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bree_collaborative_finalizes_recommendations_in_response_to_volk_v_demeerleerBree Collaborative Finalizes Recommendations in Response to Volk v. DeMeerleerLatest_NewsShared_Content/News/Membership_Memo/20200123/bree_collaborative_finalizes_recommendations_in_response_to_volk_v_demeerleer<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/bill-oxford-OXGhu60NwxU-unsplash-645x425px.jpg" class="pull-right" /> </div> <h5> January 23, 2020</h5> <h2> Bree Collaborative Finalizes Recommendations in Response to Volk v. DeMeerleer </h2> <p> At the request of the Washington State Legislature, the <a href="http://www.breecollaborative.org/topic-areas/previous-topics/risk-of-violence/">Dr. Robert Bree Collaborative</a> recently adopted recommendations intended to address clinician uncertainty resulting from the 2016 Washington State Supreme Court decision <em>Volk v. DeMeerleer</em>. <a href="http://www.breecollaborative.org/topic-areas/previous-topics/risk-of-violence/">The Risk of Violence to Others Report and Recommendations</a> can be downloaded for review from the Bree Collaborative website. </p> <p> While intended to provide an overview of best practices for clinical care, the Bree Collaborative is concerned about setting actionable recommendations in light of the standards set in <em>Volk</em>, and suggests that even with these recommendations, legislative action is needed to address the questions raised by court's decision, including: </p> <ul> <li>Addressing <em>Volk's</em> discrepancies with current law (RCWs 71.05.120, 70.02.050, and 70.02.230).</li> <li>Creating one uniform standard on the duties of mental health professionals to protect third parties from violent acts of patients to supersede <em>Volk</em> and apply regardless of treatment settings.</li> <li>Clarifying the scope of the duty to protect by specifying the range of clinicians subject to the duty to protect, conditions that trigger the duty to protect, persons to whom the duty to protect is owed, and options for discharging the duty to protect.</li> </ul> <p> The WSMA was actively engaged in the work group that created the recommendations. The Bree Collaborative will now send the recommendations to the state Health Care Authority in accordance with its usual process for review and approval and will also send them to the House Health Care & Wellness Committee and the Senate Health & Long Term Care Committee. </p> <p> The <em>Volk</em> decision was <a href="[@]Shared_Content/News/Weekly_Rounds/2018/Volk_decision_a_few_words_make_a_huge_difference">aggressively opposed by the WSMA</a> and a large coalition of national and state partners due to its substantial expansion of clinician liability and the potential chilling effect on patient care. We are pleased to see the Bree Collaborative address the need for the Legislature to address significant legal ambiguities in order to support Washington's mental health professionals. </p> <p> If you have questions, email Katerina LaMarche, JD, at <a href="mailto:katerina@wsma.org">katerina@wsma.org</a>. </p> </div>1/23/2020 12:00:00 AM1/1/0001 12:00:00 AM
legislative_session_week_one_highlightsLegislative Session Week One HighlightsLatest_NewsShared_Content/News/Membership_Memo/20200123/legislative_session_week_one_highlights<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/2020-Leg-Session-Social-Graphic-645x425px.jpg" class="pull-right" /> </div> <h5> January 23, 2020</h5> <h2> Legislative Session Week One Highlights </h2> <p> </p> <p> If a physician colleague asks you "<a href="[@]WSMA/Membership/Why_Join_the_WSMA/WSMA/Membership/Why_Join_the_WSMA_/Why_Join_the_WSMA.aspx?hkey=de6b7c3d-8b5a-420d-a55e-db6e2faf5715">What's the value of membership in the WSMA</a>?" a quick and easy answer is the work we, and many of your committed WSMA member colleagues, do on the ground in Olympia during the state legislative session. That work was on full display last week, as Washington state lawmakers began their "short" 60-day working session. Proposed bills on issues of importance to physicians - credentialing, maintenance of certification, a low-carbon fuel standard, to name a few - were heard in committee hearings, several featuring WSMA physician advocates providing testimony. </p> <p> The legislative session kicked off with the swearing in of a new Speaker of the House, Rep. Laurie Jinkins of the Tacoma area. Jinkins is the first new House speaker in over two decades, and - in two historic firsts - the first woman House speaker and its first openly gay speaker. </p> <p> Here is a brief rundown of the priority health care bills heard last week in committees, a few shout-outs to our physician advocates who testified, and what's in store for this week (and in case you missed it, WSMA CEO Jennifer Hanscom lays out our top legislative priorities in our inaugural legislative update video <a href="https://vimeo.com/384585974">here</a>). </p> <h3> Legislative session week one (Jan. 13-17): Health care highlights </h3> <p> <strong>Health care provider credentialing</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=1552&Initiative=false&Year=2019">HB 1552</a>, <em>WSMA supports</em> </p> <p> Among other provisions, House Bill 1552 would require insurers to retroactively reimburse for care delivered by providers during credentialing time, upon approval of credentialing application. It also would reduce the deadline by which insurers must approve or deny credentialing applications to 45 days. WSMA members Ken Lee, MD; Edward Cates, MD; and Christie Mcannally, office manager at Pioneer Family Practice, joined WSMA's Director of Policy Jeb Shepard to testify in support of this legislation during a public hearing in the House Committee on Health Care & Wellness on Jan. 15. <a href="https://vimeo.com/386784881" target="_blank">Watch Drs. Lee and Cates testimony</a>. </p> <p> <strong>Prohibiting maintenance of certification as a condition for insurer network participation</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=2313&Initiative=false&Year=2019">HB 2313</a>, <em>WSMA supports</em> </p> <p> House Bill 2313 would prohibit insurers from requiring that physicians participate in maintenance of certification programs as a condition of being a participating provider in health plans. WSMA member Ken Lee, MD, and WSMA Director of Government Affairs Sean Graham testified in support of this legislation during a public hearing in the House Committee on Health Care & Wellness on Jan. 15. </p> <p> <strong>Physician assistants</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=2378&Initiative=false&Year=2019">HB 2378</a>,<em>WSMA supports</em> </p> <p> House Bill 2378 would make modifications to modernize the Physician Assistant Practice Act and to facilitate the ability of physician assistants to gain employment and practice. WSMA contract lobbyist Katie Kolan, JD, testified in support of this legislation during a public hearing in the House Committee on Health Care & Wellness on Jan. 17. </p> <h3> Other priority issues heard during week one (Jan. 13-17) </h3> <p> <strong>Health coverage for young adults</strong> –<a href="https://app.leg.wa.gov/billsummary?BillNumber=1697&Year=2019&Initiative=false">HB 1697</a>, <em>WSMA supports</em> </p> <p> House Bill 1687 would expand Medicaid coverage to all individuals aged 19 to 26 whose income is at or below 138% of the federal poverty level and who are not eligible for traditional Medicaid (i.e. undocumented individuals.). </p> <p> <strong>Expiration date for notification of a biosimilar</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=2251&Initiative=false&Year=2019">HB 2251</a>, <em>WSMA supports</em> </p> <p> House Bill 2251 would extend by five years the expiration date for required notification to a prescriber in the event of the substitution of a biosimilar drug for a biologic drug. </p> <p> <strong>Student health plans</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=2252&Initiative=false&Year=2019">HB 2252</a>, <em>WSMA supports</em> </p> <p> House Bill 2252 would require that student health plans that provide coverage for maternity care services also provide coverage for abortions. </p> <p> <strong>Living donor act</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=6039&Initiative=false&Year=2019">SB 6039</a>, <em>WSMA supports</em> </p> <p> Senate Bill 6039 would make it illegal for insurers to decline, limit, or price coverage based on an individual's status as a living organ donor or discriminate against them in any way for the same reason. </p> <p> <strong>Direct primary care</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=6062&Year=2019&Initiative=false">SB 6062</a>, <em>WSMA supports</em> </p> <p> Senate Bill 6062 would repeal a reporting requirement for direct primary care practices to operate in the state. </p> <p> <strong>Health system transparency</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=2036&Initiative=false&Year=2019">HB 2036</a>, <em>WSMA opposes</em> </p> <p> House Bill 2036 would impose new financial reporting requirements on hospitals and apply the same requirements to ambulatory surgical facilities. </p> <p> <strong>Low carbon fuel standard</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=5412&Initiative=false&Year=2019">SB 5412</a>, <em>WSMA supports</em> </p> <p> Senate Bill 5412 would require a 20% reduction in the carbon intensity of transportation fuels. </p> <p> <strong>Increasing access to medications for people with opioid use disorder</strong> – <a href="https://app.leg.wa.gov/billsummary?BillNumber=2335&Initiative=false&Year=2019">HB 2335</a>, <em>WSMA supports</em> </p> <p> House Bill 2335 would increase allowances for pharmacies to administer, dispense, or deliver drugs to patients who receive evidence-based opioid use disorder treatment "at the health care entity" and in compliance with Washington State Pharmacy Commission rules. This legislation was developed by WSMA member Lucinda Grande, MD. </p> <h3> Legislative session week two (Jan. 21-25). Public hearings were on the following: </h3> <ul> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6077&Year=2019&Initiative=false">SB 6077</a> <strong>,</strong> concerning high-capacity magazines.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6106&Initiative=false&Year=2019">SB 6106</a>, improving postpartum Medicaid coverage.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6128&Initiative=false&Year=2019">SB 6128</a>, extending coverage during the postpartum period.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6097&Initiative=false&Year=2019">SB 6097</a>, requiring the insurance commissioner to review a health carrier's surplus levels as part of its rate filing review process.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2240&Initiative=false&Year=2019">HB 2240</a>, concerning high-capacity magazines.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2241&Initiative=false&Year=2019">HB 2241</a>, concerning assault weapons and large-capacity magazines.