x425.jpg" class="pull-right" alt="Surgical mask" />
</div>
<h5>July 8, 2021</h5>
<h2>OIC Responds to Carrier Non-Payment of New PPE CPT Code 99072</h2>
<p>The <a href="https://wsma.org/Shared_Content/News/Latest_News/2021/wsma_presses_oic_on_carrier_non_payment_of_new_ppe_cpt_code_99072">WSMA recently expressed concerns</a> to the Washington State Office of the Insurance Commissioner regarding carrier noncompliance under recently enacted Senate Bill 5169, which requires commercial carriers to reimburse for PPE costs during the pandemic. The OIC has taken a number of steps in response to our concerns.</p>
<p>After receiving our letter on behalf of health care stakeholders, the OIC conducted outreach to plans it regulates, to clarify that the legislation applies to all fully insured health plans and to ensure they are paying CPT 99072 as per the legislation. A few carriers informed the agency that the IT changes necessary to process the claims were not in place when the legislation went into effect, but the programming has since been completed and claims initially denied/delayed are being successfully reprocessed. Additionally, the OIC has provided "<a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/oic-health-carrier-health-plan-status-061821-final.pdf]">How to determine health plan fully insured status</a>," a chart with instructions from carriers on how to identify what entity regulates their plans.</p>
<p>If you are still having PPE claims denied by fully insured health plans, the OIC recommends you <a href="https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status">file a complaint using its online complaint form</a>.</p>
</div> | 7/7/2021 11:59:59 AM | 7/8/2021 12:00:00 AM |
| parents_encouraged_to_get_a_jump_on_child_vaccinations | Parents Encouraged to Get a Jump on Child Vaccinations | Advocacy | Shared_Content/News/Latest_News/2021/parents_encouraged_to_get_a_jump_on_child_vaccinations | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img alt="Child getting a vaccination" src="/images/Newsletters/MembershipMemo/2021/July/cdc-immunization-645x425px.jpg" class="pull-right" />
</div>
<h5>July 8, 2021</h5>
<h2>Parents Encouraged to Get a Jump on Child Vaccinations</h2>
<p>Over the past two weeks, families with children 4 to 6 years old received letters in the mail from the Department of Health with information about which vaccines their child may be missing. The outreach is part of an effort in health care organizations in Washington to encourage families to get up to date on vaccines ahead of the 2021-22 school year.</p>
<h3>DOH outreach to parents</h3>
<p>The DOH letter includes an important flyer on <a href="https://www.doh.wa.gov/Portals/1/Documents/Pubs/348-295-SchoolImmReqforParents2021-2022.pdf" target="_blank">Required Immunizations for School Year 2021-2022</a>. Along with a reminder that all students, including those learning remotely, must comply with immunization requirements for school, the DOH outreach encourages parents to contact their child's health care provider to schedule the catch-up vaccines. The letter is available in <a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/overdue-parent-letter-english-final.pdf]">English</a> and <a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/overdue-parent-letter-spanish-final.pdf]">Spanish</a>.</p>
<h3>How primary care can help</h3>
<p>The WSMA will join the Washington Chapter of the American Academy of Pediatrics to push public messaging to parents on routine child vaccinations in July and August, in anticipation of the school year. The WSMA continues to hear from members concerned about the crush of appointments in the weeks just preceding the school year. The message to parents will emphasize the urgency of getting their child protected now. Practices are encouraged to join us in this effort.</p>
<ul>
<li>WCAAP has developed <a href="https://immunitycommunitywa.org/covid-19-vaccine/">a toolkit with DOH, WithinReach, and Public Health - Seattle &amp; King County with social media messages and images</a>.</li>
<li>The <a href="https://www.doh.wa.gov/CommunityandEnvironment/Schools/Immunization">DOH offers additional resources on school and child care immunization</a>.</li>
</ul>
<p>The WCAAP will also be supporting providers by creating a parent education piece/FAQ they can share with families and offering provider education. The WSMA will keep members in the loop as those efforts develop.</p>
<h3>Promoting COVID-19 vaccination to parents</h3>
<p>Children 12 and up are now eligible for a COVID-19 vaccine and younger children may be eligible by this fall. COVID-19 vaccines can now be given at the same time as any other vaccines-there is no longer a need to wait two weeks between COVID-19 vaccines and other routine childhood vaccines. Find resources at the links above and at <a href="http://www.covidvaccinewa.org/">CovidVaccineWA.org</a>.</p>
