| ama-webinar-protecting-patients-from-inappropriate-scope-of-practice-expansions | AMA Webinar: Protecting Patients from Inappropriate Scope of Practice Expansions | Advocacy | Shared_Content/News/Membership_Memo/2023/june-9/ama-webinar-protecting-patients-from-inappropriate-scope-of-practice-expansions | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/june/steth-warm-background-645x425.jpeg" class="pull-right" alt="stethoscope laying on a cloth" /></div>
<h5>June 9, 2023</h5>
<h2>AMA Webinar: Protecting Patients from Inappropriate Scope of Practice Expansions</h2>
<p>Patients deserve care led by physicians-the most highly educated, trained, and skilled health care professionals. Through research, advocacy, and education, organized medicine vigorously defends the practice of medicine against scope of practice expansions that threaten patient safety. In this new on-demand webinar, you'll learn more about the importance of these issues, with presenters from the American Medical Association, the Medical Association of Georgia, and our own Sean Graham, WSMA's director of government affairs. Included in the discussion are ways physician advocates can get involved. <a href="https://www.ama-assn.org/about/events/ama-advocacy-insights-webinar-series-protecting-patients-inappropriate-scope-practice">Access the webinar and transcript from the AMA website</a>.</p>
</div> | 6/8/2023 2:43:03 PM | 6/9/2023 12:00:00 AM |
| first-two-episodes-of-better-prescribing-better-treatment-podcast-now-available | First Two Episodes of Better Prescribing, Better Treatment Podcast Now Available | Advocacy | Shared_Content/News/Membership_Memo/2023/june-9/first-two-episodes-of-better-prescribing-better-treatment-podcast-now-available | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/june/wsma-bpbt-seafoamevergreen-logo-645x425px.png" class="pull-right" alt="Better Prescribing, Better Treatment logo" /></div>
<h5>June 9, 2023</h5>
<h2>First Two Episodes of Better Prescribing, Better Treatment Podcast Now Available</h2>
<p>This week, the WSMA is launching a 14-episode podcast featuring conversations with experts on an array of topics about how we can reduce the dependence on opioids for pain management where appropriate, help those suffering with chronic conditions safely, and help those with addiction. A sole production of the WSMA and hosted by Nathan Schlicher, MD, JD, the podcast is available at no cost to all physicians, physician assistants, and health professionals, and supports the goals of the <a href="[@]wsma/resources/opioids/better_prescribing_better_treatment/wsma/resources/opioids/better-prescribing-better-treatment.aspx?hkey=b6fb0ec0-8bc2-4e53-bf4c-9f148599cbeb">Better Prescribing, Better Treatment safe-prescribing program</a>.</p>
<h3>About the podcast</h3>
<p>Through the course of the series, the WSMA Better Prescribing, Better Treatment Podcast will address the gaps in practice that exist between the current state of prescribing and the best practices surrounding opioid and controlled substance prescriptions. The risks of both short- and long-term administration of opioids in combination with and separately from sedative medications impose risks that cross specialties and systems. </p>
<p>Each podcast episode is available to all physicians and health professionals either as audio or audio and video. Episodes will be posted on the <a href="[@]wsma/resources/opioids/better-prescribing-better-treatment-podcast/wsma/resources/opioids/better-prescribing-better-treatment-podcast.aspx?hkey=5d4ff39d-6d34-45da-a94f-d95e682b2863">WSMA Better Prescribing, Better Treatment Podcast webpage</a> approximately every two weeks through the summer months, with the first episode now available. Creation of the podcast is made possible through funding from the federal Bureau of Justice Assistance and the Washington State Department of Health.</p>
<h3>About the host</h3>
<p>Nathan Schlicher, MD, JD, MBA, FACEP, is an emergency room physician with TeamHealth Northwest and St. Joseph Medical Center and is a past president of the WSMA. Dr. Schlicher is the physician lead for the Better Prescribing, Better Treatment safe-prescribing program.</p>
<h3>About the first episode: The Future of the Better Prescribing, Better Treatment Program at the WSMA</h3>
<p>In this podcast, Dr. Schlicher is joined by WSMA Program Manager Monica Salgaonkar, MHA, CPHQ, and WSMA Director of IT Troy Brown to discuss the new areas of development in the Better Prescribing, Better Treatment program at the WSMA.</p>
<p>Learning objectives:</p>
<ul>
<li>Recall the history and background of Better Prescribing, Better Treatment.</li>
<li>Describe the areas of expansion of Better Prescribing, Better Treatment.</li>
<li>Using data components, determine how the data may be used to drive improvement.</li>
<li>Get more involved in Better Prescribing, Better Treatment and know who to contact for questions or coaching.</li>
</ul>
<p>This activity is approved for <em>AMA PRA Category 1 Credit</em><sup>TM</sup>. <a href="[@]wsma/resources/opioids/better-prescribing-better-treatment-podcast.aspx">Access the podcast from the WSMA website</a>.</p>
<h3>About the second episode: The History of Opioid Prescribing Legislation</h3>
<p>In this podcast, Dr. Schlicher sits down with WSMA Policy Director Jeb Shepard to discuss the history of opioid prescribing in the state, the origins of BPBT, and its overall impact on prescribing.</p>
<p>Learning objectives</p>
<ul>
<li>Summarize the history and background of opioid prescribing legislation over the years.</li>
<li>List the stakeholders involved in addressing the opioid use public health crisis in Washington state.</li>
<li>Understand the effects of HB 1427 and SB 5380 on opioid prescribing in Washington state and have strategies to comply with them.</li>
<li>Get engaged in Olympia and testify on rules and regulation of important medical issues.</li>
</ul>
<p>This activity is approved for <em>AMA PRA Category 1 Credit</em><sup>TM</sup>. <a href="[@]wsma/resources/opioids/better-prescribing-better-treatment-podcast.aspx">Access the podcast from the WSMA website</a>.</p>
</div> | 6/7/2023 2:43:18 PM | 6/9/2023 12:00:00 AM |
| wsma-2023-interim-policy-agenda-takes-shape | WSMA 2023 Interim Policy Agenda Takes Shape | Advocacy | Shared_Content/News/Membership_Memo/2023/june-9/wsma-2023-interim-policy-agenda-takes-shape | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/june/ls-2023-02-005-645x425px.jpeg" class="pull-right" alt="Washington state capitol building" /></div>
<h5>June 9, 2023</h5>
<h2>WSMA 2023 Interim Policy Agenda Takes Shape</h2>
<p>While the Washington state legislative session has concluded, rulemaking season is just ramping up, along with new opportunities for direct advocacy for physicians and physician assistants.</p>
<p>Bills that are signed into law, as well as executive orders, often require <a href="https://wsma.org/wsma/advocacy/legislative_regulatory/understanding-the-regulatory-process.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">public rulemaking for implementation</a>. State agencies, boards, commissions, and the federal government all use rulemaking to decide the finer details of policies-details that may ultimately decide how the new law or order impacts physicians, physician assistants, and practices.</p>
<p>The WSMA's policy department staff monitors and engages on rules impacting the house of medicine. During this year's rulemaking season, the WSMA will seek to implement our <a href="[@]WSMA/About/Policies/Whats_Our_Policy/Policy_Index.aspx">policy goals</a> through advocacy on a number of rulemakings at both the state and federal levels. These include:</p>
<ul>
<li>Improving patient safety by requiring accessible labeling for prescription medication.</li>
<li>Civil and criminal protection for reproductive health care professionals.</li>
<li>Critical flexibilities for medical assistants entering and reentering the workforce.</li>
<li>A diaper benefit for families receiving temporary assistance.</li>
<li>Improving interoperability and prior authorization process at the Centers for Medicare and Medicaid Services.</li>
<li>Health equity continuing medical education for physicians and physician assistants.</li>
<li>Telemedicine prescribing flexibilities for buprenorphine and other controlled substances.</li>
<li>Scope of practice proposals for licensed midwives, dentists, naturopaths, and medical assistants.</li>
</ul>
<p>While not exhaustive of all the rulemakings on which WSMA's policy team engages, <a href="[@]wsma/advocacy/legislative___regulatory/regulatory-priorities/wsma/advocacy/legislative_regulatory/regulatory-priorities.aspx?hkey=562242c2-5e6b-4b10-887d-7b7efce4645c">a list of our top regulatory priorities is available on the WSMA website</a>.</p>
<p>The WSMA will keep you apprised of opportunities to comment on our top regulatory priorities. If you have thoughts on our advocacy efforts or feedback on any of our regulatory engagement, please contact <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
</div> | 6/7/2023 2:43:07 PM | 6/9/2023 12:00:00 AM |
| cigna-delays-implementation-of-modifier-25-policy | Cigna Delays Implementation of Modifier 25 Policy | Advocacy | Shared_Content/News/Membership_Memo/2023/may-26/cigna-delays-implementation-of-modifier-25-policy | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/billing-invoice-645x425.jpeg" class="pull-right" alt="Billing invoice" /></div>