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2303&Initiative=false&Year=2019">HB 2303</a>, concerning professional licensing requirements for service members and military spouses.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6288&Initiative=false&Year=2019">SB 6288</a>, creating the Washington office of firearm violence prevention.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1562&Initiative=false&Year=2019">HB 1562</a>, concerning health care benefit management</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6254&Initiative=false&Year=2019">SB 6254</a>, protecting public health and safety by enhancing the regulation of vapor products.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2457&Initiative=false&Year=2019">HB 2457</a>, establishing the health care cost transparency board.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=2438&Initiative=false&Year=2019">HB 2438</a>, concerning establishment of the prescription opioid impact account.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6070&Initiative=false&Year=2019">SB 6070</a>, concerning public disclosures by state-funded substance use disorder treatment programs and facilities.</li> <li><a href="https://app.leg.wa.gov/billsummary?BillNumber=6086&Initiative=false&Year=2019">SB 6086</a>, increasing access to medications for opioid use disorder.</li> </ul> <p> Stayed tuned for highlights from those hearings. For regular updates on our advocacy during session, visit our <a href="[@]WSMA/News_Publications/Latest_News/Advocacy_Report/WSMA/News_Publications/Newsletters/WSMA_Advocacy_Report.aspx?hkey=fbce906b-dbfb-4af3-8790-11f84275cf1e">online Advocacy Report</a>. </p> <h3> Physician advocacy in person in Olympia can make a difference </h3> <p> Don your white coat and come to the Capitol on Tuesday, Feb. 25 for the 2020 WSMA Legislative Summit, our "doctors' day on the Hill." The event is free for members - <a href="[@]WSMA/Events/Legislative_Summit/WSMA/Events/Legislative_Summit/Legislative_Summit.aspx?hkey=ec5e0510-cee2-4aa9-b549-905d63952454">learn more and register online today</a>. Or consider lending your expertise and experience to lawmakers by testifying on a bill or issue you care about. Contact Alex Wehinger at <a href="mailto:alex@wsma.org">alex@wsma.org</a>to learn more. </p> </div>1/23/2020 12:00:00 AM1/1/0001 12:00:00 AM
naturopath_scope_expansion_bill_set_for_house_voteNaturopath Scope Expansion Bill Set for House VoteLatest_NewsShared_Content/News/Membership_Memo/20200123/naturopath_scope_expansion_bill_set_for_house_vote<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/Megaphone-Evergreen-645x425px.jpg" class="pull-right" /> </div> <h5> January 23, 2020</h5> <h2> Naturopath Scope Expansion Bill Eligible for House Vote </h2> <p> </p> <p> A perennial issue for physicians - the <a href="[@]WSMA/About/Policies/Whats_Our_Policy/Scope_Of_Practice/Scope_Of_Practice_General.aspx">expansion of non-physician scope of practice without the requisite education or training</a> - has reared its head again this session. </p> <p> <a href="https://app.leg.wa.gov/billsummary?Year=2019&BillNumber=1630">House Bill 1630</a>, legislation held over from 2019 and strongly opposed by the WSMA, was made eligible for a vote in the House this week (the vote is pending at the time of this writing). The bill would grant naturopaths prescriptive authority for Schedule III-V drugs, without detailing specific education and training requirements, and require a "practice agreement" with a physician - requiring physicians to supervise naturopaths - while leaving the term undefined and potentially ripe for abuse. If passed by the Legislature, HB 1630 will jeopardize patient safety, increase the proliferation of potentially dangerous prescription drugs, and blur the lines between care provided by physicians and naturopaths. <strong>Our bottom line:</strong> Ensuring access to care is a legitimate issue, but it should be addressed through more responsible means <strong> - </strong> such as increasing medical residencies and providing incentives for members of our existing workforce to increase their Medicaid patient panels. </p> <p> Thank you to all the WSMA members who responded to our call to action this week urging a "no" vote from House lawmakers. If you haven't yet contacted your representatives, <a href="https://takeaction.wsma.org/act-now-to-stop-expansion-of-naturopath-scope-of-practice/" target="_blank">do so today</a>. We will continue keeping you apprised of developments pending the outcome of the House vote. </p> </div>1/23/2020 12:00:00 AM1/1/0001 12:00:00 AM
physicians_in_washington_and_nationally_advocate_for_stronger_gun_violence_policyPhysicians in Washington and Nationally Advocate for Stronger Gun Violence PolicyLatest_NewsShared_Content/News/Membership_Memo/20200123/physicians_in_washington_and_nationally_advocate_for_stronger_gun_violence_policy<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Concepts/gun_safety-645x425px.jpg" class="pull-right" /> </div> <h5> January 23, 2020</h5> <h2> Physicians in Washington and Nationally Advocate for Stronger Gun Violence Policy </h2> <p> </p> <p> With several <a href="[@]Shared_Content/News/Membership_Memo/20200123/legislative_session_week_one_highlights.aspx">gun violence and injury prevention bills introduced in the Legislature</a>, here's a brief reminder of related policy recommendations around which national organized medicine has reached consensus and a review of actions taken by the <a href="[@]WSMA/About_Us/Leadership/House_of_Delegates/WSMA/About/Leadership/House_of_Delegates/House_of_Delegates.aspx?hkey=e2c50002-384d-4ff7-9116-5ce7a51116e7">WSMA House of Delegates</a> on gun violence during its October meeting. </p> <p> Firearm injury and death: A call to action from national organized medicine </p> <p> Leading national physician organizations, including the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American College of Surgeons, American Medical Association, and American Psychiatric Association, recently published specific policy recommendations that the organizations believe can reduce firearm-related injury and death in the United States. The recommended policies take a public health approach to the prevention of firearm injuries and deaths, integrating medical, public health, and legal perspectives. Specific policy recommendations cover the following topics: </p> <ul> <li>Background checks for firearm purchases.</li> <li>Need for research on firearm injury and death.</li> <li>Intimate partner violence.</li> <li>Safe storage of firearms.</li> <li>Mental health.</li> <li>Extreme risk protection orders.</li> <li>Physician counseling of patients and "gag laws."</li> <li>Firearms with features designed to increase their rapid and extended killing capacity.</li> </ul> <p> Policy details can be found in the article "<a href="https://annals.org/aim/fullarticle/2748085/firearm-related-injury-death-united-states-call-action-from-nation">Firearm-Related Injury and Death in the United States: A Call to Action From the Nation's Leading Physician and Public Health Professional Organizations</a>," published Oct. 15, 2019, in the in the Annals of Internal Medicine. </p> <h3> New WSMA House of Delegates policy on firearm injury and death </h3> <p> Endorsing the call to action from national organized medicine was one of several gun violence policies adopted by the WSMA House of Delegates at its annual meeting last October. The full text of Resolution C-23 – Reducing Firearm-Related Injury and Death, 2019 Updates, is below. WSMA leadership and staff use policy passed by the House of Delegates when taking positions on legislation and other policy being debated by policymakers. </p> <p style="margin-left: 40px;"> <strong>C-23 – Reducing Firearm-Related Injury and Death, 2019 Updates</strong> <strong>(ADOPTED AS AMENDED)</strong> </p> <p style="margin-left: 40px;"> RESOLVED, that the WSMA support and help publicize the interspecialty statement on "Firearm-Related Injury and Death in the United States: A Call to Action From the Nation's Leading Physician and Public Health Professional Organizations" or the current best policy. (Directive to Take Action); and BE IT FURTHER </p> <p style="margin-left: 40px;"> RESOLVED, that the WSMA support research to help us understand and reduce the multi-factorial causes and consequences of firearm-related injury and death (New HOD Policy); and BE IT FURTHER </p> <p style="margin-left: 40px;"> RESOLVED, that the WSMA support policy that would prohibit those guilty of violence against a family member or intimate partner - including dating partners, cohabitants, stalkers, and those who victimize any family member - from purchasing or possessing firearms (Reaffirm HOD Policy); and BE IT FURTHER </p> <p style="margin-left: 40px;"> RESOLVED, that the WSMA support improved access to mental health care, while cautioning against broadly including all individuals with a mental health or substance use disorder in a category of individuals prohibited from purchasing firearms (New HOD Policy); and BE IT FURTHER </p> <p style="margin-left: 40px;"> RESOLVED, that the WSMA note the life-saving impact of prior laws against certain types of rapid-fire weapons and high-capacity magazines, and calls for responsible regulation of weapons and weapon accessories whose unique use is the killing of large numbers in short time periods (Reaffirm HOD Policy); and BE IT FURTHER </p> <p style="margin-left: 40px;"> RESOLVED, that the WSMA reaffirm existing "Guns and Weapons" policy on "<a href="http://www.wsma.org/WSMA/About/Policies/Whats_Our_Policy/Guns_And_Weapons/Background_Checks_And_Waiting_Periods.aspx">Background Checks and Waiting Periods</a>"; on "<a href="http://www.wsma.org/WSMA/About/Policies/Whats_Our_Policy/Guns_And_Weapons/Children.aspx">Children</a>"; on "<a href="http://www.wsma.org/WSMA/About/Policies/Whats_Our_Policy/Guns_And_Weapons/Extreme_Risk_Protection_Orders.aspx">Extreme Risk Protection Orders</a>"; on "<a href="http://www.wsma.org/WSMA/About/Policies/Whats_Our_Policy/Guns_And_Weapons/Gun_Control.aspx">Gun Control</a>"; and on "<a href="http://www.wsma.org/WSMA/About/Policies/Whats_Our_Policy/Guns_And_Weapons/Gun_Safety_Education.aspx">Gun Safety Education</a>". (Reaffirm HOD Policy) </p> <p> For more information on WSMA policy, contact the WSMA's new policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>. </p> </div>1/23/2020 12:00:00 AM1/1/0001 12:00:00 AM