<p>Thank you for all you do to keep Washington's families healthy.</p>
</div> | 7/7/2021 12:00:10 PM | 7/8/2021 12:00:00 AM |
| act_by_aug_1_to_request_exemption_from_long_term_care_insurance_tax | Act by Aug. 1 to Request Exemption from Long-Term Care Insurance Tax | Advocacy | Shared_Content/News/Latest_News/2021/act_by_aug_1_to_request_exemption_from_long_term_care_insurance_tax | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/long-term-care-645x425.jpg" class="pull-right" alt="Couple watching sunset" />
</div>
<h5>June 25, 2021</h5>
<h2>Act by Aug. 1 to Request Exemption from Long-Term Care Insurance Tax</h2>
<p>The Washington Long-Term Care Trust Act enacted in 2019 mandates a payroll tax at the rate of 0.58% of your and your employees' compensation, with tax proceeds earmarked for Washington's new long-term care program referred to as the WA Cares Fund. To avoid that tax-which has limited benefits for high-wage earners -you must have an alternative long-term care plan in place before you can request an exemption from the state program. Despite the act's provision for an exemption, there is no guarantee you will receive one, so acting quickly is critical.</p>
<h3>Alternative long-term care plans for WSMA members</h3>
<p>The WSMA has entered into an agreement with Wolf &amp; Associates to offer long-term care insurance solutions for WSMA members. While the <a href="http://www.wacaresfund.wa.gov/about-the-wa-cares-fund/">WA Cares Fund</a> goes into effect Jan. 1, 2022, you only have until Aug. 1 to purchase an alternative plan to apply for an exemption from the state plan. (The deadline to file an exemption is Nov. 1, but underwriting the plan takes two months.)</p>
<p>Why seek an alternative plan to the state plan? Because based on WSMA's assessment, the state plan is problematic for:</p>
<ul>
<li>High-wage earners</li>
<li>Anyone retiring within 10 years</li>
<li>People who plan to live outside Washington in retirement</li>
<li>People who live in border communities, such as Idaho and Oregon, but work in Washington state</li>
</ul>
<p>The <em>maximum lifetime benefits</em> under the WA Cares Fund are $36,500. Being fully vested in the program will not occur until after 10 years. Without vesting, you will not be entitled to benefits in retirement, despite having paid into the tax.</p>
<p>If the mandated state plan works for you, there is no need to take any further action. However, if you wish to explore an alternative plan, here's how the WSMA can help:</p>
<h3>Step one</h3>
<p>To pursue the purchase of a <strong>minimum plan</strong> allowed in order to seek an exemption, do the following:</p>
<p>First, you need to provide both personal information and medical information (such as medications, past hospitalizations, surgeries, and other cardiac, cancer, orthopedic, and other treatments) by filling out the following <a href="https://www.wolfltc.com/forms/#/app-health/applicants">secure online questionnaire</a>. Plan on 20 minutes to complete this information. Note: This is NOT an application, simply a secure method of gathering information necessary to assess rates and insurability. After completion, you will be prompted by email to schedule a time with a long-term care specialist from WSMA's trusted partner Wolf &amp; Associates to discuss plan options.</p>
<p>To get quotes on <strong>comprehensive coverage</strong> based on your and/or your family's needs, do the following:</p>
<p>First, you need to provide both personal information and medical information (such as medications, past hospitalizations, surgeries, and other cardiac, cancer, orthopedic, and other treatments) by filling out the following <a href="https://www.wolfltc.com/forms/#/health">secure online questionnaire</a>. Plan on 20 minutes to complete this information. Note: This is NOT an application, simply a secure method of gathering information necessary to assess rates and insurability. After completion, you will be prompted by email to schedule a time with a long-term care specialist from WSMA's trusted partner Wolf &amp; Associates to discuss plan options.</p>
<h3>Step two</h3>
<p>Once you complete either form you will be emailed a booking link to schedule a meeting with a long-term care specialist who will assist you. You will want to book expeditiously as the window to act is limited.</p>
<h3>For a full understanding</h3>
<p>To understand more about the Washington Long-Term Care Trust Act, watch <a href="https://www.wolfltc.com/forms/#/enrollment/gEO3L">this video</a>.</p>
</div> | 6/23/2021 3:25:28 PM | 6/25/2021 12:00:00 AM |
