| 2023-wsma-legislative-summit-features-panel-discussion-on-state-of-abortion-care | 2023 WSMA Legislative Summit Features Panel Discussion on State of Abortion Care | Advocacy | Shared_Content/News/Membership_Memo/2023/january-27/2023-wsma-legislative-summit-features-panel-discussion-on-state-of-abortion-care | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/2023-leg-summit-graphic-keiser-645x425px.png" class="pull-right" alt="2023 Legislative Summit logo" /></div>
<h5>January 27, 2023</h5>
<h2>2023 WSMA Legislative Summit Features Panel Discussion on State of Abortion Care </h2>
<p>At the WSMA Legislative Summit next Friday, Feb. 3, we'll check in on the many legislative proposals regarding access to abortion currently being debated in Olympia during a robust panel discussion on the state of abortion care in Washington. Our guest panelists include Senator Karen Keiser (D-Des Moines), Nari Heshmati, MD, WSMA president elect and OB-GYN, and Courtney Normand, Planned Parenthood state director.</p>
<p>Protecting access to abortion and reproductive care is one of the priority legislative and budget items highlighted at this year's Legislative Summit. Other priorities include across-the-board Medicaid reimbursement rate increases, standardizing the prior authorization process, and preventing inappropriate scope-of-practice increases. If you are passionate about direct advocacy or have been looking for ways to engage with the work of the WSMA, next Friday's Summit is a great opportunity to come to Olympia, learn more about WSMA's legislative agenda, and help deliver our advocacy message directly to your elected representatives. The free event begins at 8 a.m. in the Columbia Room of the Legislative Building at 416 Sid Snyder Avenue SW, Olympia, WA 98504. A light breakfast and lunch will be provided. <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5&amp;_zs=A3aFd1&amp;_zl=soFk8">Register for the event online</a>.</p>
</div> | 1/25/2023 3:47:23 PM | 1/27/2023 12:00:00 AM |
| action-alert-on-medicaid-reimbursement | Action Alert on Medicaid Reimbursement | Advocacy | Shared_Content/News/Membership_Memo/2023/january-27/action-alert-on-medicaid-reimbursement | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/megaphone-evergreen-645x425px.jpeg" class="pull-right" alt="megaphone illustration" /></div>
<h5>January 27, 2023</h5>
<h2>Action Alert on Medicaid Reimbursement</h2>
<p>The WSMA is committed to focusing on the one of the biggest funding challenges faced by physicians and health care practitioners: Medicaid payment rates that do not come close to covering the cost of care and do not support access to care for the most vulnerable. During the 2023 legislative session now underway in Olympia, the WSMA is asking the Washington State Legislature to support an increase in Medicaid reimbursement rates for professional services to the equivalent paid by Medicare, adjusting to inflation moving forward. The estimated fiscal impact for the 2023-25 biennium is $200.4 million in state general funds, leveraging a more than 2-to-1 federal match for an overall investment of $634.8 million.</p>
<p>This week, we sent an action alert to WSMA members to encourage grassroots advocacy on this issue. It's imperative that lawmakers hear directly from members of the physician community on how these funds will affect their ability to practice good medicine and provide patient care. If you haven't yet responded to the call to action, please take a moment to contact your legislators. <a href="https://www.votervoice.net/WSMA/Campaigns/99646/Respond">Visit the WSMA's new Action Center to send your message</a>.</p>
</div> | 1/26/2023 12:30:25 PM | 1/27/2023 12:00:00 AM |
| session-update-public-hearings-on-abortion-access-and-prior-authorization-this-week | Session Update: Public Hearings on Abortion Access and Prior Authorization This Week | Advocacy | Shared_Content/News/Membership_Memo/2023/january-27/session-update-public-hearings-on-abortion-access-and-prior-authorization-this-week | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/2023-legislative-session-updates-645x425px.png" class="pull-right" alt="2023 Legislative Session Updates logo" /></div>
<h5>January 27, 2023</h5>
<h2>Session Update: Public Hearings on Abortion Access and Prior Authorization This Week </h2>
<p>Proposed bills on two key WSMA legislative priorities - establishing abortion and reproductive care protections and standardizing prior authorization practices - received public hearings this week as state lawmakers closed out week three of the 105-day legislative session.</p>
<h3>Access to abortion care takes center stage</h3>
<p>A number of bills on the subject of access to abortion received hearings on Tuesday, Jan. 24, including:</p>