wsma_acts_as_legislature_moves_to_cement_b_and_o_tax_increaseWSMA Acts as Legislature Moves to Cement B&O Tax IncreaseLatest_NewsShared_Content/News/Membership_Memo/20200123/wsma_acts_as_legislature_moves_to_cement_b_and_o_tax_increase<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/NoToBO-Graphic-V2-No-Logo-645x425px.jpg" class="pull-right" /> </div> <h5> January 23, 2020</h5> <h2> WSMA Acts as Legislature Moves to Cement B&O Tax Increase </h2> <p> </p> <p> This week, your WSMA is mobilizing in response to the <a href="https://takeaction.wsma.org/no-bo-tax-increase-on-health-care/">news that state lawmakers are seeking to revisit the business & occupation (B&O) tax surcharge passed in 2019</a> - a tax increase that singled out, among other professions, independent physicians in our state. </p> <p> In light of new, less-than-predicted revenue projections from the tax, legislators hope to come to agreement on a set of "fixes" to the B&O tax surcharge bill from 2019, <a href="https://app.leg.wa.gov/billsummary?BillNumber=2158&Initiative=false&Year=2019">House Bill 2158</a>, and pass the modifications quickly before moving on to other session priorities. Unfortunately, the fixes leave intact the 20 percent increase in the B&O tax paid by independent physician practices - and, if passed, would have the effect of cementing that increase in state law for years to come. </p> <p> Both the House and the Senate will consider separate bills this week to modify House Bill 2158. At the time of this writing, lawmakers in the Senate and House fiscal committees have scheduled hearings on Tuesday and Thursday of this week to hear testimony on the proposed bills. WSMA executive leadership and staff will be in Olympia for the hearings, and several WSMA members will take time out of their busy practices to come to the Capitol and provide testimony, including WSMA member and trustee Teresa Girolami, MD, a solo practice physician in Redmond. The WSMA is also working to position several physicians impacted by the tax increase in front of the television camera - a special thanks to Dr. Girolami and Dr. Tammy Bunn of Yelm Family Medicine for their willingness to be interviewed by news media. </p> <p> <strong>The B&O tax surcharge is bad for Washington's practices - and access to care</strong> </p> <p> Testimony by WSMA leadership and physician members impacted by the tax surcharge will reflect the feedback we've received from members statewide. With a steep increase in their fixed business expenses - and no easy way to offset those costs - physician practices are facing choices that range from bad to worse. Just in the past two weeks we've heard from: </p> <ul> <li>A small-group practice serving a rural community that has restricted their Medicaid panels to adult patients.</li> <li>A multispecialty group practice that has laid off a longtime staff member.</li> </ul> <p> <a href="[@]WSMA/Advocacy/Legislative___Regulatory/No_to_B_and_O/WSMA/Advocacy/Legislative_Regulatory/No_to_B_and_O/no_to_b_and_o_.aspx?hkey=d5807781-a824-4b2c-a8f4-70ed597ddfa8#videos">Others have described the need to reduce salaries</a>, and the resulting difficulty in attracting qualified staff; some, primarily in rural communities, have pointedly questioned their ability to keep their doors open altogether. </p> <p> The WSMA has been <a href="[@]WSMA/Advocacy/Legislative___Regulatory/No_to_B_and_O/WSMA/Advocacy/Legislative_Regulatory/No_to_B_and_O/no_to_b_and_o_.aspx?hkey=d5807781-a824-4b2c-a8f4-70ed597ddfa8">clear in our message from day one</a>: With practice viability and patient access to care at stake, Washington's independent physicians must be exempted from the B&O tax surcharge. If you haven't yet done so, <a href="https://takeaction.wsma.org/no-bo-tax-increase-on-health-care/">send a message to your lawmakers today</a>. </p> </div>1/23/2020 12:00:00 AM1/1/0001 12:00:00 AM
Behind_the_CoverBehind the CoverLatest_NewsShared_Content/News/Latest_News/2020/January/Behind_the_Cover<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/News/WSMAReports-Extras-Website-645x425.jpg" class="pull-right" alt="WSMA Reports Extras logo" /></div> <h5>January 17, 2020</h5> <h2>Behind the Cover</h2> <p>Kicking off the new year with our January/February edition of <em>WSMA Reports</em>, art director Erin Foster selected internationally renowned Spanish-Argentinian illustrator <a href="http://www.martinelfman.com/" target="_blank">Martín Elfman</a> as the issue’s cover illustrator. </p> <p> “What drew me to Martín's work is his keen sensibility for pinpointing a story's concept with striking minimalist elements,” she says. “He also has a deft line quality and sense of color that I felt would make for a strong cover art. He definitely did not disappoint!”<br /> <br /> <a href="javascript://[Uploaded files/News and Publications/Publications/WSMA Reports Archive/WSMA_JanFeb 2020-PRINTERS FINAL.pdf]">View the cover illustration for <em>WSMA Reports</em>' January/February 2020 issue</a> .</p> <p> The cover story focuses on the federal and state actions that may impact the medical profession during the legislative sessions in 2020. From that broad-based topic, the article touched on many of the concerns currently plaguing physicians—administrative burdens caused by prior authorization, the threat to independent physician practices from the state’s business and occupation (B&O) tax, and the need for reimbursement to catch up with the emerging technology of telemedicine. </p> <p> Here’s how Martín saw the challenge: “The story behind the cover is about the challenges lawmakers will face in the next legislative session. How to give a graphic shape to concepts as abstract as legality and health? After much thought, I suddenly realized that the dome of the Washington State Capitol building can easily be transformed into the bell of a stethoscope. This is my favorite moment of the creative process, the spark in which everything fits and an unexpected solution appears. From there, with that little finding in my pocket, it was just about adding a doctor at the other end of the stethoscope, listening carefully to measure the state of health of the legislative chamber."</p> <p> His concept was spot on from our perspective. All that was needed was to make the Capitol building look like our own state Capitol in Olympia, and to write a headline that tied it all together. And done! Check it out and let us know what you think. </p> <p><em>WSMA Reports is a benefit of membership. Non-members may <a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA/News_Publications/Publications/Publications.aspx?hkey=8f14076c-10b8-48ab-9595-8c256836e393">purchase a subscription</a>.</em> </p> </div>1/17/2020 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_january_17_2020_5_things_to_know_while_reconsidering_those_new_years_resolutionsWeekly Rounds: January 17, 2020 - 5 Things to Know While Reconsidering Those New Year's ResolutionsLatest_NewsShared_Content/News/Weekly_Rounds/2020/weekly_rounds_january_17_2020_5_things_to_know_while_reconsidering_those_new_years_resolutions<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>January 17, 2020</h5> <h2>5 Things to Know While Reconsidering Those New Year's Resolutions</h2> <p> As your medical association, one of our primary roles is to keep you informed of what's happening in the political and policy world. We are engaged in relevant health care discussions locally and nationally so that we can keep you up to date on current developments, as well as what's coming up next. We also ensure that your voice - as physicians and physician assistants - is heard and considered in those critical conversations. </p> <p> During this time of rapid change, we are seeing a desire and intent to reduce costs in health care by using an "easy" lever - ratcheting down physician reimbursement, among other things. It is more critical than ever that we engage in these conversations - no matter how uncomfortable - and advocate for policies and processes that will improve the health of patients, while not jeopardizing your ability to practice and to financially withstand any new payment models. Only by engaging can you realize the full potential of your expertise. Physicians and PAs have a role to play not only in healing patients' ills, but also in preventing unaffordable health care that can be a causal agent in creating those ills in the first place. </p> <h3>State legislative session begins</h3> <p> This year's session is off to a fast start, with 2,000 bills rolled over from last year, another 500+ prefiled by opening day on Monday, and another 1,000+ yet to come. On Tuesday alone, there were more than 200 new bills introduced. </p> <p> For the WSMA, our top advocacy priorities this session will be working to repeal the business and occupation (B&O) tax increase on independent physicians, promoting a sensible alternative to prior authorization, and advocating for telemedicine payment parity. </p> <p> With your help, our efforts will be even more powerful. Do you have personal experiences of egregious prior authorization requirements? The impact of the B&O tax surcharge on your practice? Problems incorporating telemedicine due to low reimbursement? </p> <p> Your stories, particularly specific instances that negatively impacted your ability to provide optimal care, help inform our advocacy. Share those stories with Sean Graham, WSMA's government affairs director at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p> <p> As this year's 60-day session evolves, we'll keep you posted regularly on developments via our communications channels. You can also visit our <a href="[@]WSMA/News_Publications/Latest_News/Advocacy_Report/WSMA/News_Publications/Newsletters/WSMA_Advocacy_Report.aspx?hkey=fbce906b-dbfb-4af3-8790-11f84275cf1e&_zs=B3aFd1&_zl=Ij0R6">online Advocacy Report page</a> for breaking news, and for weekly "insider" email updates from our legislative staff, write Alex Wehinger at <a href="mailto:alex@wsma.org">alex@wsma.org</a> to be added to the distribution list. </p> <p> Also, if you can break away from your practice, join us in Olympia at the Capitol on Tuesday, Feb. 25 for the 2020 WSMA Legislative Summit. We need WSMA members from all of Washington's 49 legislative districts to attend so that lawmakers personally meet their physician constituents and directly hear their concerns. The event is free for members - learn more and <a href="[@]WSMA/Events/Legislative_Summit/WSMA/Events/Legislative_Summit/Legislative_Summit.aspx?hkey=ec5e0510-cee2-4aa9-b549-905d63952454&_zs=B3aFd1&_zl=Jj0R6">register online</a> today. </p> <h3>Washington's balance billing ban</h3> <p> Since the first of the year, balance billing for emergency services and for certain procedures performed by out-of-network physicians working in in-network facilities are prohibited due to Washington state's Balance Billing Protection Act (BBPA). For more on what you need to know, visit the <a href="[@]WSMA/Resources/Practice_Management/Balance_Billing/Balance_Billing.aspx?