| health_care_authority_finalizes_prescription_monitoring_program_rule | Health Care Authority Finalizes Prescription Monitoring Program Rule | Advocacy | Shared_Content/News/Latest_News/2021/health_care_authority_finalizes_prescription_monitoring_program_rule | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/April/Rx_bottle_doctor_laptop_645x425.jpg" class="pull-right" alt="Doctor holding up a pill bottle while working at laptop" />
</div>
<h5>June 25, 2021</h5>
<h2>Health Care Authority Finalizes Prescription Monitoring Program Rule</h2>
<p>The Washington State Health Care Authority has finalized a <a href="https://www.hca.wa.gov/assets/102-21-06-097.pdf" target="_blank" rel="noreferrer">rulemaking</a> that implements federal prescription drug monitoring program requirements per Section 5042 of the SUPPORT Act.</p>
<p>Starting Oct. 1, 2021, physicians must check an Apple Health (Medicaid) client's history in the state's prescription monitoring program before prescribing controlled substances. Physicians may delegate this task to anyone at the practice with authorization to access the PMP, so long as the physician reviews all of the client's prescriptions. The date and time of the retrieval and review of information must be documented in the patient record.</p>
<p>Outpatient pharmacists will be required to review the PMP before dispensing a controlled substance.</p>
</div> | 6/23/2021 3:25:19 PM | 6/25/2021 12:00:00 AM |
| join_wsmas_latinx_section_leadership_advisory_council | Join WSMA's Latinx Section Leadership Advisory Council | Advocacy | Shared_Content/News/Latest_News/2021/join_wsmas_latinx_section_leadership_advisory_council | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/latinx-physician-645x425.jpg" class="pull-right" alt="Latinx physician" />
</div>
<h5>June 25, 2021</h5>
<h2>Join WSMA's Latinx Section Leadership Advisory Council</h2>
<p>Your leadership is needed to help us shape the goals and objectives for the development of the <a href="http://wsma.informz.net/z/cjUucD9taT0xMDA3MzE1OSZwPTEmdT0xMDc4MTEwNDgzJmxpPTg3NTAwMDU4/index.html">WSMA Latinx Section</a>. By serving on the section's leadership advisory council, you would help shape the work of the Latinx Section within the WSMA. This work is just getting started, so this is a great time to lend your voice. We'll be respectful of your time, as we gather virtually over the next several months.</p>
<p>Here's what to do to be considered:</p>
<ul>
<li>Email a letter of interest and CV to Lauren Fielder at <a href="mailto:lauren@wsma.org">lauren@wsma.org</a> by Friday, July 9. In your letter, please address the following:</li>
<ol>
<li>Why do you want to serve in the leadership of the Latinx Section?</li>
<li>Please share some of your professional experiences working in Latinx communities in Washington state.</li>
<li>Please share your affiliations with any Latinx-serving organizations in Washington or nationally.</li>
<li>Any other relevant information you would like to share.</li>
</ol>
</ul>
<p>Learn more about the <a href="[@]WSMA/Membership/Latinx_Section/WSMA/Membership/Latinx_Section/Latinx_Advisory_Group.aspx?hkey=dcc8886a-b320-46f5-8adf-5103c9a18f15">Latinx Section</a> and get involved today!</p>
</div> | 6/23/2021 3:25:11 PM | 6/25/2021 12:00:00 AM |
| key_deadlines_for_the_2021_wsma_annual_meeting | Key Deadlines for the 2021 WSMA Annual Meeting | Advocacy | Shared_Content/News/Latest_News/2021/key_deadlines_for_the_2021_wsma_annual_meeting | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/am-201910128-645x425.jpg" class="pull-right" alt="People waiting in line to speak at a microphone" />
</div>
<h5>June 25, 2021</h5>
<h2>Key Deadlines for the 2021 WSMA Annual Meeting</h2>
<p>The Annual Meeting of the WSMA House of Delegates is the WSMA's premier policymaking event, when the approximately 200 voting members of the WSMA House of Delegates gather to debate and determine policy for the association, elect officers, and network with colleagues. For WSMA members interested in proposing policy or serving as a delegate at the 2021 Annual Meeting, Sept. 25-26 at The Westin Bellevue, be sure to take note of the following guidance and key dates.</p>
<h3>Deadlines for submitting resolutions</h3>
<p>Good policy starts with a resolution-a proposal asking the WSMA to take a position or act on an issue. Resolutions are considered by delegates during the annual meeting and, if adopted, help guide the direction of the association and raise awareness of issues of importance to the practice of medicine in Washington. 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="[@]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. 6</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.</p>