<h5>May 26, 2023</h5>
<h2>Cigna Delays Implementation of Modifier 25 Policy</h2>
<p>The Cigna Group, one of the country's largest health insurers, has announced that it is delaying implementation of a concerning <a href="https://static.cigna.com/assets/chcp/secure/pdf/resourceLibrary/clinReimPolsModifiers/Notifications/Modifier_25_Significant_Separately_Identifiable_Evaluation_and_Management.pdf" target="_blank" rel="noreferrer">policy</a> that would have required the submission of medical records with all evaluation and management claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed. The policy, that was due to go into effect on May 25, would have added significant, unnecessary administrative burden and compliance costs to physician practices, disincentivized physicians from providing unscheduled services, and created duplicate requests.</p>
<p>In addition to the WSMA executive committee meeting with Cigna's market medical executive for the Pacific Northwest, the WSMA signed onto <a href="https://wsma.informz.net/WSMA/data/images/AMA-Cigna-modifier-25-signon-040323.pdf" target="_blank" rel="noreferrer">an American Medical Association letter</a> urging Cigna to rescind the policy. We also submitted <a href="https://wsma.informz.net/WSMA/data/images/WSMA-Cigna-Letter-April-2023.pdf" target="_blank" rel="noreferrer">our own letter</a> to Cigna outlining the negative impact the policy will have on Washington state physicians if it is enacted as proposed.</p>
<p>Cigna is currently reevaluating this reimbursement policy update. The WSMA has urged Cigna to work collaboratively with the physician community to ensure any future policy under consideration is not administratively burdensome and is focused on education to ensure modifier 25 is being billed appropriately.</p>
</div> | 5/25/2023 3:53:56 PM | 5/26/2023 12:00:00 AM |
| house-of-delegates-resolutions-due-by-aug-4-for-inclusion-in-delegate-handbook | House of Delegates Resolutions Due by Aug. 4 for Inclusion in Delegate Handbook | Advocacy | Shared_Content/News/Membership_Memo/2023/may-26/house-of-delegates-resolutions-due-by-aug-4-for-inclusion-in-delegate-handbook | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/venticinque-221001-9210-645x425px.jpeg" class="pull-right" alt="WSMA House of Delegates speaker" /></div>
<h5>May 26, 2023</h5>
<h2>House of Delegates Resolutions Due by Aug. 4 for Inclusion in Delegate Handbook</h2>
<p>Resolutions are one of the key drivers of legislative and regulatory policy for the WSMA. The following guidance and key dates will help you succeed in creating and submitting your resolutions for consideration by the WSMA House of Delegates. And don't forget to mark your calendars: The 2023 Annual Meeting of the WSMA House of Delegates will take place Sept. 23-24 at the Westin Bellevue. This yearly conference is WSMA's primary policymaking event, where resolutions will be debated by WSMA members and considered for adoption by the association's House of Delegates.</p>
<h3>First steps</h3>
<p>If you have an idea for a policy that you'd like the House of Delegates to adopt, take a moment and consult the <a href="[@]wsma/about/policies/whats_our_policy/policy_index.aspx">WSMA Policy Compendium</a> to make sure the subject isn't already addressed in current WSMA policy. Alternatively, you may seek to modify existing WSMA policy. If you'd like to advance a change in the governance and regulation of the WSMA, review the <a href="javascript://[Uploaded files/News and Publications/newsletters/2023/wsma-bylaws-2022.pdf]">WSMA Bylaws</a>&nbsp;for reference.</p>
<h3>Check for health equity impact</h3>
<p>Policies may disparately impact communities, particularly various disadvantaged or marginalized communities. Before submitting your policy proposal in the form of a resolution, use this <a href="javascript://[Uploaded files/News and Publications/newsletters/2023/health-equity-polices-evaluation-tool.docx]">equity evaluation tool</a>&nbsp;to consistently assess the diversity, equity, and inclusion impacts of potential new WSMA policy. The <a href="http://www.wsma.org/wsma/about/who_we_are/dei-committee.aspx">WSMA DEI Committee</a> will be using the tool as it evaluates resolutions before the House and will add a health equity note as appropriate.</p>
<h3>Formatting and submitting your resolution</h3>
<p>After you've completed the preceding steps, you must then <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#howto">organize your policy proposal as a resolution</a>, the required format for consideration by the House of Delegates. Resolutions must be sponsored by at least two members of the House of Delegates (which includes delegates, alternate delegates, and members of the board of trustees), and must be submitted in writing by one of those sponsors. 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 find sponsors. Contact us at <a href="mailto:hod@wsma.org">hod@wsma.org</a> or 206.441.9762 for assistance.</p>
<h3>Resolution deadlines</h3>
<p>Resolutions must be submitted to the WSMA for review at <a href="mailto:hod@wsma.org">hod@wsma.org</a> by the following deadlines:</p>
<ul>
<li>Aug. 4 - Deadline for resolutions and reports to be submitted for publication in delegate handbook.</li>
<li>Aug. 24 - Final deadline for resolutions and reports. Resolutions received after this date must have the consent of two-thirds of the House at the opening session to be considered.</li>
<li>Aug. 24 - Delegate handbook will be available for download.</li>
<li>Sept. 23-24 - The 2023 WSMA Annual Meeting.</li>
</ul>
<p>After submission, WSMA staff will review the resolution for any legal or legislative concerns and will work with you to establish a fiscal note (the cost, if any, to implement the resolution if adopted).</p>
<h3>More information</h3>
<ul>
<li><a href="[@]wsma/events/annual_meeting/wsma/events/annual_meeting/annual_meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">WSMA Annual Meeting</a></li>
<li><a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx">How to Write a Resolution</a></li>
<li><a href="[@]wsma/about/policies/whats_our_policy/policy_index.aspx">What's Our Policy?</a> - <em>make sure your resolution isn't already a policy!</em></li>
</ul>
<p>Should you have additional questions on the meeting or resolution drafting, contact the WSMA policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.</p>
</div> | 5/25/2023 3:54:55 PM | 5/26/2023 12:00:00 AM |
| 2023-wsma-annual-meeting-resolution-template-guidance-now-available | 2023 WSMA Annual Meeting: Resolution Template, Guidance Now Available | Advocacy | Shared_Content/News/Membership_Memo/2023/may-12/2023-wsma-annual-meeting-resolution-template-guidance-now-available | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/resolutions-print-2-cropped-645x425px.png" class="pull-right" alt="WSMA resolutions on paper" /></div>
<h5>May 12, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>
2023 WSMA Annual Meeting: Resolution Template, Guidance Now Available
</h2>
<p>
Mark your calendars: The 2023 Annual Meeting of the WSMA House of Delegates will take place Sept. 23-24 at the Westin Bellevue. This yearly conference is WSMA's primary policymaking event, where resolutions will be introduced, debated, and considered for adoption by the association's House of Delegates.
</p>
<p>
Resolutions are one of the key drivers of legislative and regulatory policies for the WSMA, often serving as responses to current issues facing the house of medicine and steering WSMA's advocacy. With summer around the corner, now is a good time to turn your ideas into resolutions.
</p>
<p>
Resolutions must be submitted in the <a href="javascript://[Uploaded files/News and Publications/newsletters/2023/wsma-draft-resolution-template.docx]">format outlined in this template</a>. If you are new to resolution writing, we encourage you to review WSMA's <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">resolution guidelines</a>, which walk you through the process and offer tips and tricks for success along the way.
</p>
<h3>
Important meeting deadlines
</h3>
<ul>
<li>Aug. 4 - Deadline for resolutions and reports to be submitted for publication in delegate handbook.</li>
<li>Aug. 24 - Final deadline for resolutions and reports. Resolutions received after this date must have the consent of two-thirds of the House at the opening session to be considered.</li>
<li>Aug. 24 - Delegate handbook will be available for download.</li>
<li>Sept. 1 - Deadline to make room reservations at The Westin Bellevue.</li>
<li>Sept. 23-24 - The 2023 WSMA Annual Meeting.</li>
</ul>
<h3>
More information
</h3>
<ul>
<li><a href="[@]wsma/events/annual_meeting/wsma/events/annual_meeting/annual_meeting.aspx?hkey=fea49254-3815-4dc9-8710-53ff2e3a100f">WSMA Annual Meeting</a></li>
<li><a href="[@]WSMA/Events/Annual_Meeting/How_to_Write_a_Resolution/How_to_Write_a_Resolution.aspx">How to Write a Resolution</a></li>
<li><a href="[@]wsma/about/policies/whats_our_policy/policy_index.aspx">What's Our Policy?</a> - M<em>ake sure your resolution isn't already a policy!</em></li>
</ul>
<p>
Should you have additional questions on the meeting or resolution drafting, contact the WSMA policy department at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.