_zs=B3aFd1&_zl=Kj0R6">balance billing page</a> on the WSMA website to learn about the scope of prohibition, reimbursement, determining patient eligibility, dispute resolution, network adequacy, enforcement, etc. </p> <h3>Leadership Development Conference scholarships available </h3> <p> One of our most popular, must-attend events is the WSMA Leadership Development Conference, scheduled for May 15-16 at Campbell's Resort on Lake Chelan. Providing professional development for physicians and PAs at all stages of their career is one of our top priorities, and the LDC is a centerpiece of our educational offerings. </p> <p> We believe growing leadership skills is so important, we are offering a limited number of scholarships for this year's conference. Scholarships cover registration fees, event meals, and lodging for two nights in one standard room (travel to and from the conference is not covered by the scholarship). </p> <p> To be eligible for a scholarship, applicants must: </p> <ul> <li>Be a member of the WSMA in 2020. </li> <li>Have not attended a WSMA Leadership Development Conference before. </li> <li><a href="https://www.surveymonkey.com/r/2020LDCScholarship">Submit a complete application</a> by Wednesday, Jan. 29. </li> </ul> <h3>MIPS data due March 31</h3> <p> The data submission period for Merit-based Incentive Payment System-eligible clinicians who participated in the Medicare Quality Payment Program's 2019 performance period is now open. The deadline for submission is 5 p.m. PST, March 31. Accountable care organizations and pre-registered groups and virtual groups may also submit their 2019 data through the Center for Medicare & Medicaid Services web interface. Quality measures reported via Medicare Part B claims have been submitted throughout the 2019 performance period. Sign into the CMS <a href="https://qpp.cms.gov/">QPP website</a> for your preliminary feedback on Part B claims measure data processed to date. CMS will update this feedback at the end of the submission period with claims processed by your Medicare Administrative Contractor within the 60-day runout period. </p> <p> How to submit your 2019 MIPS data </p> <ol> <li>Go to the <a href="https://qpp.cms.gov/">Quality Payment Program website</a>. </li> <li>Sign in using your QPP access credentials*.</li> <li>Submit your MIPS data for the 2019 performance period or review the data reported on your behalf by a third party.</li> </ol> <p> *To sign in, clinicians will need to register in the HCQIS Authorization Roles and Profile (HARP) system. For clinicians who need help enrolling with HARP, please refer to the <a href="https://qpp.cms.gov/">QPP Access User Guide</a>. Clinicians who are not sure if they are eligible to participate in the Quality Payment Program can check their final eligibility status using the <a href="https://qpp.cms.gov/participation-lookup">QPP Participation Status Lookup Tool</a>. Clinicians and groups that are opt-in eligible will need to make an election before they can submit data. (No election is required for those who don't want to participate in MIPS.) </p> <p> Clinicians in small practices (including those in rural locations), health professional shortage areas, and medically underserved areas may <a href="https://qpp.cms.gov/about/small-underserved-rural-practices">request technical assistance</a> from organizations that can provide no-cost support. </p> <p> To learn more about how to submit data, please review the resources available in the <a href="https://qpp.cms.gov/about/resource-library">QPP Resource Library</a>. </p> <h3>Standing together yields results</h3> <p> You belong with us! Membership in the WSMA makes you part of a community of physicians and PAs who believe in a brighter health care future. It also makes you part of the largest physician professional association in the state, and the only one that represents all physicians and PAs, regardless of specialty, practice setting, beliefs or political views. </p> <p> Our work has a greater impact with your support - your time, talent, and financial contribution. If you're among the many who have already renewed your membership, thank you! If you haven't yet renewed, please do so today. </p> <p> <a href="[@]renew?_zs=B3aFd1&_zl=Qj0R6">Renew online</a>, by phone at 206.441.9762, or return the renewal notice that was recently mailed to you. </p> <p> Thank you for being an important part of the WSMA! </p> </div>1/17/2020 12:00:00 AM1/1/0001 12:00:00 AM
Video_Legislative_Session_Week_1_in_BriefVideo Legislative Session Week 1 in BriefLatest_NewsShared_Content/News/Latest_News/2020/January/Video_Legislative_Session_Week_1_in_Brief<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/News/2020-Leg-Update-Video-Still-Play-Button.jpg" class="pull-right" alt="Legislative Update Video Week 1" /></div> <h5>January 14, 2020</h5> <h2>Video: Legislative Session Week 1 in Brief</h2> <p> To kick-off our weekly legislative update series, WSMA CEO Jennifer Hanscom previews WSMA's top three policy priorities for physicians and physician assistants as the state legislative session gets underway. <a href="https://vimeo.com/384585974" target="_blank">Watch the one-minute video</a>.</p> <p> Stay tuned for more updates and tips on how you can help our legislative advocacy as session unfolds. And thank you for your membership in the WSMA—together we will make Washington state the best place to practice medicine and receive care. </p> <p> If you haven’t yet renewed your WSMA membership for 2020, <a href="https://wsma.org/WSMA/Membership/Join_Renew/WSMA/Membership/Join_Renew/Join_Renew.aspx?hkey=37a820cf-9d05-4812-b9dd-c29b9a75356d" target="_blank">do so today</a>—your membership powers our work on your behalf and on behalf of medicine in Washington state. </p> <p> Not yet a WSMA member? Join the WSMA and join more than 11,000 physicians and physician assistants working to make Washington the best place to practice medicine and receive care. <a href="https://wsma.org/WSMA/Membership/Why_Join_the_WSMA/WSMA/Membership/Why_Join_the_WSMA_/Why_Join_the_WSMA.aspx?hkey=de6b7c3d-8b5a-420d-a55e-db6e2faf5715" target="_blank">Learn more and join us!</a></p> </div>1/14/2020 12:00:00 AM1/1/0001 12:00:00 AM
hca_accepting_public_comments_on_public_option_procurement_standardsHCA Accepting Public Comments on Public Option Procurement StandardsLatest_NewsShared_Content/News/Membership_Memo/20200108/hca_accepting_public_comments_on_public_option_procurement_standards<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/Washington-State-Evergreen.jpg" class="pull-right" /> </div> <h5> January 9, 2020</h5> <h2> HCA Accepting Public Comments on Public Option Procurement Standards </h2> <p> </p> <p> Washington state officials have <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20191223/court_decision_prolongs_aca_uncertainty_washington_moves_ahead_with_public_option">unveiled the standard plan designs for Cascade Care</a>, the "public option" plans that will hit the state health insurance market in 2021. The Health Care Authority is now seeking public comment on thequality, value, and affordability standardsfor the plans. This feedback will help inform the public option procurement process, which will occur in February. To review the procurement standards and provide feedback to the state, <a href="https://www.surveymonkey.com/r/LTBRF7C">click here</a>. HCA's public comment period ends on Friday, Jan. 17. The WSMA is in the process of developing formal comments, which we will make available to members once submitted. As a reminder: The WSMA remains opposed to the reimbursement caps that are the primary cost-control feature of the Cascade Care plans. 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. We will continue to highlight our concerns in our comments to the HCA, as well as voice our support for those elements of the plans that we believe will be beneficial to patients and physicians. For a copy of our formal comments once finalized, email Sean Graham at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p> </div>1/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
scholarships_available_for_2020_leadership_development_conferenceScholarships Available for 2020 Leadership Development ConferenceLatest_NewsShared_Content/News/Membership_Memo/20200108/scholarships_available_for_2020_leadership_development_conference<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Events/LDC_2017.05.306-medium-645x425px.jpg" class="pull-right" /> </div> <h5> January 9, 2020</h5> <h2> Scholarships Available for 2020 Leadership Development Conference </h2> <p> </p> <p> The Leadership Development Conference is one of WSMA's most popular events, allowing attendees to enjoy prime learning, networking, and recreational opportunities in a beautiful lakeside resort setting. A limited number of scholarships are available for this year's conference, scheduled for May 15-16 at Campbell's Resort on Lake Chelan. Help us identify and cultivate the next generation of clinician leaders by spreading the word! </p> <p> Scholarships cover registration fees, event meals, and lodging for two nights in one standard room. Travel to and from the conference is not covered by the scholarship. To be eligible for a scholarship, applicants must: </p> <ul> <li>Be a member of the WSMA in 2020.</li> <li>Have not attended a WSMA Leadership Development Conference before.</li> <li>Submit a complete application by Wednesday, Jan. 29 <strong>.</strong></li> </ul> <p> The scholarship application form is <a href="https://www.surveymonkey.com/r/2020LDCScholarship">available online</a>. The WSMA executive committee will select up to five scholarship recipients at its February meeting. Preference will be given to early career applicants (e.g. students, residents, fellows, those under 40, and those in their first 10 years of practice). </p> <p> The one-and-a-half-day Leadership Development Conference is designed for clinicians at all levels of leadership experience and will provide practical information and skills that can be used in any setting—at work, in the community, or in organized medicine. The conference presents an excellent opportunity for physicians seeking leadership positions in their career, regardless of the type or size of their organization or practice. Encourage all physicians involved in a leadership capacity in your organization to attend. </p> <p> Contact Brendan Cox at 206.441.9762 or <a href="mailto:brendan@wsma.org">brendan@wsma.org</a> if you have any questions. </p> </div>1/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
wsma_practice_guidance_on_washingtons_balance_billing_banWSMA Practice Guidance on Washington’s Balance Billing BanLatest_NewsShared_Content/News/Membership_Memo/20200108/wsma_practice_guidance_on_washingtons_balance_billing_ban<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Concepts/invoice_645x425.jpg" class="pull-right" alt="invoice" /> </div> <h5> January 9, 2020</h5> <h2> WSMA Practice Guidance on Washington's Balance Billing Ban </h2> <p> </p> <p> Due to years of work by the WSMA and the state hospital association, Washington state's new law not only protects patients from unexpected bills, but also preserves the ability for physicians and providers to negotiate fair reimbursements from insurers in the state. Washington's Balance Billing Protection Act (BBPA) is now in effect, and the WSMA has you covered, with detailed guidance to help your practice or organization understand the law. Visit our <a href="https://wsma.org/WSMA/Resources/Practice_Management/Balance_Billing/Balance_Billing.aspx">balance billing page on the WSMA website</a> to learn more about scope of prohibition, reimbursement, determining patient eligibility, dispute resolution, network adequacy, enforcement, and more. </p> </div>1/9/2020 12:00:00 AM1/1/0001 12:00:00 AM