<p><strong>Aug. 26</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. Delegate handbook will be available from the WSMA website for download.</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 2021 WSMA Annual Meeting, please contact your local county society or state specialty society.</p>
<h3>Annual Meeting registration and agenda</h3>
<p>The WSMA Annual Meeting is free for members. See <a href="[@]WSMA/Events/Annual_Meeting/WSMA/Events/Annual_Meeting/Annual_Meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">the meeting webpage</a> for the meeting agenda and to register.</p>
</div> | 6/23/2021 3:25:30 PM | 6/25/2021 12:00:00 AM |
| physician_assistant_modernization_act_takes_effect_july_1 | Physician Assistant Modernization Act Takes Effect July 1 | Advocacy | Shared_Content/News/Latest_News/2021/physician_assistant_modernization_act_takes_effect_july_1 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/female-doc-patient-masks-645x425.jpg" class="pull-right" alt="Patient in exam room" />
</div>
<h5>June 25, 2021</h5>
<h2>Physician Assistant Modernization Act Takes Effect July 1</h2>
<p>Major components of <a href="http://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bills/Session%20Laws/House/2378-S.SL.pdf?q=20210524114451">House Bill 2378</a>, legislation introduced by the Washington Academy of Physician Assistants and supported by your WSMA, take effect on July 1. The bill makes a number of changes to delegation agreements (now referred to as practice agreements), PA to physician ratios (5:1 to 10:1), and removes the restrictions on PAs practicing at remote sites.</p>
<h3>Putting HB 2378 into practice</h3>
<p>Whether you're a PA, supervising physician, or a practice manager, it is a good time to review the legislation and make any necessary changes. For guidance on implementing changes at your practice and the creation of practice agreements, watch "<a href="[@]WSMA/Education/On_Demand_Webinars/WSMA/education/On_Demand_Webinars/Webinars_OnDemand.aspx?hkey=c3940e65-ff14-4c25-a05d-b85a147c9fa0">Putting HB 2378 into Practice</a>," an on-demand webinar featuring WSMA Policy Analyst Billie Dickinson and WAPA President Gabrielle Zecha, PA-C, MHA, available to members on the WSMA website.</p>
<p>The Washington Medical Commission also offers resources, including:</p>
<ul>
<li><a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/implementation-of-house-bill-2378-pas.pdf]">A one-page brief on the implementation of HB 2378</a> </li>
<li><a href="https://wmc.wa.gov/licensing/applications-and-forms/practice-agreements">Updated website information</a></li>
<li><a href="https://wmc.wa.gov/sites/default/files/public/documents/Model%20Practice%20Agreement.pdf" target="_blank" rel="noreferrer">A model practice agreement</a></li>
</ul>
<p>Should you have questions on HB 2378 and what the changes mean for you, email WSMA's policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
</div> | 6/23/2021 3:25:25 PM | 6/25/2021 12:00:00 AM |
| sunrise_reviews_on_the_horizon_midwifery_optometrists_and_anesthesiologist_assistants | Sunrise Reviews on the Horizon: Midwifery, Optometrists, and Anesthesiologist Assistants | Advocacy | Shared_Content/News/Latest_News/2021/sunrise_reviews_on_the_horizon_midwifery_optometrists_and_anesthesiologist_assistants | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/eye-exam-645x425.jpg" class="pull-right" alt="Patient getting an eye exam" />
</div>
<h5>June 25, 2021</h5>
<h2>Sunrise Reviews on the Horizon: Midwifery, Optometrists, and Anesthesiologist Assistants</h2>
<p>Sunrise reviews are the process by which the state Department of Health considers proposals that would create new health professions or amend the practices of regulated health professions. These reviews offer opportunities for feedback from physicians and the wider public and bear watching as they can prompt future legislation impacting the practice of medicine.</p>
<h3>How a sunrise review works</h3>
<p>Following a request from either the House or Senate health care committee chair, the Department of Health will review proposals submitted by applicants, request public comment, compile a draft report, request public comment again, and submit a final report with its recommendations to the Legislature. While these recommendations are technically advisory, they often serve as the basis for future legislation. </p>
<p>A resolution was adopted at the 2019 WSMA House of Delegates establishing policy on scope proposals that helps to guide our orientation toward these sunrise reviews.</p>
<h4>WSMA scope of practice policy</h4>
<p>RESOLVED that the WSMA oppose efforts for non-physician practitioners to expand the scope of their practice to include additional services currently performed by physicians, in the absence of either commensurate education and supervised training requirements, or a demonstrable and compelling societal need (New HOD Policy).</p>