</p>
</div> | 5/11/2023 3:05:42 PM | 5/12/2023 12:00:00 AM |
| gov-inslee-signs-wsma-prior-authorization-modernization-bill | Gov. Inslee Signs WSMA Prior Authorization Modernization Bill | Advocacy | Shared_Content/News/Membership_Memo/2023/may-12/gov-inslee-signs-wsma-prior-authorization-modernization-bill | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/hb1357-bill-signing-2023-645x425px.jpeg" class="pull-right" alt="Governor signing bill" /></div>
<h5>May 12, 2023</h5>
<h2>
Gov. Inslee Signs WSMA Prior Authorization Modernization Bill
</h2>
<p>
Gov. Jay Inslee this week signed <a href="http://wsma.informz.net/z/cjUucD9taT0xMTA2MzQ4MyZwPTEmdT0xMDc4MTA4MzYwJmxpPTEwMTg2OTgxMA/index.html">House Bill 1357</a>, WSMA prior authorization legislation, into law. The bill signing is the result of a years-long effort by the WSMA on behalf of its physician and physician assistant members to reduce the administrative burdens and care delays associated with the insurance carrier practice.
</p>
<p>
The reforms contained in HB 1357, which passed the House and Senate unanimously during the 2023 state legislative session, will help establish Washington state as a leader in prior authorization reform. The bill expedites turnaround times for determinations and mandates the implementation of electronic prior authorization processes that integrate into electronic health records, which has been proven to reduce administrative burden. Importantly, the bill applies as broadly as possible on the state level, covering all state-regulated health plans, both for health care services and prescription drugs.
</p>
<p>
The new law will go into effect Jan. 1, 2024, and applies the following timelines for prior authorization determinations:
</p>
<ul>
<li>For prior authorizations submitted through electronic processes such as web portals:</li>
<ul>
<li>One calendar day for expedited requests</li>
<li>Three calendar days for standard requests (excluding holidays)</li>
</ul>
<li>For prior authorizations submitted through non-electronic processes such as faxes:</li>
<ul>
<li>Two calendar days for expedited requests</li>
<li>Five calendar days for standard requests</li>
</ul>
</ul>
<p>
During the legislative process, WSMA's government affairs team worked with lawmakers to amend HB 1357 to build on <a href="https://www.cms.gov/regulations-and-guidance/guidance/interoperability/index">federal prior authorization rulemaking</a> initiated by the Centers for Medicare and Medicaid Services on the eve of the state legislative session. The WSMA will be actively engaged in the implementation of HB 1357, as well as in the associated federal rulemaking from CMS.
</p>
<p>
<em>Pictured (from left to right): Rep. Marcus Riccelli (D-Spokane); Matt Helder, government relations director for the American Cancer Society; Gov. Jay Inslee; Rep. Tarra Simmons (D-Bremerton); Sean Graham, director of government affairs for the WSMA; Teresa Girolami, MD, WSMA Board of Trustees.</em>
</p>
</div> | 5/11/2023 2:57:06 PM | 5/12/2023 12:00:00 AM |
| physician-and-pa-advocacy-after-the-state-legislative-session | Physician and PA Advocacy After the State Legislative Session | Advocacy | Shared_Content/News/Membership_Memo/2023/may-12/physician-and-pa-advocacy-after-the-state-legislative-session | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/spring-wa-capitol-645x425px.jpeg" class="pull-right" alt="Washington capitol building in the spring" /></div>
<h5>May 12, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>
Physician and PA Advocacy After the State Legislative Session
</h2>
<p>
The 2023 state legislative session has come to an end. While <a href="https://www.governor.wa.gov/news-media/inslee-announces-special-session-date-take-drug-possession-law">Gov. Inslee has announced</a> that he will convene a special legislative session on May 16 to address drug decriminalization and the state Supreme Court's 2021 decision in State v. Blake still looms, the activities of the Legislature, as well as those of WSMA's team in Olympia, will largely transition to focusing on the legislative "interim," the period between legislative sessions.
</p>
<p>
State agency rulemaking activity generally increases during the legislative interim, and we will be keeping you apprised of that work as it progresses in our member communications, as well as <a href="[@]wsma/advocacy/legislative___regulatory/regulatory-priorities/wsma/advocacy/legislative_regulatory/regulatory-priorities.aspx?hkey=562242c2-5e6b-4b10-887d-7b7efce4645c">on the WSMA website</a>.
</p>
<p>
For physicians and physician assistants interested in furthering connections with legislators, the period between sessions is the most effective time to build relationships. You can find more information on our <a href="[@]wsma/advocacy/physician_advocacy/physician-advocacy.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">website</a> on steps to schedule a meeting with your state legislators, or you can contact WSMA Government Affairs and Policy Coordinator Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a> and we'll help facilitate a connection.
</p>
<p>
WSMA members can expect to receive the 2023 Legislative Report by mail in the coming weeks. The report contains a summary of policy outcomes from the state legislative session and how they can impact the practice of medicine. Members may also view an <a href="[@]wsma/advocacy/legislative___regulatory/Legislative%20Activities/wsma/advocacy/legislative_regulatory/legislative-activities.aspx?hkey=231ee068-da1d-49ae-b5bc-01a857b21a9b">on-demand webinar hosted by Sean Graham and Alex Wehinger of WSMA's government affairs team</a>, which provides a look at the outcomes of the 2023 legislative session and gives an insider's perspective on the broader health care policy landscape.
</p>
</div> | 5/8/2023 10:28:05 AM | 5/12/2023 12:00:00 AM |
| telemedicine-prescribing-flexibilities-extended-for-six-months-after-public-pushback | Telemedicine Prescribing Flexibilities Extended for Six Months After Public Pushback | Advocacy | Shared_Content/News/Membership_Memo/2023/may-12/telemedicine-prescribing-flexibilities-extended-for-six-months-after-public-pushback | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/telemedicine-illustration-645x425px.png" class="pull-right" alt="telemedicine illustration" /></div>
<h5>May 12, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>
Telemedicine Prescribing Flexibilities Extended for Six Months After Public Pushback
</h2>
<p>
Despite the end this week of the federal public health emergency and associated flexibilities, physicians, physician assistants, and other licensed prescribers may continue to prescribe controlled substances virtually as the federal government gives itself more time to consider rulemaking related to telehealth prescribing.
</p>
<p>
After <a href="https://www.dea.gov/documents/2023/2023-05/2023-05-03/statement-dea-administrator-anne-milgram-covid-19-telemedicine">announcing last week</a> that the federal agency had "received a record 38,000 comments on its proposed telemedicine rules," the U.S. Drug Enforcement Administration, together with the Substance Abuse and Mental Health Services Administration, on Tuesday issued a temporary rule extending telemedicine flexibilities adopted during the COVID-19 public health emergency for six months, or through Nov. 11, 2023. For any practitioner-patient telemedicine relationships that have been or will be established up to Nov. 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the public health emergency will be extended for one year, or through Nov. 11, 2024.
</p>
<p>
As the WSMA has <a href="[@]Shared_Content/News/Membership_Memo/2023/march-24/dea-proposes-extending-telemedicine-flexibilities-for-prescribing-controlled-substances.aspx?_zs=A3aFd1&amp;_zl=ToAt8">previously</a>&nbsp;<a href="[@]Shared_Content/News/Membership_Memo/2023/april-14/wsma-provides-feedback-on-dea-rulemaking-extending-telemedicine-flexibilities?_zs=A3aFd1&amp;_zl=5fJv8">reported</a>, the DEA has proposed rulemaking to expand telemedicine flexibilities adopted during the COVID-19 public health emergency. The <a href="http://www.wsma.org/Shared_Content/News/Membership_Memo/2023/march-24/dea-proposes-extending-telemedicine-flexibilities-for-prescribing-controlled-substances.aspx?_zs=A3aFd1&amp;_zl=ToAt8">proposed rules</a>, intended to provide safeguards for a narrow subset of telemedicine and audio-only consultations that result in the prescribing of a controlled substance, including buprenorphine for treatment of opioid use disorder, have been widely criticized by the medical community for their restrictions on access to needed treatments. The WSMA, in collaboration with the American Medical Association, submitted <a href="[@]Shared_Content/News/Membership_Memo/2023/april-14/wsma-provides-feedback-on-dea-rulemaking-extending-telemedicine-flexibilities?_zs=A3aFd1&amp;_zl=5fJv8">comment letters</a>&nbsp;outlining various concerns with the rules and requesting that the DEA amend these elements of the proposed rules to avoid a lapse in patient care, promote patient safety, and avoid nonoptimal treatment options.