a_look_at_wsma_advocacy_priorities_on_eve_of_legislative_sessionA Look at WSMA Advocacy Priorities on Eve of Legislative SessionLatest_NewsShared_Content/News/Membership_Memo/20200108/a_look_at_wsma_advocacy_priorities_on_eve_of_legislative_session<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Concepts/State.Capitol.Olympia_2015-645x425px.jpg" class="pull-right" alt="State Capitol, Olympia" /> </div> <h5> January 9, 2020</h5> <h2> A Look at WSMA Advocacy Priorities on Eve of Legislative Session </h2> <p> </p> <p> The 2020 state legislative session begins on Monday. Repealing the B&O tax increase on independent physicians, promoting a sensible alternative to prior authorization, and advocating for telemedicine payment parity will lead WSMA's advocacy efforts during session, with many more priorities filling out our agenda. The WSMA is your proxy and your voice in Olympia, and our efforts are made stronger with your participation. Here's what you need to know as we head into session - and a request for your help. </p> <p> The primary duty of the Legislature during this "short" 60-day session will be to negotiate <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20191223/governor_releases_supplemental_budget_proposal">a supplemental budget package</a> making adjustments to the two-year budget passed in 2019. Lawmakers will also consider legislation on an array of topics, with WSMA's legislative staff carefully reviewing all health care-related policy that stands to impact physicians, patients, and the practice of medicine. </p> <p> <strong>WSMA's priority legislative items</strong> </p> <p> <strong>Repeal the B&O tax surcharge on independent physician practices –</strong> During the 2019 session, legislation was adopted imposing a 20% surcharge on the B&O tax paid by independent (i.e. non-hospital affiliated) physician practices, among other health care providers and businesses. </p> <p> <em>WSMA ask: Repeal the tax on physicians and health care providers under </em><em><a href="https://app.leg.wa.gov/billsummary?BillNumber=2158&Year=2019&Initiative=false">House Bill 2158</a> </em><em>from 2019</em> <strong>.</strong> </p> <p> <strong>Prior authorization –</strong> Insurance carriers impose prior authorization requirements on patient care before covering services in some circumstances, delaying care and creating administrative burden. </p> <p> <em>WSMA ask:</em> <em>Collect data on insurer prior authorization practices and promote appropriate use criteria in lieu of prior authorization.</em> </p> <p> <strong>Telemedicine payment parity –</strong> <a href="https://app.leg.wa.gov/billsummary?BillNumber=5385&Year=2019&Initiative=false">Senate Bill 5385</a> requires services delivered via telemedicine to be reimbursed at the same rate as if they were delivered in person. It was approved by the Senate in 2019 by a vote of 47-2 but died in the House. </p> <p> <em>WSMA ask: Pass Senate Bill 5385 to increase utilization of telemedicine. </em></p> <em> </em> <p> <strong>We need your help</strong> – Do you have stories you can share with our advocacy team about egregious examples of prior authorization requirements? The impact of the B&O tax surcharge on your practice? Problems incorporating telemedicine due to low reimbursement? Your stories, particularly specific instances that negatively impacted your ability to provide optimal care, can help inform our advocacy. Email your experiences to Sean Graham, WSMA's government affairs director, at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p> <p> <strong>Staying informed and how to engage in direct advocacy during session</strong> </p> <p> During session, we'll keep you posted on developments via our communications channels. You can also visit our <a href="https://wsma.org/WSMA/News_Publications/Latest_News/Advocacy_Report/WSMA/News_Publications/Newsletters/WSMA_Advocacy_Report.aspx?hkey=fbce906b-dbfb-4af3-8790-11f84275cf1e">online Advocacy Report page</a> for breaking news. For weekly "insider" email updates from our legislative staff, email Alex Wehinger at <a href="mailto:alex@wsma.org">alex@wsma.org</a> to be added to her distribution list. </p> <p> If you'd like to help support our advocacy more directly, come to Olympia on Feb. 25 for the 2020 WSMA Legislative Summit. There you'll join your like-minded colleagues and peers from across the state as we take our advocacy message directly to legislators. We need WSMA members from all of Washington's 49 legislative districts to attend, to ensure lawmakers throughout the state hear our message on behalf of physicians and patients. The event is free for members—learn more and register <a href="https://wsma.org/WSMA/Events/Legislative_Summit/WSMA/Events/Legislative_Summit/Legislative_Summit.aspx">online</a> today. </p> <p> And be sure to check out this month's issue of WSMA Reports, which features a special focus on WSMA's advocacy and how to be a good physician advocate. The publication should be in your mailbox now. </p> </div>1/8/2020 12:00:00 AM1/1/0001 12:00:00 AM
a_doctor_in_the_houseA Doctor in the HouseLatest_NewsShared_Content/News/Latest_News/2020/January/a_doctor_in_the_house<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/News/WSMA_JanFeb-2020-PRINTERS-FINAL-Cover-645x425px.jpg" class="pull-right" alt="WSMA Reports January-February 2020 cover" /></div> <h5>January 2, 2020</h5> <h2>A Doctor in the House</h2> <p> By John Gallagher </p> <p> It was just a year ago that Issaquah pediatrician Rep. Kim Schrier, MD, entered the U.S. House of Representatives representing Washington state's 8th Congressional District. She became not only one of 89 first-time members of the House, but also the only woman physician in Congress. "I had no idea really what to expect," Dr. Schrier says now, looking back. "I had no idea of what a day-to-day life of a member of Congress would be." </p> <p> What she discovered was that the environment on Capitol Hill wasn't the snake pit that most people think exists in the current Congress. </p> <p> "I was so pleasantly surprised to find good people who just want to do the best for their communities, who sacrifice their lives at home, their time, and their privacy," Dr. Schrier says. "They're very welcoming. It's an honor to be part of the freshmen class with so many people from different backgrounds, but all motivated to run for the same reasons." </p> <h3>A doctor's heart for health care</h3> <p> Dr. Schrier's reason for running was to advance health care policy. "I spent a lot of time on the campaign trail talking about having a woman doctor in Congress," she says. "A lot is happening in the health care arena, and we shouldn't leave these decisions up to people who haven't worked in, lived in, and been patients in this crazy system of ours." </p> <p> Living up to her promise, Dr. Schrier began her first term by diving right in to health care policy and legislation and serves as co-chair of the New Democratic Coalition Health Care Task Force. As is befitting for a pediatrician, one of her key issues has been the Vaccines Awareness Campaign to Champion Immunization Nationally and Enhance Safety (VACCINES) Act, which she introduced. The bill would track places with high vaccine hesitancy, or decreasing vaccine rates, study why this is happening, and then target information to those places specifically tailored to the reason. </p> <p> "If my VACCINES bill can help increase immune rates and push back against the narrative of the anti-vaxxers, I would feel great, even if that's the only thing I accomplished," she says. </p> <p> Dr. Schrier has been heavily involved in other health care legislation, such as efforts to shore up the Affordable Care Act. She has also been active in efforts to expand Medicare to include vision coverage and to protect patients against surprise billing. </p> <p> She heard stories of patients who checked their plans' provider directories to make sure that their physician would be in network, only to discover when they were hit with a huge bill that the directory was out of date. As a result, Dr. Schrier reached across the aisle to co-sponsor legislation with Republican and fellow physician Rep. Phil Roe that would mandate insurance companies update their provider directories in a timely manner. </p> <p> Dr. Schrier is also a supporter of HR 3, The Lower Drug Costs Now Act, which would authorize the Secretary of Health and Human Services to negotiate prices for the 250 most expensive drugs covered by Medicare, with the cost savings passed on to the private market. </p> <p> "I'm really excited about HR 3," she says. "I've heard over and over again, 'I don't understand why they pay less in Canada than we do.' That's essentially would this bill would do." </p> <p> Dr. Schrier has also introduced a bill that would speed up development of a biosimilar version of insulin. But her perspective on the issue is as much as a patient than as a physician, since she has Type 1 diabetes. </p> <p> "I just yesterday called to order another bottle of my own insulin, Humalog, and it was no longer on the dispensary," she says. "It would cost $300 for a bottle! It's kind of crazy to me that it costs so much and that formularies change like that for no apparent reason." </p> <h3>A trusted resource</h3> <p> While all these legislative initiatives are the logical outgrowth of her own experience, Dr. Schrier has also become a resource for other members of Congress. </p> <p> "What I find is my colleagues come to me to run questions by me about surprise billing or women's health," she says. "I get questions about milk and the Dairy Council pressuring my colleagues to support sweet milk in schools." </p> <p> That extends to medical advice. </p> <p> "I still get to be the consultant for all my colleagues with children about their rashes, fevers, and sleeping through the night," she notes. Then there was the time when a member of Congress fainted and she offered medical assistance. </p> <p> Dr. Schrier also brings her perspective as a pediatrician to issues that for many outside of medicine may seem unconnected to health care, such as immigration. The Trump administration's policy of separating children from their parents at the border is also a health crisis because it is creating adverse childhood experiences (ACEs), which studies have shown carry lifelong consequences. </p> <p> "They've already been through all kinds of trauma in journey, then we take them away from parents, and it's adding ACEs upon ACEs and creating