<h3>Sunrise reviews your WSMA is monitoring</h3>
<p>WSMA's government affairs and policy team is currently reviewing three sunrise reviews that propose changes to the scope of practice for several health professions.</p>
<ul>
<li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/SunriseRequest-AnesthesAssistants.pdf" target="_blank" rel="noreferrer">proposal</a> from the Washington State Society of Anesthesiologists to create a license for anesthesiologist assistants. Read the draft legislation <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/H14211-AnesthesAsstDraftBill.pdf" target="_blank" rel="noreferrer">here</a>.</li>
</ul>
<ul>
<li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/SunriseRequest-Midwives.pdf" target="_blank" rel="noreferrer">proposal</a> from the Midwives Association of Washington to increase the midwifery scope of practice. This proposal includes adding "limited prescription authority for contraception and medications and therapies for various common conditions in pregnancy and postpartum, for those with appropriate training." Read the draft legislation <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/H16391-DraftBill-Midwives.pdf" target="_blank" rel="noreferrer">here</a>.</li>
</ul>
<ul>
<li>A <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/OptometrySunriseRequest.pdf" target="_blank" rel="noreferrer">proposal</a> from the Optometric Physicians of Washington to increase the optometrist scope of practice. Proposed changes include expanding their scope of practice to include certain surgical procedures, the use of lasers and ultrasounds for therapeutic purposes, and broad prescriptive authority without specifying any additional education or training requirements. The proposal also would grant sole authority to determine what constitutes the practice of optometry to the Board of Optometry. Read the draft legislation <a href="https://www.doh.wa.gov/Portals/1/Documents/2000/2021/S-30852-DraftBillOptometry.pdf" target="_blank" rel="noreferrer">here</a>.</li>
</ul>
<h3>Provide feedback by July 16</h3>
<p>While the original deadline to submit public comment on these reviews was July 5, your WSMA successfully advocated for an extension of the deadline due to the pandemic. Comments on the initial proposals are now due by July 16 at midnight and should be emailed to <a href="mailto:sunrise@doh.wa.gov.">sunrise@doh.wa.gov.</a></p>
<p>Should you have any questions, concerns, or feedback, or if the WSMA can be helpful to your organization on these issues, please reach out to <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
</div> | 6/23/2021 3:25:22 PM | 6/25/2021 12:00:00 AM |
| wsma_presses_oic_on_carrier_non_payment_of_new_ppe_cpt_code_99072 | WSMA Presses OIC on Carrier Non-Payment of New PPE CPT Code 99072 | Advocacy | Shared_Content/News/Latest_News/2021/wsma_presses_oic_on_carrier_non_payment_of_new_ppe_cpt_code_99072 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/handwashing-surgeons-masks-hospital-645x425.jpg" class="pull-right" alt="Surgeon scrubbing their hands" />
</div>
<h5>June 25, 2021</h5>
<h2>WSMA Presses OIC on Carrier Non-Payment of New PPE CPT Code 99072</h2>
<p>The WSMA has convened a coalition of health care stakeholders to express concerns regarding state-regulated insurance carrier compliance with Senate Bill 5169, recently passed WSMA-priority legislation intended to help providers with the increased costs of personal protective equipment during the pandemic.</p>
<p>Since going into effect on April 16, the WSMA and other associations have heard from members of varying practice types and locations who report being denied reimbursement for new billing code 99072 pursuant to the legislation. In a <a href="javascript://[Uploaded files/News and Publications/Newsletters/2021/coalition-letter-sb-5169-final.pdf]">letter to the Washington State Office of the Insurance Commissioner</a>, the WSMA-led coalition raised these additional issues:</p>
<ul>
<li>Several health profession associations have contacted the OIC for assistance and individual providers have filed complaints through the Consumer Advocacy Division.</li>
<li>Members have struggled to discern those plans to which SB 5169 applies.</li>
<li>Members are experiencing difficulties and administrative burden associated with the implementation of SB 5169, which is time-limited to the federal public health emergency.</li>
</ul>