</p>
<p>
The WSMA will keep you apprised of the progress of these rules and will review final language to determine its impact on physician practices. Reach out to WSMA Policy Analyst Shelby Wiedmann at <a href="mailto:shelby@wsma.org">shelby@wsma.org</a> with any questions or concerns.
</p>
</div> | 5/11/2023 3:01:43 PM | 5/12/2023 12:00:00 AM |
| the-covid-19-public-health-emergency-ends-what-you-need-to-know | The COVID-19 Public Health Emergency Ends: What You Need to Know | Advocacy | Shared_Content/News/Membership_Memo/2023/may-12/the-covid-19-public-health-emergency-ends-what-you-need-to-know | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/doctor-patient-masks-645x425px.jpeg" class="pull-right" alt="Doctor and patient in masks" /></div>
<h5>May 12, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>
The COVID-19 Public Health Emergency Ends: What You Need to Know
</h2>
<p>
The public health emergency issued in response to the COVID-19 pandemic formally ended this Thursday, May 11. Many flexibilities at both the state and federal levels will be discontinued, while others will stay in place for a bit longer. If your practice has utilized these pandemic flexibilities, here is what you need to know.
</p>
<h3>
HHS COVID-19 public health emergency transition roadmap
</h3>
<p>
For an overview of flexibilities that will and will not be impacted at the end of the federal public health emergency on May 11, review the U.S. Department of Health and Human Services <a href="https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html">COVID-19 Public Health Emergency Transition Roadmap</a>.
</p>
<h3>
Telehealth platforms must be HIPAA-compliant by Aug. 9
</h3>
<p>
During the public health emergency, the HHS Office for Civil Rights exercised enforcement discretion allowing physicians, physician assistants, and other licensed health professionals to use telehealth in good faith, even if their platforms or software were not compliant with the Health Insurance Portability and Accountability Act. The federal government has granted a 90-day transition period - until Aug. 9, 2023 - for practices to come into compliance with HIPAA requirements as they pertain to telehealth platforms.
</p>
<p>
During this <a href="https://www.hhs.gov/about/news/2023/04/11/hhs-office-for-civil-rights-announces-expiration-covid-19-public-health-emergency-hipaa-notifications-enforcement-discretion.html">90-day transition period</a>, the Office for Civil Rights will continue to exercise its enforcement discretion and will not penalize covered health care professionals for noncompliance with the <a href="https://www.hhs.gov/about/news/2023/04/11/hhs-office-for-civil-rights-announces-expiration-covid-19-public-health-emergency-hipaa-notifications-enforcement-discretion.html">HIPAA rules</a> that occurs in the course of the good faith provision of telehealth services. The agency has also published clarifying <a href="https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/hipaa-audio-telehealth/index.html">guidance</a> on when and how HIPAA applies to telehealth.
</p>
<h3>
State-regulated health insurance plans must continue to pay at parity for telemedicine services
</h3>
<p>
WSMA-supported <a href="https://app.leg.wa.gov/billsummary?Year=2019&amp;BillNumber=5385">legislation</a> requiring health insurance plans regulated by the Washington State Office of the Insurance Commissioner to pay at parity for service delivered via telemedicine has taken effect permanently. This requirement will not end with the public health emergency unwinding. The law does not apply to plans not regulated by the OIC, including certain self-insured and ERISA plans.
</p>
<p>
WSMA-supported <a href="https://app.leg.wa.gov/billsummary?BillNumber=1196&amp;Year=2021&amp;Initiative=false">legislation</a> requiring insurers to provide the same coverage and reimbursement for audio-only telemedicine services as they would for care delivered in-person or via audio-visual telemedicine will also remain in effect. The law does not apply to plans not regulated by the OIC, including self-insured and ERISA plans. Effective Jan. 1, 2023, an <a href="https://lawfilesext.leg.wa.gov/biennium/2021-22/Pdf/Bills/Session%20Laws/House/1821-S.SL.pdf?q=20220609145159">"established relationship"</a> is required for audio-only telemedicine services:
</p>
<ul>
<li><a href="https://www.wsha.org/articles/audio-only-telemedicine-law-changes-hospital-facility-fees-prohibited-and-established-relationship-requirement-modified/">For behavioral health services</a>, including substance use disorder treatment, a physician or PA can establish a relationship with the patient with one in-person visit or audio-visual telemedicine visit within the past three years. This change is permanent.</li>
<li><a href="https://www.wsha.org/articles/audio-only-telemedicine-law-changes-hospital-facility-fees-prohibited-and-established-relationship-requirement-modified/">For all other health care services</a>, for calendar year 2023, a physician or PA can establish a relationship with the patient with one in-person visit or one audio-visual telemedicine visit within the past two years. For calendar year 2024 and beyond, a physician or PA must have at least one in-person visit with the patient within the past two years to establish a relationship.</li>
</ul>
<h3>
Additional telemedicine considerations: Medicare and Medicaid
</h3>
<p>
Apple Health (Medicaid) will no longer reimburse for services provided over email or text. The HHS Office for Civil Rights announced that the Notification of Enforcement Discretion for Telehealth Remote Communications during the COVID-19 public health emergency will end on May 11. Effective for dates of service on and after May 11, the Washington State Health Care Authority will no longer cover emailing or texting as an option for providing services via telemedicine. See <a href="https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDAsInVyaSI6ImJwMjpjbGljayIsInVybCI6Imh0dHBzOi8vd3d3LmhjYS53YS5nb3Yvbm9kZS8zMDEiLCJidWxsZXRpbl9pZCI6IjIwMjMwNDIxLjc1NTY5NTQxIn0.Ic9j7fnRjwtVv67euOJV83a_q4aNSlXMOOga5EsvRFk/s/704563189/br/161173941441-l">HCA's billing guides and fee schedules</a>&nbsp;under Telehealth for more information; email questions to <a href="mailto:HCAAppleHealthClinicalPolicy@hca.wa.gov">HCAAppleHealthClinicalPolicy@hca.wa.gov</a>.
</p>
<p>
The Centers for Medicare and Medicaid Services is developing an FAQ resource to answer many questions associated with telemedicine billing and coding. WSMA staff will add this FAQ, along with other guidance related to the transition out of the public health emergency, on our <a href="[@]wsma/resources/covid-19_response/wsma/resources/COVID-19/covid-19_response.aspx?hkey=958ce791-54b8-4eba-892f-54924db26b60">COVID-19 professional resources webpage</a>.
</p>
<p>
In the meantime, you may review the below resources on telemedicine:
</p>
<ul>
<li><a href="https://www.cms.gov/coronavirus-waivers">Information on CMS waivers and flexibilities</a>&nbsp;- includes fact sheets providing information about which waivers and flexibilities have been terminated, have been made permanent, or will end at the conclusion of the public health emergency.</li>
<li>CMS hosted a forum on April 12 where policy staff addressed questions related to billing and coding. The transcript and recording will be posted to this webpage: <a href="https://www.cms.gov/outreach-and-education/outreach/opendoorforums/podcastandtranscripts">Physicians, Nurses, and Allied Health Professionals</a>.</li>
<li><a href="https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency/telehealth-policy-updates">HHS telehealth policy updates</a>&nbsp;- includes information on telemedicine for rural health, behavioral health, and extensions of telemedicine access options.</li>
</ul>
<h3>
DEA requirements for prescribing buprenorphine via telemedicine are changing
</h3>
<p>
During the federal public health emergency, the U.S. Drug Enforcement Administration waived the requirement that a physician or PA must have an established relationship with a patient prior to prescribing controlled substances to ensure patient continuity of care. In anticipation of the end of the public health emergency, the DEA has <a href="https://www.federalregister.gov/documents/2023/03/01/2023-04217/expansion-of-induction-of-buprenorphine-via-telemedicine-encounter">proposed rules</a> that would allow practitioners to prescribe a 30-day supply of non-narcotic controlled medications, including buprenorphine, via telemedicine or audio-only telemedicine encounters without an in-person medical evaluation. Prescribing controlled substances beyond the initial 30-day supply will only be authorized for practitioners who have conducted an in-person medical evaluation. After receiving extensive feedback from organized medicine on concerns with the proposed telemedicine rules, the DEA and the Substance Abuse and Mental Health Services Administration this week issued a temporary rule extending the pandemic telemedicine flexibilities for six months while the agencies continue to consider the rulemaking.
</p>
<h3>
Reimbursement for personal protective equipment ending
</h3>
<p>
In the spring of 2021, WSMA's <a href="https://app.leg.wa.gov/billsummary?BillNumber=5169&amp;Year=2021">first-in-the nation legislation</a> requiring state-regulated commercial insurance carriers to reimburse $6.57 per patient encounter for personal protective equipment through the federal public health emergency is set to expire on May 11.