a generation with problems with their mental and physical health," she says. "This is no way to treat kids." </p> <p> Whether any of Dr. Schrier's proposed legislation can make it to the president's desk in a polarized Congress is impossible to predict. </p> <p> "I can always hope for cooperation," she says optimistically. "I think that's up to the president to rise above it. Then I think we can get a lot done." </p> <p> Sometimes that polarization spills over into Dr. Schrier's congressional workday. A Republican colleague tried to introduce an amendment into a higher education bill that would prohibit universities with an associated medical center from getting federal funds unless they promised to provide medical care for any baby born alive. </p> <p> "That's just a dog whistle for the crazy notion on the other side that doctors are killing babies," she says. "A woman doctor carries weight in that position. I would speak so authoritatively to it." </p> <p> All these experiences and more have confirmed to Dr. Schrier that her decision to run for Congress was the right call. </p> <p> "I worried that I might give up practice and not win, but I have to tell you that I have grown a ton as a person through this experience and I have not had a moment of regret," she says. "I can do a lot more good for kids from Washington than from the confines of my own doctor's office." </p> <p> Besides, Dr. Schrier says, being in Congress isn't all that different from being a resident, with one big difference. "There's just a lot of running around, up and down stairs, hustling to get to somewhere where you're only going to be for 10 minutes, then hustling back to somewhere else," she says. "Except that I have to do it much less comfortable shoes." </p> <p> <em>John Gallagher is a Washington state-based freelance writer who specializes in covering health care.</em> </p> <p> <em>This article was featured in the January/February 2020 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA/News_Publications/Publications/Publications.aspx?hkey=8f14076c-10b8-48ab-9595-8c256836e393">purchase a subscription</a>.</em> </p> </div>1/2/2020 12:00:00 AM1/1/0001 12:00:00 AM
policy_prognosis_uncertainPolicy Prognosis: UncertainLatest_NewsShared_Content/News/Latest_News/2020/January/policy_prognosis_uncertain<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/News/WSMA_JanFeb-2020-PRINTERS-FINAL-Cover-645x425px.jpg" class="pull-right" alt="WSMA Reports January-February 2020 cover" /></div> <h5>January 2, 2020</h5> <h2>Policy Prognosis: Uncertain</h2> <p> By John Gallagher </p> <p> At a national level, the number of challenges affecting physicians and their practices seems almost endless. Administrative burdens, financial pressures, and emerging technologies are all changing the profession. Whether it's congressional legislation on tax policy or state-level insurance regulations, physicians around the country are buffeted by constant changes. In response, legislators are being forced to play catch-up with a rapidly shifting landscape. </p> <p> Washington state is no exception. </p> <p> Last year's legislative session was exceptionally busy, with bills addressing a broad range of issues, including vaccination exemptions, opioid prescribing, a public option plan, and a prohibition on balance billing. </p> <p> "Last year saw a slew of big-ticket items," says Sean Graham, WSMA's director of government affairs. "Lawmakers told us they wanted to let those policies sink in. Of course, they always say that—then the next session everyone has bills they're pushing." </p> <p> Still, the upcoming legislative session offers an opportunity to tackle plenty of other pressing issues. Among them are the administrative burdens caused by prior authorization, the threat to independent physician practices from the state's business and occupation (B&O) tax, and the need for reimbursement to catch up with the emerging technology of telemedicine. </p> <h3>The prior authorization nightmare</h3> <p> The exact shape of any legislation about the first two issues will be determined as the session gets underway. In terms of the breadth of its impact, prior authorization is the biggest concern. </p> <p> Imagine a patient presenting at a practice at 4 in the afternoon with severe abdominal pains. "We can't order a CT scan to rule out appendicitis because it requires prior authorization," says Amber Pedersen, the administrator for Valley Obstetrics and Gynecology in Spokane Valley. Because prior authorization takes at least one to three days, Pedersen says the patient will be referred to the ED, where the costs to her and to the health care system are far higher. </p> <p> "Prior authorization is an everyday nightmare for every single doctor in every single specialty," says Teresa Girolami, MD, president of the King County Medical Society. "Prior authorization gets in the way of good medical care." </p> <p> Prior authorization is also a major source of physician burnout. The American Medical Association estimates that physician practices complete an average of 31 prior authorizations a week per physician, consuming roughly 14.9 hours—almost two full business days—of physician and staff time. A bill is pending in Congress to standardize prior authorization across Medicare Advantage plans. </p> <p> The AMA released its 2018 Prior Authorization Physician Survey results last year, surveying 1,000 practicing physicians about the impact of prior authorization on their work. More than 90% of the physicians reported care delays associated with prior authorization, and almost as many said that the burdens of prior authorization have increased over the past five years. Most disturbing was the fact that 28% of the physicians reported that prior authorization had led to a serious adverse event for a patient in their care. </p> <p> Physicians and practice administrators in Washington echo the national survey results. Dr. Girolami recalls a patient who came to her office on a Friday. Dr. Girolami ordered a CT scan, which led to a biopsy and a diagnosis of metastatic colon cancer. By Wednesday, the patient was meeting with an oncologist. </p> <p> "Then someone had the nerve to call me about prior authorization," Dr. Girolami says. After telling the insurer that she had quickly identified a lifethreatening condition, Girolami was able to get the plan to back down. </p> <p> Then, there's the cumbersome administrative burden imposed by prior authorization. Pedersen, who works at a practice with nine providers, says that one staffer in the office deals with an average of five to seven prior authorizations each day. </p> <p> "I can grasp the concept, but it's gone too far," she says. "We spend anywhere from 30 minutes to an hour for one prior authorization for certain carriers. What the staff complain about most is that when you call the carrier for assistance, on average you get transferred three times. Sometimes, it takes 10 minutes just to get to the right person to answer a question or to get the correct form that needs to be filled out. Some carriers have different forms depending on the test or medication." </p> <p> For an obstetrics practice, genetic screening is now the standard of care, but Pedersen says that most screenings still require prior authorization. New medications almost invariably require prior authorizations, but plans also request prior authorizations for even common treatments. </p> <p> "When I first started in health care, I don't remember getting prior authorizations except for chemo meds," Pedersen says. "Now I'm getting them for everyday therapy." </p> <h3>B&O tax burden unfairly targets independent practices </h3> <p> While all practices struggle with the costs that prior authorization imposes on them, independent practices are now struggling with an additional burden due to legislation passed last year. The state legislature increased the B&O tax on independent practices by 20%, threatening the viability of many of those practices, particularly in already underserved rural areas where they are common. Getting the legislature to roll back the increase, which funds college financial aid for students from families earning below the state median income, will be a challenge. </p> <p> While other professions were included in the tax increase, they can make their customers pay for it. "Medicine should have been excluded from this increase because we are not like other forms of business getting taxed," says Chelsea Unruh, MD, a physician at Yelm Family Medicine and president of the Thurston-Mason County Medical Society. "We don't get to control our prices and we don't get to say what we charge." </p> <p> Dr. Unruh says managing a private practice is difficult enough, given the tight margins. "I have to make sure I pay staff and keep the lights on, and pay my salary, too, so I can pay my loans back," they say. </p> <p> The B&O tax has had a direct impact on the care the practice is able to provide, leading to care being restricted or even ended for poorer patients. "I have to limit how many Medicaid people I can see because of the overhead of being in a private practice," they say. "The B&O tax added even more pressure onto that already-tight overhead and is making it more difficult to be able to serve the vulnerable population. It's one of the most frustrating parts of being in medicine." </p> <p> As an internist in a solo practice, Dr. Girolami experiences similar pressures. "If you take charity care, Medicaid, or Apple Health, you're already running in the hole," she says. "You have to limit the number of people you see, which gives them way less choice. It's painful." </p> <p> Dr. Girolami also says that the additional expense leads to diverting investments that could improve office efficiency. "That money may have been earmarked for a texting service or software," she says. "Now you have to take a hard look at it." As a result, she says, the tax "is punitive to smaller groups." </p> <p> The fallout may not be limited to current investments. Dr. Unruh says that the tax will make it harder to recruit physicians to rural practices, worsening an already bad problem. </p> <p> "Folks coming out of medical school are coming out with more loans than we've ever seen in the past and not as much incentive to go into private practice," they say. "We're limiting our ability to be competitive for a new workforce." </p> <h3>The technology reimbursement gap</h3> <p> Technology—specifically telemedicinewill also be on the agenda for the next legislative session. By allowing for long-distance clinician-patient contact, telemedicine has the potential to provide medical care to those who would otherwise have to travel for it or not receive it at all. </p> <p> However, while Washington insurers must provide coverage, telemedicine may be reimbursed at a lower rate than an in-person visit, which disincentivizes use of the technology. About 10 states, including California and Florida, have passed legislation to correct this disparity, but a bill to do so in Washington, SB 5385, failed to pass last year. The bill will automatically be reintroduced in the new session. Sen. Randi Becker, sponsor of the legislation, worked in the medical field for 24 years, starting as a practice receptionist and ending as an administrator. </p> <p> "The intent of the legislation is to acknowledge the value of treating patients in a location that works for them," she says. "We want people to get the care they need at the time they need without having to travel." She points out that the need is especially keen in rural areas of the state where specialists are in short supply. </p> <p> Becker notes that advances in health care technology often lag behind policy. (As an administrator, she led her clinic in developing the first internet billing system to transmit a claim to Medicare.) "I have always believed in technology in the health care arena," she says. "As a nation, we have embraced technology. But why do we not embrace it as easily in health care? We can't get in the way of technology." </p> <p> By eliminating the payment disparity, Becker believes that telemedicine will be able to develop its potential more readily. She's hopeful about the bill's chances this time around. "Time was a factor last time," she says. "There's optimism about this going through this year." </p> <p> <em>John Gallagher is a freelance journalist specializing in covering health care.