<p>The WSMA and its coalition partners have requested, among other things, that the OIC provide guidance on where the law <em>does</em> apply and, in that communication, include that carriers must respond to provider requests for clarity as to whether a plan is state regulated or not. For now, if you are experiencing challenges in receiving insurer reimbursement for this billing code, the WSMA continues to advise <a href="[@]Shared_Content/News/Membership_Memo/2021/June_11/carriers_not_paying_new_ppe_cpt_code_99072_file_a_complaint_with_the_oic?_zs=A3aFd1&amp;_zl=c63i7">filing a complaint with the state Office of the Insurance Commissioner</a>.</p>
</div> | 6/23/2021 3:25:16 PM | 6/25/2021 12:00:00 AM |
| carriers_not_paying_new_ppe_cpt_code_99072_file_a_complaint_with_the_oic | Carriers Not Paying New PPE CPT Code 99072? File a Complaint with the OIC | Advocacy | Shared_Content/News/Membership_Memo/2021/June_11/carriers_not_paying_new_ppe_cpt_code_99072_file_a_complaint_with_the_oic | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2021/June/Doc-Patient-Exam-Room-645x425px.jpg" class="pull-right" alt="Doctor and patient in exam room" />
</div>
<h5>June 10, 2021</h5>
<h2>Carriers Not Paying New PPE CPT Code 99072? File a Complaint with the OIC</h2>
<p>WSMA-championed <a href="https://app.leg.wa.gov/billsummary?BillNumber=5169&amp;Year=2021&amp;Initiative=false">Senate Bill 5169</a>, requiring commercial insurance carriers to reimburse for personal protective equipment costs during the pandemic, is now in effect. Physicians or health care providers treating patients with state-regulated commercial health plans that have incurred costs for PPE may now bill the newly created CPT code 99072 and be reimbursed $6.57 per patient encounter, as recommended by the AMA's RUC committee. </p>
<p>If you are experiencing challenges in receiving insurer reimbursement for this billing code, file a complaint with the state Office of the Insurance Commissioner <a href="https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status">here</a>. If practices experiencing issues with billing this code do not reach out to the OIC to file a complaint, the WSMA cannot advocate effectively. </p>
<!--div class="col-sm-5 pull-right secondaryImage" style="text-align: center;"><img alt="" src="/images/Newsletters/MembershipMemo/2021/June/Doctor-Patient-Masks-645x425px.jpg" class="pull-right" />
</div-->
<p>It is important to note that the law does not apply to self-funded plans (also known as "ERISA" plans), union-negotiated plans, personal injury protection plans, and patients from the state's Department of Labor &amp; Industries. If you are having difficulty identifying if a plan is self-insured, the OIC recommends reaching out to your insurance carrier representative to ask if the plan is regulated by the OIC. This is a yes or no question; if they are unable or unwilling to share that information, the OIC recommends filing a complaint.</p>
</div> | 6/22/2021 3:03:45 PM | 6/10/2021 12:00:00 AM |
| health_care_authority_announces_primary_care_stakeholder_survey | Health Care Authority Announces Primary Care Stakeholder Survey | Advocacy | Shared_Content/News/Membership_Memo/2021/June_11/health_care_authority_announces_primary_care_stakeholder_survey | <div class="col-md-12">
<h5>June 10, 2021</h5>
<h2>Health Care Authority Announces Primary Care Stakeholder Survey </h2>
<p>The Washington State Health Care Authority invites you to respond to its <a href="https://ohsu.ca1.qualtrics.com/jfe/form/SV_6x7J9pyVPjBhjBs">primary care stakeholder survey</a>. The purpose of the survey is to gather physician, provider, and other stakeholder input on proposed provider accountabilities under the Health Care Authority's <a href="https://www.hca.wa.gov/about-hca/value-based-purchasing/multi-payer-primary-care-transformation-model">multi-payer primary care transformation model</a>. Feedback from this survey will be combined with payer input to build out a framework of accountabilities for both providers and payers under this model.</p>
<p>Specifically, the survey asks for input on: </p>
<ul>
<li>Your level of support for the specific <a href="https://www.hca.wa.gov/assets/program/pc-survey-reference-proposed-provider-accountabilities-june-2021.pdf" target="_blank" rel="noreferrer">proposed accountabilities.</a></li>
<li>What providers will need to successfully implement each accountability.</li>
<li>How each accountability should be monitored to measure progress under the model.</li>
</ul>
<p>The WSMA has been closely monitoring the development of this new state model, working with a value-based payment physician work group to <a href="[@]Shared_Content/News/Membership_Memo/20200813/wsma_submits_comment_on_hca_multi_payer_primary_care_model">submit formal comments</a> during previous stakeholder reviews. In our comments, the WSMA emphasized the importance of upfront investments from payers in transformation efforts, accurate and reliable data/measurables, and the Quadruple Aim, among other priorities.</p>
</div> | 6/22/2021 3:04:24 PM | 6/10/2021 12:00:00 AM |