</p>
<h3>
HCA, DSHS redetermining Medicaid client renewals
</h3>
<p>
The Health Care Authority and Department of Social and Health Services resumed normal operations on April 1, 2023, which means they have <a href="https://www.hca.wa.gov/about-hca/programs-and-initiatives/apple-health-medicaid/apple-health-and-public-health-emergency">begun the process of redetermining client renewals</a>. Termination of coverage for non-renewals will resume May 31, 2023. Most individuals on Apple Health can apply for or renew their coverage through WA Healthplanfinder. Additionally, WA Healthplanfinder will attempt to auto-renew individuals' coverage 60 days prior to the end of their renewal date.
</p>
<p>
If you see Apple Health clients in your practice, <a href="https://wsma.informz.net/WSMA/data/images/Attachments/Apple-Health-Renewals-2023.pdf" target="_blank" rel="noreferrer">consider posting this printable flyer</a>, which urges patients to ensure their contact information is up to date so they can be contacted about the Medicaid coverage renewal process. You may also direct your Apple Health clients to HCA's <a href="https://www.hca.wa.gov/free-or-low-cost-health-care/i-need-medical-dental-or-vision-care/update-my-income-or-address-report-change">Report a Change</a> webpage where they can review and update their contact information.
</p>
<p>
With questions on these or any other items related to the end of the public health emergency, contact the WSMA policy team at <a href="mailto:policy@wsma.org">policy@wsma.org</a>.
</p>
</div> | 5/8/2023 10:27:44 AM | 5/12/2023 12:00:00 AM |
| wsma-urges-washingtons-congressional-delegation-to-support-medicare-payment-reform | WSMA Urges Washington's Congressional Delegation to Support Medicare Payment Reform | Advocacy | Shared_Content/News/Membership_Memo/2023/may-12/wsma-urges-washingtons-congressional-delegation-to-support-medicare-payment-reform | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/may/medicare-barcode-645px.jpeg" class="pull-right" alt="Medicare barcode" /></div>
<h5>May 12, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>
WSMA Urges Washington's Congressional Delegation to Support Medicare Payment Reform
</h2>
<p>
Organized medicine is united in support of a long-term Medicare payment solution that centers on annual inflationary updates. Legislation currently before Congress, H.R. 2474, is such a solution. If passed by Congress, the legislation would advance the ongoing need to provide financial stability to physician practices and help preserve access to care for Medicare beneficiaries.
</p>
<p>
H.R. 2474 would provide an annual inflation update equal to the Medicare Economic Index for Medicare physician payments. As reported in the last Membership Memo, the WSMA signed on to an <a href="[@]Shared_Content/News/Membership_Memo/2023/april-28/action-alert-urge-congressional-support-of-medicare-annual-inflation-update.aspx?_zs=A3aFd1&amp;_zl=OIqw8">AMA comment letter commending the introduction of H.R. 2474</a>. Since then, the WSMA has contacted Washington's congressional delegation urging their support. In our <a href="javascript://[Uploaded files/News and Publications/newsletters/2023/wsma-comment-support-hr-2474-04282023-cantwell.pdf]">comment letter</a>, the WSMA shared that physicians treating Medicare patients experienced a drop in payments by 22% (adjusted for inflation) between 2001 and 2021 and as such, have been providing care under increasingly thin operating margins, further exacerbated by the COVID-19 pandemic and inflation. By providing an annual inflation update to Medicare physician payments, H.R. 2474 would ease financial strain felt by physicians and ensure the delivery of high-quality health care among Washington's Medicare patients.
</p>
<p>
As a result of WSMA outreach, at least one congressional office will be co-sponsoring H.R. 2474. If you haven't yet done so, take a moment to <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fCampaigns%2f103669%2fRespond">contact your legislators</a> and urge them to help fix the flawed Medicare physician payment system by supporting H.R. 2474.
</p>
</div> | 5/8/2023 10:27:54 AM | 5/12/2023 12:00:00 AM |
| 2023-legislative-session-adjourns | 2023 Legislative Session Adjourns | Advocacy | Shared_Content/News/Latest_News/2023/2023-legislative-session-adjourns | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/821841811"><img src="/images/Newsletters/latest-news/2023/may/legislative-update-final.png" alt="WSMA Legislative Update Final Edition for 2023 logo" /></a></div>
<h5>May 1, 2023 </h5>
<h2>2023 Legislative Session Adjourns</h2>
<p>
With the 2023 legislative session now adjourned, WSMA's Associate Director of Legislative and Political Affairs Alex Wehinger gives an update on how and when bills passed by the Legislature are signed by the governor. <a href="https://vimeo.com/821841811">Watch the video</a>.
</p>
</div> | 5/1/2023 10:59:14 AM | 5/1/2023 12:00:00 AM |
| action-alert-urge-congressional-support-of-medicare-annual-inflation-update | Action Alert: Urge Congressional Support of Medicare Annual Inflation Update | Advocacy | Shared_Content/News/Membership_Memo/2023/april-28/action-alert-urge-congressional-support-of-medicare-annual-inflation-update | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/april/medicare-barcode-645px.jpeg" class="pull-right" alt="Medicare bardode" /></div>
<h5>April 28, 2023</h5>
<h2>Action Alert: Urge Congressional Support of Medicare Annual Inflation Update</h2>
<p>The WSMA joined the American Medical Association and nearly 120 national physician specialty societies and state medical associations in <a href="https://searchlf.ama-assn.org/letter/documentDownload?uri=%2Funstructured%2Fbinary%2Fletter%2FLETTERS%2Fltrf.zip%2FHR-2474-AMA-Federation-Letter-of-Support-4-19-23.pdf" target="_blank" rel="noreferrer">a letter</a> commending Reps. Raul Ruiz, MD (D-CA), Larry Bucshon, MD (R-IN), Ami Bera, MD (D-CA), and Mariannette Miller-Meeks, MD (R-IA), for introducing H.R. 2474, bipartisan legislation that would tie annual Medicare physician fee schedule updates to the Medicare Economic Index. If passed by Congress, the legislation would help provide financial stability to physician practices and preserve access to care for Medicare beneficiaries.</p>
<p>Unlike virtually all other health professionals participating in the Medicare program, physician services do not receive an annual inflationary update. Providing an annual inflation update <a href="[@]Shared_Content/News/Membership_Memo/2023/march-24/medpac-recommends-tying-physician-payment-update-to-inflation">equal to the MEI for Medicare physician payments is essential</a> to enabling physician practices to better absorb payment distributions triggered by budget neutrality rules, performance adjustments, and periods of high inflation. It will also help physicians invest in their practices and implement new strategies to provide high-value care.</p>
<h3>Contact your members of Congress</h3>
<p>Organized medicine is united in support of a long-term payment solution that centers on annual inflationary updates. To help this effort, take a moment to <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fCampaigns%2f103669%2fRespond">contact your legislators</a> and urge them to help fix the flawed Medicare physician payment system by supporting H.R. 2474.</p>
<p>The AMA provides the following charts, which may be used in conversations with members of Congress to let them know the Medicare physician payment system needs reform to become a more sustainable, value-based system that better meets the needs of patients and physicians:</p>
<ul>
<li><a href="https://www.ama-assn.org/system/files/medicare-provider-updates-chart-2023.pdf" target="_blank" rel="noreferrer">Medicare payment updates for 2023</a> </li>
<li><a href="https://www.ama-assn.org/system/files/medicare-updates-inflation-chart-cumulative.pdf" target="_blank" rel="noreferrer">Medicare updates compared to inflation (with comparison)</a> </li>
<li><a href="https://www.ama-assn.org/system/files/medicare-updates-inflation-chart.pdf" target="_blank" rel="noreferrer">Medicare updates compared to inflation (without comparison)</a> </li>
<li><a href="https://www.ama-assn.org/system/files/key-measures-medicare-economic-index-chart.pdf" target="_blank" rel="noreferrer">Key measures of practice expense in the Medicare Economic Index</a> </li>
<li><a href="https://www.ama-assn.org/system/files/medicare-spending-enrollee.pdf" target="_blank" rel="noreferrer">Medicare spending per enrollee</a> </li>
<li><a href="https://www.ama-assn.org/system/files/real-inflation-adjusted-spending-enrollee.pdf" target="_blank" rel="noreferrer">Real (inflation-adjusted) Medicare physician spending per enrollee</a> </li>
</ul>
</div> | 4/27/2023 2:31:53 PM | 4/28/2023 12:00:00 AM |
| mips-hardship-exception-due-to-covid-19-continues-in-2023 | MIPS Hardship Exception Due to COVID-19 Continues in 2023 | Advocacy | Shared_Content/News/Membership_Memo/2023/april-28/mips-hardship-exception-due-to-covid-19-continues-in-2023 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/april/stethoscope-numbers-645x425px.jpeg" class="pull-right" alt="stethoscope on a spreadsheet" /></div>
<h5>April 28, 2023</h5>
<h2>MIPS Hardship Exception Due to COVID-19 Continues in 2023</h2>