</em> </p> <p> <em>This article was featured in the January/February 2020 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA/News_Publications/Publications/Publications.aspx?hkey=8f14076c-10b8-48ab-9595-8c256836e393">purchase a subscription</a>.</em> </p> </div>1/2/2020 12:00:00 AM1/1/0001 12:00:00 AM
practice_health_in_jeopardyPractice Health in JeopardyLatest_NewsShared_Content/News/Latest_News/2020/January/practice_health_in_jeopardy<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/News/WSMA_JanFeb-2020-PRINTERS-FINAL-Cover-645x425px.jpg" class="pull-right" alt="WSMA Reports January-February 2020 cover" /></div> <h5>January 2, 2020</h5> <h2>Practice Health in Jeopardy</h2> <p> By Teresa M. Girolami, MD </p> <p> <em>Dear Valued Customer: Due to an increase in operating costs, we're raising prices on our coffee beverages - please pardon the inconvenience.</em> </p> <p> When I read that note at my favorite coffee shop, I didn't hesitate to accept the price increase. As the owner of small private practice in Redmond, I empathize with decisions that must be made with increasing expenses. </p> <p> It also got me thinking again, as I often do, of the ways in which running a private practice or independent clinic differs from other small businesses—and how our business model is increasingly under threat in Washington state. </p> <p> Last year, state lawmakers passed a 20% increase in the business and occupation (B&O) tax on small service businesses, including independent physician practices like mine. I doubt the Legislature realized the impact this tax increase has on independent practices and clinics—where roughly a third or more of our state's physicians practice—and the patients they serve. </p> <p> How are physician businesses unlike other small businesses? We get paid mainly by insurance companies, not by our primary customers. We have limited negotiation power and we get paid less each year. Unlike a coffee shop, when our expenses go up, we have no way to recover the resulting loss. We cannot—and don't want to—pass this expense on to our patients. </p> <p> And yet it's patients—largely our most vulnerable ones—who bear the brunt of this legislative decision. Unfairly targeting independent physician businesses with tax increases forces them to make hard decisions to keep their doors open in a highly competitive environment. Patients covered by public programs that are low payers, like Medicare and Medicaid (which covers many of our state's children), are being turned away. </p> <p> In a worst-case scenario, a practice will close, with many more patients losing access to their primary physicians. Just last year, three rural practices closed, citing increasing business expenses. </p> <p> The health of our state's independent practices should concern all physicians. Patients who can't access preventive care often end up in urgent care clinics and emergency rooms. This adds strain to already over-burdened emergency centers and drives up everyone's cost of care. In other instances, patients are absorbed by employed physicians with panels already stretched thin, leading to more burnout. </p> <p> Increasing the B&O tax impacts businesses like mine in too many crucial ways to cover here, but each is essential to maintaining the health of independent practices and the balance of our health ecosystem. </p> <p> On behalf of King County Medical Society, I sponsored a resolution passed unanimously by the WSMA House of Delegates that directs the WSMA to advocate to amend state law to exempt all physicians from the B&O tax increase to protect the vital health interests of our communities. I urge all WSMA members, and all Washington state physicians, to oppose this unfair tax increase that will disproportionately harm independent practices and clinics. </p> <p> I trust my local coffee shop will weather its increased expenses. But I am deeply concerned about thousands of small businesses like mine. Our health, and the health of Washington's medical community, is in jeopardy. Those consequences are far more serious than the loss of a morning cup of coffee. </p> <p> <em>Teresa M. Girolami, MD, is the president of King County Medical Society and owner of BelRed Internal Medicine, PLLC.</em> </p> <p> <em>This article was featured in the January/February 2020 issue of WSMA Reports, WSMA's print newsletter. WSMA Reports is a benefit of membership. Non-members may <a href="https://wsma.org/WSMA/News_Publications/Publications/WSMA/News_Publications/Publications/Publications.aspx?hkey=8f14076c-10b8-48ab-9595-8c256836e393">purchase a subscription</a>.</em> </p> </div>1/2/2020 12:00:00 AM1/1/0001 12:00:00 AM
weekly_rounds_december_30_2019_as_the_year_ends_budget_wrangling_beginsWeekly Rounds: December 30, 2019 - As the Year Ends, Budget Wrangling BeginsLatest_NewsShared_Content/News/Weekly_Rounds/2019/weekly_rounds_december_30_2019_as_the_year_ends_budget_wrangling_begins<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="Weekly Rounds logo" class="pull-right" src="/images/Logos/Weekly-Rounds-Article-Graphic-645x425px.jpg" /></div> <h5>December 30, 2019</h5> <h2>As the Year Ends, Budget Wrangling Begins </h2> <p>Jennifer Hanscom, Executive Director/CEO</p> <p> As we prepare to bid adieu to 2019 and chill the Champagne to greet 2020, I'm reflecting on federal and state budget actions that impact our work and profession. Here's a rundown on recent activities. </p> <p> Just before Christmas, the president signed two spending packages - totaling $1.4 trillion - that not only averted a government shutdown, but also included several wins for health care. One of the attached bills followed recent Washington state action as it will ban the sale of tobacco and e-cigarettes to anyone under the age of 21. The package also included $25 million for federal research on gun safety, delays Medicaid payment cuts to disproportionate-share hospitals for five months, and repeals three Affordable Care Act taxes: a 40% excise tax on employer-provided health plans that exceed certain thresholds; a health insurance tax; and a 2.3% excise tax on medical devices. </p> <p> Surprisingly, Congress did not include any provisions on balance billing, nor did it address prescription drug costs - both were issues that we had expected to see in the final package. </p> <p> As that spending package heads toward the president's desk, here in the "other" Washington, Gov. Jay Inslee released his 2020 supplemental budget proposal. This budget is primarily intended to make necessary adjustments to the two-year budget adopted by the Legislature last year, which went into effect July 1. </p> <p> In summary, the governor's proposal appropriates all forecasted revenue and does not propose to raise any new revenue, though it does rely on funds from the state's "rainy day" reserve account. Here are some highlights of interest to us: </p> <ul> <li>$1.1M toward supporting the prescription drug monitoring program.</li> <li>$8.4M to backfill Washington state family planning services that lost funding when the U.S. Department of Health and Human Services changed the rules related to abortion services.</li> <li>$10.5M to cover funding for Foundational Public Health Services that was anticipated from vapor distribution taxes, which will be insufficient given the governor's executive order banning flavored vapor products.</li> <li>$989K toward vape and tobacco cessation via counseling support services for 18- to 20-year-olds in recognition of the new state law raising the minimum age for legal sale of tobacco and vapor products to 21.</li> <li>$366K to support the Newborn Screening Laboratory since the State Board of Health added spinal muscular atrophy to the list of diseases screened through the state's mandatory newborn screening panel.</li> <li>o HCA is requesting $183K in addition to DOH's request to cover costs related to the inclusion of this test.</li> <li>$2.8M to fund ProviderOne operational costs. </li> <li>$1.2M to support a pilot program that provides mental health drop-in services.</li> <li>$558K to plan and administer efforts to implement the public option.</li> <li>$298K toward developing and implementing the prescription drug price transparency program.</li> <li>$11.3M to reconcile amounts owed to Federally Qualified Health Centers for reimbursements for Medicaid patients.</li> <li>$150K for the HCA to conduct an information request for a diabetes disease management program.</li> <li>$1.9M for the Children's Health Insurance Program (CHIP).</li> </ul> <p> You can <a href="https://ofm.wa.gov/budget/state-budgets/gov-inslees-proposed-2020-supplemental-budget">review the governor's proposal here</a>. It's worth nothing that this is only the first step in the 2020 budget process and is by no means the final product. The House and Senate will introduce their respective supplemental budgets during the 2020 session, which may incorporate elements of the governor's proposals. A final budget must be approved before lawmakers conclude their work for 2020. </p> <p> Your WSMA government affairs and policy team in Olympia is working hard in preparation for the start of the 2020 legislative session. It will be what is known as a "short" session. It's a 60-day session that occurs during even-numbered years each biennium as outlined in the state constitution. Session starts on Jan. 13, but some legislators have already <a href="https://app.leg.wa.gov/billinfo/prefiled.aspx?year=2019">prefiled bills</a> in anticipation of session. </p> <p> Looking ahead to the new year, here are some important dates to keep in mind: </p> <ul> <li>Jan. 8: Pre-session Advocacy Council webinar (<a href="https://zoom.us/meeting/register/877b81fe318b5500c5b9141539e44ee6">click here to register</a>)</li> <li>Jan. 13: Start of regular session</li> <li>Feb. 25: <a href="[@]WSMA/Events/Legislative_Summit/WSMA/Events/Legislative_Summit/Legislative_Summit.aspx?hkey=ec5e0510-cee2-4aa9-b549-905d63952454&_zs=B3aFd1&_zl=VAXO6">WSMA Legislative Summit</a> (be sure to join us!)</li> <li>March 12: End of regular session</li> </ul> <p> Even as 2019 comes to a close during these cloudy, gray days, there's never a dull moment as we strive to protect your interests and the profession. Your participation with us makes a difference, and we appreciate your involvement. </p> <p> And with that, here's to 2020! </p> </div>12/30/2019 12:00:00 AM1/1/0001 12:00:00 AM