<p>In response to advocacy from the American Medical Association, the WSMA, and others in organized medicine, the Centers for Medicare and Medicaid Services will <a href="https://qpp.cms.gov/resources/covid19">continue</a> to allow physicians and group practices to apply for a MIPS Extreme and Uncontrollable Circumstances hardship exception to avoid up to a -9% MIPS penalty in 2025 based on 2023 performance. The exception will not be automatic, and interested physicians and groups must request reweighting of one or more MIPS performance categories due to the COVID-19 public health emergency. Requesting reweighting of all four MIPS performance categories will avoid a MIPS penalty in 2025. CMS expects to release the hardship exception application in spring 2023.</p>
<p>This is a big relief for physicians and their patients because CMS estimated in the final rule that up to one-third of MIPS-eligible clinicians would have received a penalty due to the increasingly stringent requirements to participate in MIPS in 2023. It is also likely that small, rural, and practices serving underserved populations would have been disproportionately impacted by thesepenalties.</p>
</div> | 4/27/2023 2:59:21 PM | 4/28/2023 12:00:00 AM |
| prior-authorization-reform-bill-among-successes-for-the-physician-community-as-2023-session- | Prior Authorization Reform Bill Among Successes for the Physician Community as 2023 Session | Advocacy | Shared_Content/News/Membership_Memo/2023/april-28/prior-authorization-reform-bill-among-successes-for-the-physician-community-as-2023-session- | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/april/2023-legislative-session-updates-645x425px.png" class="pull-right" alt="2023 Legislative Update logo" /></div>
<h5>April 28, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>Prior Authorization Reform Bill Among Successes for the Physician Community as 2023 Session Adjourns </h2>
<p>The 2023 legislative session adjourned "sine die" on Sunday, April 23, after legislators adopted a two-year state operating budget that takes effect July 1. The 105-day session saw numerous patient-focused policies passed of interest to physician and physician assistants, including WSMA's prior authorization standardization legislation and provisions addressing abortion access and gun violence, and a two-year spending plan adopted by legislators that includes substantial investments in health care workforce, behavioral health, abortion access, and public health.</p>
<p>The WSMA tracked and engaged on hundreds of bills during session, with health policy at the forefront of many of session's biggest conversations. Notable wins included:</p>
<h3>Prior authorization </h3>
<p>Reforming insurance carriers' prior authorization practices has regularly been cited by WSMA members as the paramount administrative challenge faced by physicians and practices. This session, priority legislation introduced by the WSMA was passed unanimously by both legislative chambers. <a href="https://urldefense.com/v3/__https:/app.leg.wa.gov/billsummary?BillNumber=1357&amp;Year=2023&amp;Initiative=false__;!!K-Hz7m0Vt54!nPeLTkE81nZg7kIhcc5Vk_D5Cvag8w62hQV2-KC4A2qhOZRYA8_WKfoCkOPWhyG-qj6tgMy_zQ$">House Bill 1357</a> will help ensure timely access to care by shortening turnaround times for decisions and mandating insurance carriers implement electronic prior authorization processes that integrate into electronic health record systems.</p>
<p>The passage of HB 1357 is a significant step in reducing the burdens posed by prior authorization and a major win for Washington's physician community. Thanks to the many physicians and physician assistants over the years who have helped inform WSMA's position and engaged in our advocacy on the issue.</p>
<h3>Abortion access </h3>
<p>Protecting access to abortion, reproductive health, and gender-affirming care services and protecting the patients and health care professionals seeking and providing those services was also at the top of WSMA's legislative agenda during the 2023 legislative session.</p>
<ul>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1340&amp;Year=2023&amp;Initiative=false">House Bill 1340</a> clarifies that providing reproductive health and gender-affirming care services consistent with Washington state standards of care, even in a state where such services are prohibited, does not constitute unprofessional conduct under Washington's Uniform Disciplinary Act.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1469&amp;Initiative=false&amp;Year=2023">House Bill 1469</a> establishes criminal and civil liability protections for patients and health care professionals receiving or delivering abortion services and gender-affirming care.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5242&amp;Initiative=false&amp;Year=2023">Senate Bill 5242</a> prohibits cost sharing (e.g., copays, deductibles) for abortion services.</li>
</ul>
<h3>Gun violence </h3>
<p>The WSMA successfully supported priority legislation recognizing and addressing the growing public health threat posed by gun violence.</p>
<ul>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1240&amp;Initiative=false&amp;Year=2023">House Bill 1240</a> prohibits the manufacture and sale of semiautomatic "assault weapons," including firearms such as the AR-15 and AK-47.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1143&amp;Initiative=false&amp;Year=2023">House Bill 1143</a> requires individuals to have recently completed a firearm safety training program and undergo a background check and 10-day waiting period to be eligible to purchase firearms.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=5078&amp;Initiative=false&amp;Year=2023">Senate Bill 5078</a> establishes a right of action against the firearm industry in circumstances where violence results from their conduct, such as advertising targeted at minors and promoting the illegal conversion of firearms. </li>
</ul>
<h3>Scope of practice … and an action alert</h3>
<p>The WSMA defeated all but one of the scope expansion proposals we opposed. The exception was <a href="https://app.leg.wa.gov/billsummary?BillNumber=5389&amp;Year=2023&amp;Initiative=false">Senate Bill 5389</a>, which expands optometrists' scope to include surgical procedures, injections, and increased prescriptive authority. The bill is currently pending the consideration of Gov. Jay Inslee. The stakes established in SB 5389 call for exceptional action, and the WSMA is urging the governor to use his veto pen and prevent the bill from becoming state law. Add your voice to ours by <a href="https://votervoice.net/WSMA/Campaigns/104453/Respond">sending a message to the governor from the WSMA Action Center today</a>.</p>
<h3>Inside the 2023-2025 state budget</h3>
<p>Totaling nearly $70 billion, the two-year spending plan passed by the Legislature makes substantial investments in health care workforce, behavioral health, abortion access, and public health. The budget increases state spending by around $5 billion, with major areas of new investments including climate change, housing and homelessness, and special education. The budget also funds more than $2 billion in pay increases for state workers collectively bargained by the governor and labor unions.</p>
<p>WSMA's top budget priorities for the 2023 session were increasing Medicaid rates and bolstering health care workforce. To the latter, the budget increases investments in physician residencies, health professional loan repayment, and nurse education and training. And while the final budget does make provisions for Medicaid rate increases, it only partially funds WSMA's ask of <a href="[@]wsma/advocacy/legislative_regulatory/issue-briefs/medicaid-professional-services-rate-increase.aspx">across-the-board increases to at least the rates paid by Medicare</a>. Continued advocacy will be needed to ensure the state is fully funding the Medicaid program and supporting access to care for patients.</p>
<p>The budget does fund Medicaid rate increases in other contexts, most notably for hospitals. In the case of hospitals and certain other entities, Medicaid funding is augmented by a "safety net assessment," which is levied on the entities to leverage additional federal funds that can be used for rate increases. By contrast, WSMA's request for professional services rate increases would be funded from the state's general fund (and also bolstered by leveraged federal dollars). The final budget and associated legislation extend the hospital safety net in perpetuity and expand it to fund rate increases. The WSMA was supportive of the hospital safety net assessment proposal that was brought forward by the Washington State Hospital Association. We are pleased to see the Legislature help ensure the financial stability of our hospital systems by extending this levy and look forward to working with lawmakers to ensure our outpatient practice community is prioritized similarly at the next opportunity.</p>
<p>Highlights of WSMA's priorities in the final budget include:</p>
<ul>
<li><strong>Medicaid reimbursement</strong>: $31.2 million for rate increases for Medicaid professional services delivered by physicians, physician assistants, and ARNPs, effective July 1, 2024. An additional $3.1 million is dedicated to primary care rate increases and $6.2 million for certain behavioral health service rates.</li>
<li><strong>Physician residencies</strong>: $18 million for physician residencies through the state's Family Medicine Residency Network. An additional $5 million is appropriated for psychiatric residencies.</li>
<li><strong>Health professional loan repayment</strong>: The budget provides increased funding for the state's <a href="https://wsac.wa.gov/washington-health-corps">Health Professional Loan Repayment Program</a>, as well as for the loan program dedicated to behavioral health professionals.</li>
<li><strong>Reproductive health care services</strong>: $15.5 million to maintain access to abortion, including funding for patient outreach, workforce retention, and security investments.</li>
<li><strong>Foundational Public Health Services</strong>: More than $300 million for continued support of the state's public health system.</li>
<li><strong>Opioid epidemic</strong>: Among numerous appropriations seeking to help address the opioid epidemic, $1.8 million for opioid education, including an expansion of the <a href="[@]wsma/resources/opioids/better_prescribing_better_treatment/wsma/resources/opioids/better-prescribing-better-treatment.aspx?hkey=b6fb0ec0-8bc2-4e53-bf4c-9f148599cbeb">Better Prescribing, Better Treatment</a> initiative of the WSMA and the Washington State Hospital Association.</li>
</ul>
<p>No significant tax increases were included in the final budget. During the 2023 session, there was consideration of replacing the state's business and occupation tax with a "margin" tax, the establishment of a "wealth tax," and increasing property taxes to fund housing, with none of those efforts making it across the finish line.</p>
<h3>A special session?</h3>
<p>Another bill that failed to make it through the process was <a href="https://app.leg.wa.gov/billsummary?BillNumber=5536&amp;Year=2023&amp;Initiative=false">Senate Bill 5536</a>, which sought to address the state Supreme Court's 2021 "Blake" decision that effectively decriminalized personal drug possession. In the 2021 session, the Legislature passed a temporary fix setting possession as a misdemeanor. That law expires June 30, so in the absence of further legislative action, personal drug possession would be decriminalized at the state level on July 1, leaving municipalities the option to adopt drug possession regulations.</p>
<p>SB 5536 was negotiated extensively throughout session, as lawmakers sought an approach that balanced public health and public safety, but on the final day of session a compromise bill was voted down by the House of Representatives. There's talk in Olympia of a forthcoming special session to address the issue, which would mark the first time since 2017 the Legislature has required extra time to complete its work.</p>
<h3>What's next for our advocacy on behalf of the physician community</h3>
<p>The engagement of physicians and physician assistants played a central role in WSMA's advocacy through the 2023 session. More than 100 WSMA members attended the Legislative Summit, convening in person at the Capitol during session for the first time since the pandemic. WSMA leaders testified on bills in person and remotely, and through our calls to action, hundreds of WSMA members sent thousands of messages to their legislators this session. Thank you all for joining us in advocacy.</p>
<p>Looking forward, we have further work to do on Medicaid reimbursement in support of fully funding the state's Medicaid program to ensure access to care for patients and fair reimbursement for physicians and physician assistants. And we know there continues to be significant workforce needs, both in terms of increasing the supply of physicians and health care professionals in our state, as well as ensuring that our existing workforce is adequately supported.</p>
<p>If there are initiatives in those areas or beyond that you think the WSMA should consider for inclusion in our legislative agenda, or if you have questions about the final budget or anything pending in Olympia, contact WSMA Government Affairs Director Sean Graham at <a href="mailto:sean@wsma.org">sean@wsma.org</a>. </p>
</div> | 4/27/2023 2:49:31 PM | 4/28/2023 12:00:00 AM |
| webinar-opioid-prescribing-regulations-post-covid-19-public-health-emergency | Webinar: Opioid Prescribing Regulations Post-COVID-19 Public Health Emergency | Advocacy | Shared_Content/News/Membership_Memo/2023/april-28/webinar-opioid-prescribing-regulations-post-covid-19-public-health-emergency | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/april/opiates-hydrocodone-645x425px.jpeg" class="pull-right" alt="Hydrocodone pill bottle" /></div>
<h5>April 28, 2023</h5>
<h2>Webinar: Opioid Prescribing Regulations Post-COVID-19 Public Health Emergency </h2>
<p>
Friday, May 5, 1-2 p.m. Free. CME available.
</p>
<p>This webinar meets the state's one-time, one-hour opioid prescribing training requirement for MDs, DOs, and PAs. </p>
<p>The federal public health emergency is set to end on May 11, and now is a good time to understand the current and emerging regulatory environment around prescribing opioids and other controlled substances at the state and federal levels.</p>
<p>Join Nathan Schlicher, MD, JD, regional director of quality assurance at TeamHealth and an emergency physician at Virginia Mason Franciscan Health; Jeb Shepard, director of policy at the WSMA; and Shelby Wiedmann, policy analyst at the WSMA, as they outline strategies to comply with current and forthcoming regulations. Speakers will: </p>
<ul>
<li>Review current Washington state opioid prescribing requirements. </li>
<li>Help you understand the new eight-hour training for Drug Enforcement Administration-registered prescribers starting in June. </li>
<li>Explain new DEA regulations for prescribing controlled substances via telemedicine after the end of the federal public health emergency. </li>
<li>Improve pain management practices through WSMA's peer-led initiative: Better Prescribing, Better Treatment. </li>
</ul>
<p>Speakers will detail additional resources available for up-to-date evidence-based information on opioid prescribing. The live webinar is open to WSMA members and nonmembers. </p>
<p><a href="[@]Shared_Content/Events/Event_Display.aspx?eventkey=CPDCMPLY23">Register for the webinar.</a> This activity has been approved for <em>AMA PRA Category 1 Credit</em>â„¢. This live session will be recorded and offered on demand on the WSMA website as a member benefit (nonmember pricing will be available).</p>
</div> | 4/27/2023 2:32:48 PM | 4/28/2023 12:00:00 AM |
| wsma-urges-washington-congressional-delegations-support-of-federal-office-of-gun-violence-pr | WSMA Urges Washington Congressional Delegation's Support of Federal Office of Gun Violence P | Advocacy | Shared_Content/News/Membership_Memo/2023/april-28/wsma-urges-washington-congressional-delegations-support-of-federal-office-of-gun-violence-pr | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/april/us-capitol-building-645x425px.jpeg" class="pull-right" alt="US Capitol building" /></div>
<h5>April 28, 2023</h5>
<h2>WSMA Urges Washington Congressional Delegation's Support of Federal Office of Gun Violence Prevention</h2>
<p><a href="https://www.congress.gov/bill/118th-congress/house-bill/1699/text?s=1&amp;r=1">H.R. 1699</a>, which would establish an Office of Gun Violence Prevention within the Office of Legal Policy of the U.S. Department of Justice, was introduced in the U.S. House of Representatives with the goal of evaluating current laws and regulations that can be maximized and modernized to reduce firearm violence, as well as developing policy recommendations to promote evidence-based firearm violence prevention strategies.</p>
<p>The WSMA believes firearm violence is a growing public health issue impacting the entire nation. WSMA's House of Delegates has adopted various firearm policies, including <a href="[@]wsma/about/policies/whats_our_policy/guns-and-weapons/national-bureau-for-firearm-injury-prevention.aspx">one</a> which compels WSMA's support of the creation of a National Bureau for Firearm Injury Prevention. As such, the <a href="javascript://[Uploaded files/News and Publications/newsletters/2023/wsma-comment-support-hr-1699-04122023-murray.pdf]">WSMA sent a letter</a>&nbsp;urging members of Washington's congressional delegation to support H.R. 1699.</p>
</div> | 4/27/2023 3:05:11 PM | 4/28/2023 12:00:00 AM |
| wsma-praises-lawmakers-for-protecting-health-and-safety-of-patients-access-to-care | WSMA Praises Lawmakers for Protecting Health and Safety of Patients, Access to Care | Advocacy | Shared_Content/News/Press_Release/2023/wsma-praises-lawmakers-for-protecting-health-and-safety-of-patients-access-to-care | <div class="col-md-12">
<div class="col-sm-5 pull-right"><img src="/images/Logos/Press-Release-Graphic-2019-Branding.png" class="pull-right" alt="WSMA press release logo" /></div>
<h5>April 20, 2023</h5>
<h2>Washington State Medical Association Praises Lawmakers for Protecting Health and Safety of Patients, Access to Care</h2>
<p>
SEATTLE, WA - The Washington State Medical Association, which represents more than 12,000 physicians and physician assistants, today commended the Washington State Legislature for enacting legislation that prioritizes the health and safety of all Washingtonians and the sanctity of the patient-physician relationship, including provisions ensuring abortion access, addressing gun violence, and reforming those prior authorizations that unnecessarily delay patient care.
</p>
<p>
The following bills were passed by the Legislature during the 2023 state legislative session and are expected to be signed into law by Gov. Jay Inslee.