court_decision_prolongs_aca_uncertainty_washington_moves_ahead_with_public_optionCourt Decision Prolongs ACA Uncertainty; Washington Moves Ahead with Public OptionLatest_NewsShared_Content/News/Membership_Memo/20191223/court_decision_prolongs_aca_uncertainty_washington_moves_ahead_with_public_option<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img alt="" src="/images/Logos/Washington-State-Evergreen.jpg" class="pull-right" /> </div> <h5> December 23, 2019 </h5> <h2> Court Decision Prolongs ACA Uncertainty; Washington Moves Ahead with Public Option </h2> <p> A federal appeals court last week <a href="https://khn.org/news/federal-appeals-court-strikes-down-portion-of-obamacare/">ruled the individual mandate provision of the Affordable Care Act unconstitutional</a>, in yet another blow to the federal health reform law. The court stopped short of rendering the entire law invalid; it instead requested <a href="https://www.fiercehealthcare.com/payer/appeals-court-strikes-down-individual-mandate-aca-case-but-punts-severability">a lower court make that determination</a>, postponing a final decision on the fate of the law indefinitely. Washington state, along with 15 other states, the District of Columbia, and the U.S. House of Representatives, is defending the ACA in the federal suit. </p> <p> In another closely watched development, Washington state officials unveiled the standard plan designs for Cascade Care—the "public option" plans that will hit the market in 2021—and began outreach to the physician and provider community. If you missed last week's webinar overview of Cascade Care, an archived recording is forthcoming; for now, slides from the session are available, detailing the plan designs and the methodology being considered for determining physician and provider payments. </p> <ul> <li><a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/cascade_care_provider_webinar_121619.pptx]">Cascade Care Provider Webinar slides</a>.</li> <li><a href="javascript://[Uploaded files/News and Publications/Newsletters/2019/medicare_methodology_carrier_workgroup_draft_121619.pptx]">Medicare Methodology Carrier work group slides</a>.</li> </ul> <p> As detailed in the second set of slides, the "ceiling" on physician and provider reimbursements, one of the primary cost-control measures of the public option plans, was <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20190508/public_option_bill_passes_with_rate_setting_provision">strongly opposed by the WSMA</a>, and we remain deeply concerned about the ability of physicians and providers to participate in the plans and the effect that will have on access to care for plan enrollees. We will continue to provide members with updates as Cascade Care's implementation proceeds. </p> </div>12/23/2019 12:00:00 AM1/1/0001 12:00:00 AM
governor_releases_supplemental_budget_proposalGovernor Releases Supplemental Budget ProposalLatest_NewsShared_Content/News/Membership_Memo/20191223/governor_releases_supplemental_budget_proposal<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Concepts/Stock.image_2017.WA.State.Capitol.Building_Double-645x425%20(1).jpg" class="pull-right" alt="Washington State Capitol" /> </div> <h5> December 23, 2019 </h5> <h2> Governor Releases Supplemental Budget Proposal </h2> <p> Gov. Jay Inslee released his 2020 supplemental budget proposal last week. The proposal sets the stage for the state legislative session that begins in January, when lawmakers will negotiate a supplemental budget package making adjustments to the two-year budget passed in 2019. While primarily focused on investments to address homelessness and climate change, the governor's plan does propose modest investments in health care, and, importantly, avoids cuts in current health care spending and does not propose new or increased taxes. </p> <p> Health care provisions in the governor's budget proposal include: </p> <ul> <li>$1.1 million toward supporting the state's prescription monitoring program.</li> <li>$8.4 million to backfill Washington state family planning services that lost funding when the U.S. Department of Health and Human Services changed rules related to abortion services.</li> <li>$10.5 million to cover funding for Foundational Public Health Services that was anticipated to come from taxes on vapor products but is not likely to materialize due to changes such as banning flavored vapor products.</li> <li>$989,000 toward vape and tobacco cessation via counseling support services for 18- to 20-year-olds.</li> <li>$366,000 to support the Newborn Screening Laboratory since the Washington State Board of Health added spinal muscular atrophy to the list of diseases screened through the state's mandatory newborn screening panel.</li> <li>$2.8 million to fund ProviderOne operational costs.</li> <li>$238 million for the Medicaid Quality Improvement Program to support the transformation waiver.</li> <li>$56 million toward Medicaid Transformation Project alignment.</li> <li>$1.2 million to support a pilot program that provides mental health drop-in services.</li> <li>$558,000 to plan and administer efforts to implement the public option.</li> <li>$298,000 toward developing and implementing the prescription drug price transparency program.</li> <li>$11.3 million to reconcile amounts owed to Federally Qualified Health Centers for reimbursements for Medicaid patients.</li> <li>$1.9 million for the Children's Health Insurance Program.</li> </ul> <p> Review the governor's full proposal <a href="https://ofm.wa.gov/budget/state-budgets/gov-inslees-proposed-2020-supplemental-budget">here</a>. The governor's proposal is the first step in the 2020 budget process; the House and Senate will introduce their respective supplemental budget proposals during session, which may incorporate elements of the governor's proposals. A final budget must be agreed to before lawmakers conclude their work for 2020. </p> </div>12/23/2019 12:00:00 AM1/1/0001 12:00:00 AM
us_house_passes_bold_bill_to_lower_drug_costsU.S. House Passes Bold Bill to Lower Drug CostsLatest_NewsShared_Content/News/Membership_Memo/20191223/us_house_passes_bold_bill_to_lower_drug_costs<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Concepts/Prescription%20with%20Money.jpg" class="pull-right" alt="Prescription with money" /> </div> <h5> December 23, 2019 </h5> <h2> U.S. House Passes Bold Bill to Lower Drug Costs </h2> <p> Democrats in the U.S. House of Representatives have taken a bold step toward addressing the skyrocketing costs of prescription medications by passing H.R. 3 - "The Lower Drug Costs Now Act." The legislation would allow Medicare to negotiate prices with pharmaceutical companies and set price caps based on international prices, among other provisions. The WSMA remains alarmed at the crisis of soaring drug costs, which has become one of the primary drivers of health care spending in the U.S. and puts many life-saving medications increasingly out of reach for the average patient. And there are hidden costs for the physician community as well, with private and public payers relying on prior authorizations or slashing reimbursements to offset the high costs of medications. With the Republican-led Senate and President Donald Trump having expressed their opposition to the legislation, Democratic lawmakers and candidates are expected to use the bill as a campaign issue in 2020. </p> </div>12/23/2019 12:00:00 AM1/1/0001 12:00:00 AM
walmart_delays_epcs_mandateWalmart Delays EPCS MandateLatest_NewsShared_Content/News/Membership_Memo/20191223/walmart_delays_epcs_mandate<div class="col-md-12"> <div class="col-md-5 pull-right" style="text-align: center;"><img src="/images/Concepts/Rx_bottle_doctor_laptop_645x425.jpg" class="pull-right" alt="Doctor with pill bottle working at laptop" /> </div> <h5> December 23, 2019 </h5> <h2> Walmart Delays EPCS Mandate </h2> <p> Walmart will <a href="https://www.usatoday.com/story/money/2019/12/11/electronic-prescriptions-walmart-take-paper-rx-2021/4380115002/">delay its decision to only accept electronic prescriptions for controlled substances (EPCS)</a>, scheduled to go into effect Jan. 1. The retail giant delayed the mandate in response to concerns from the AMA and others in the medical community, who warned that the stringent policy, which would not allow exceptions, would lead to significant disruptions in patient care. The AMA detailed its concerns in <a href="https://searchlf.ama-assn.org/undefined/documentDownload?uri=%2Funstructured%2Fbinary%2Fletter%2FLETTERS%2F2019-11-26-Letter-to-Van-Gilder-Walmart-EPCS.pdf" target="_blank">a letter to Walmart</a>, noting that fewer than half of U.S. physicians had the proper technology and certification to adopt EPCS and that major regulatory barriers still stand in the way of widespread adoption. Among its recommendations, the AMA said it believed Walmart should not require EPCS in a state unless that state's legislature or regulatory boards have approved the policy. The AMA noted that some states have already begun implementing EPCS, usually with exceptions and hardship waivers available to ensure access to care isn't disrupted. (With its recently passed opioid omnibus bill, House Bill 5380, Washington is one such state—and the WSMA was instrumental in securing an exemption process that <a href="https://wsma.org/Shared_Content/News/Membership_Memo/20191211/practice_impact_new_laws_taking_effect_jan_1">considers economic hardship, technological limitations, or other exceptional circumstances</a>.) Walmart did not indicate if or when it would schedule a new implementation date or whether it would adjust the policy. In a statement welcoming the decision, AMA President Patrice Harris, MD, emphasized the importance of physician involvement in policymaking, saying that the policy "was not developed in consultation with the nation's physicians, who support electronic prescribing of controlled substances, but want to see it implemented in a manner that supports—rather than disrupts—patient care." </p> </div>12/23/2019 12:00:00 AM1/1/0001 12:00:00 AM
 

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