</p>
<p>
<strong>Abortion access </strong>
</p>
<ul>
<li>House Bill 1340 clarifies that providing reproductive health and gender-affirming care services consistent with Washington state standards of care, even in a state where such services are prohibited, does not constitute unprofessional conduct under Washington's Uniform Disciplinary Act.</li>
<li>House Bill 1469 establishes criminal and civil liability protections for patients and health care professionals receiving or delivering abortion services and gender-affirming care.</li>
<li>Senate Bill 5242 prohibits cost sharing (e.g., copays, deductibles) for abortion services.</li>
</ul>
<p>
<strong>Gun violence </strong>
</p>
<ul>
<li>House Bill 1240 prohibits the manufacture and sale of semiautomatic "assault weapons," including firearms such as the AR-15 and AK-47.</li>
<li>House Bill 1143 requires individuals to have recently completed a firearm safety training program and undergo a background check and 10-day waiting period to be eligible to purchase firearms.</li>
<li>Senate Bill 5078 establishes a right of action against the firearm industry in circumstances where violence results from their conduct such as advertising targeted at minors and promoting the illegal conversion of firearms.</li>
</ul>
<p>
<strong>Prior authorization</strong>
</p>
<ul>
<li>House Bill 1357 helps ensure timely access to care by streamlining insurance carrier prior authorization practices. The legislation will help shorten turnaround times for decisions and mandate insurance carriers implement electronic prior authorization processes that integrate into physicians' electronic health record systems.</li>
</ul>
<p>
"Washingtonians' ability to access care and addressing social determinants of health have been central to many of the biggest conversations in Olympia this year," said WSMA President Katina Rue, DO. "We are pleased to see lawmakers keep patients' health and safety top of mind by passing strong policies to protect abortion services and address gun violence, while supporting their ability to access timely care with sensible prior authorization reforms."
</p>
<p>
As the state's largest professional association representing physicians and PAs, the WSMA works to advance health care policy that prioritizes the health and wellness of Washingtonians and their communities, supports patients' ability to access their physician and health care services, and helps create and maintain a robust practice environment for physicians so they can thrive professionally.
</p>
<p>
"Everything we do at the WSMA is done with our patients in mind," said Dr. Rue. "With the continued rise in senseless gun violence, unconscionable efforts to limit reproductive health care services, and seemingly endless barriers to practicing medicine, sometimes it feels like the cards are stacked against both the individual patient and their physician. Each patient-centered policy that passes is a beacon of hope - and a step toward making our state the best place to practice medicine and to receive care."
</p>
<p>
As the 2023 session moves towards adjournment on Sunday, April 23, and legislators negotiate the final state operating budget for the 2023-25 fiscal biennium, one item that is being considered is Medicaid reimbursement rate increases for health care services delivered by physicians, PAs, and advanced registered nurse practitioners. The budget proposed by the House of Representatives would appropriate $67.8 million to raise rates while the Senate did not include this funding. The WSMA is advocating that the rate increases be included in the final operating budget.
</p>
<p>
Dr. Rue adds, "We are hopeful there will be at least modest increases in Medicaid physician payments in this budget cycle, in addition to the increases slated for hospital payments. In all likelihood, Medicaid payments for physician services will still fall short of the cost of delivering care, requiring continued work this year and in the 2024 legislative session to fully fund the state's Medicaid system and ensure access to care for all Medicaid enrollees."
</p>
<p>
For more information, contact:
</p>
<p>
Graham Short<br />
WSMA Director of Communications<br />
206.329.6851 (cell/text)<br />
<a href="mailto:gfs@wsma.org">gfs@wsma.org</a>
</p>
<p>
<strong>About the Washington State Medical Association </strong><br />
The WSMA represents more than 12,000 physicians, physician assistants, resident physicians, and medical students across all specialties and practice types in Washington state. The WSMA has advocated on behalf of the house of medicine for more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care.
</p>
</div> | 4/20/2023 9:05:58 AM | 4/20/2023 12:00:00 AM |
| free-education-feedback-on-opioid-prescribing-for-wsma-members | Free Education, Feedback on Opioid Prescribing for WSMA Members | Advocacy | Shared_Content/News/Membership_Memo/2023/april-14/free-education-feedback-on-opioid-prescribing-for-wsma-members | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/april/bpbt-logo-645px.png" class="pull-right" alt="Better Prescribing Better Treatment logo" /></div>
<h5>April 14, 2023</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>
Free Education, Feedback on Opioid Prescribing for WSMA Members
</h2>
<p>
The WSMA is excited to announce that, starting today, all members of the WSMA will be automatically enrolled in the Better Prescribing, Better Treatment peer-to-peer safe prescribing program.
</p>
<p>
Better Prescribing, Better Treatment was launched in 2017 as a quality improvement initiative jointly provided by the WSMA and the Washington State Hospital Association, in partnership with the Washington State Health Care Authority and Washington State Department of Health, and offered as an alternative to blunt pill limits and prior authorization requirements proposed by governmental regulation. Better Prescribing, Better Treatment today includes more than 60 health systems, hospitals, and medical groups and more than 12,000 licensed prescribers in Washington state. The impact of the program has been dramatic: since its introduction, overall ‘above guidelines' acute prescribing in Washington state has dropped by 49%.
</p>
<p>
While until today, enrollment in the Better Prescribing, Better Treatment program has been limited to health systems and medical groups, the WSMA believes strongly that every prescriber in Washington should have access to this beneficial program to encourage safe opioid prescribing habits. Now, with support of federal and state grant funding, the WSMA is able to expand Better Prescribing, Better Treatment to include all WSMA members, with an option to opt-out of the program.
</p>
<div class="col-sm-8 pull-right" style="text-align: center;">
<p><img src="/images/Newsletters/MembershipMemo/2023/april/chart.jpg" class="pull-right" alt="Washington Statewide Acute Prescribing Trend chart" /></p>
</div>
<p>
As part of the program, you will receive a free quarterly report of your opioid prescribing compared with peers and established Washington state opioid prescribing guidelines. The reports will give you valuable feedback and education on your opioid prescribing habits over time. Above-guideline prescribing in Washington has continued to improve every quarter since the program began. We believe that together we can continue to drive better care for every Washingtonian.
</p>
<p>As a valued member of the WSMA, you will be automatically opted in to the Better Prescribing, Better Treatment program. If you decide to opt out of the program, please click <a href="https://forms.microsoft.com/pages/responsepage.aspx?id=CgN5_wMfNU66xEvN3PBcALOjCMPHcOtMjRqWI9jf1QJUQUQyQzAzRE03QzdXNVM3WU43MlVUM0NLWS4u">here</a> to start the process.</p>
<p>
Feel free to reach out to Monica Salgaonkar <a href="mailto:monica@wsma.org">monica@wsma.org</a> if you have any concerns or questions.
</p>
</div> | 4/14/2023 12:10:50 PM | 4/14/2023 12:00:00 AM |
| nominate-a-colleague-or-yourself-for-the-2023-apple-awards | Nominate a Colleague or Yourself for the 2023 Apple Awards | Advocacy | Shared_Content/News/Membership_Memo/2023/april-14/nominate-a-colleague-or-yourself-for-the-2023-apple-awards | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/april/apple-awards-2021-all-glass-apples-medium-645x425px.jpeg" class="pull-right" alt="Apple Awards trophies" /></div>
<h5>April 14, 2023</h5>
<h2>
Nominate a Colleague or Yourself for the 2023 Apple Awards
</h2>
<p>
Day in and day out, WSMA members are busy doing extraordinary things serving the house of medicine and improving the health of Washingtonians. Because so much of this work is performed selflessly and goes unsung, we think it's nice to take a moment to draw attention to particularly noteworthy efforts and individuals. Through the WSMA's Apple Awards and William O. Robertson, MD, Patient Safety Award, we'll recognize worthy winners for leadership, advocacy, service, and patient safety.
</p>
<p>
It's easy to make a nomination. Simply go to the links noted below to find out more and complete your nominations before the May 26 deadline. The awards will be presented during the WSMA House of Delegates' annual meeting in September.
</p>
<ul>
<li><strong>President's Unsung Hero Award: </strong>This award recognizes the WSMA member who contributes extraordinary service to the profession and community. <a href="https://www.surveymonkey.com/r/9RJWHNY">Submit your nomination(s) here</a>.</li>
<li><strong>Wellness Award: </strong>This award recognizes an organization that has worked to put the joy back in medicine for Washington physicians. <a href="https://www.surveymonkey.com/r/MFQ7TMM">Submit your nomination(s) here</a>.</li>
<li><strong>Grassroots Advocate Award: </strong>This award recognizes WSMA member efforts and activities in supporting WSMA legislative priorities. <a href="https://www.surveymonkey.com/r/MF52YNY">Submit your nomination(s) here</a>.</li>
<li><strong>William O. Robertson, MD, Patient Safety Award: </strong>This award recognizes patient safety initiatives pioneered in ambulatory care settings throughout Washington state. <a href="https://www.surveymonkey.com/r/9TD3NC5">Submit your nomination(s) here</a>.</li>
</ul>
</div> | 4/13/2023 10:29:41 AM | 4/14/2023 12:00:00 AM |