<ul>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=8202&amp;Initiative=false&amp;Year=2023">Senate Joint Resolution 8202</a>, which would enshrine legal access to abortion and contraception in the Washington state constitution, was heard in the Senate Health and Long Term Care Committee.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1469&amp;Year=2023&amp;Initiative=false">House Bill 1469</a>, which would establish liability protections for patients and health care professionals from criminal and civil actions based on the provision of abortion care and gender-affirming care services, was heard in the House Civil Rights and Judiciary Committee.</li>
<li><a href="https://app.leg.wa.gov/billsummary?BillNumber=1340&amp;Initiative=false&amp;Year=2023">House Bill 1340</a>, which would specify that unprofessional conduct under our state's Uniform Discipline Act does not include the provision of abortion care in a state or for a patient who resides in a state where such services are prohibited for the purpose of Washington state licensure and discipline, was heard in the House Health Care and Wellness Committee. These protections would also extend to gender-affirming care services. HB 1340 is sponsored by Committee Chair Rep. Marcus Riccelli, D-Spokane.</li>
</ul>
<p>WSMA President Katina Rue, DO, attended the hearings testifying on behalf of the WSMA in support of these proposals. Joining Dr. Rue at the HB 1469 hearing was Sarah Prager, MD, who testified in support on behalf of the Washington Section of the American College of Obstetricians and Gynecologists. Also heard on Tuesday were <a href="https://app.leg.wa.gov/billsummary?BillNumber=5242&amp;Chamber=Senate&amp;Year=2023">Senate Bill 5242</a>, which would prohibit copays, deductibles, and other cost-sharing requirements on abortion services, and <a href="https://app.leg.wa.gov/billsummary?BillNumber=5489&amp;Initiative=false&amp;Year=2023">Senate Bill 5489</a>, the companion bill to HB 1469 establishing liability protections.</p>
<h3>Prioritizing prior authorization reform</h3>
<p>On Wednesday, WSMA priority legislation <a href="https://app.leg.wa.gov/billsummary?BillNumber=1357&amp;Year=2023&amp;Initiative=false">House Bill 1357</a> concerning prior authorization was the subject of a public hearing in the House Health Care and Wellness Committee. Sponsored by Rep. Tarra Simmons, D-Bremerton and brought forward by the WSMA, HB 1357 would limit the utilization of prior authorization where codes are approved at exceedingly high rates and standardize requirements across insurance carriers. The WSMA testified in support.</p>
<h3>In previous weeks: Scope of practice and gun violence</h3>
<p>Of particular note, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1041&amp;Year=2023&amp;Initiative=false">House Bill 1041</a>, which would grant prescriptive authority to psychologists under certain circumstances, was heard in the House Health Care and Wellness Committee on Jan. 11. The WSMA testified in opposition as <a href="[@]wsma/advocacy/legislative_regulatory/issue-briefs/scope-of-practice-efforts.aspx">per policy opposing scope efforts by nonphysician practitioners without commensurate training to ensure patient safety</a>. The second week of session saw several high-profile hearings on firearm legislation. The WSMA has a variety of relevant policy and supports legislation to reduce firearm violence, including the proposed assault weapons ban, <a href="https://app.leg.wa.gov/billsummary?BillNumber=1240&amp;Year=2023&amp;Initiative=false">House Bill 1240</a>.</p>
<h3>For more detailed session updates</h3>
<p>For weekly session updates with greater details on bills being debated in Olympia, WSMA members may subscribe to the WSMA Outreach &amp; Advocacy Report by emailing Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a>. </p>
<p>And don't forget: If you are passionate about direct advocacy, come to <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">Olympia on Feb. 3 for the 2023 WSMA Legislative Summit</a> and join your like-minded colleagues and peers from across the state as we take our advocacy message directly to legislators.</p>
</div> | 1/25/2023 3:47:08 PM | 1/27/2023 12:00:00 AM |
| updated-washington-practitioner-application-supports-physician-well-being | Updated Washington Practitioner Application Supports Physician Well-Being | Advocacy | Shared_Content/News/Membership_Memo/2023/january-27/updated-washington-practitioner-application-supports-physician-well-being | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/smiling-docs-645x425px.jpeg" class="pull-right" alt="smiling doctors" /></div>
<h5>January 27, 2023</h5>
<h2>Updated Licensing and Credentialing Applications Support Physician Well-Being</h2>
<p>The WSMA is pleased to report that physicians and other licensed practitioners will now benefit from newly updated licensing and credentialing forms in Washington state. These widely used forms have been revised with input from the physician community, and reflect a growing awareness of the barriers to wellness that medical licensing and credentialing insurance applications were creating for physicians and practitioners. </p>
<h3>Updated Washington Practitioner Application&nbsp;</h3>
<p>This month, a streamlined <a href="https://www.wamss.org/resources/washington-credentialing-standardization-group/">Washington Practitioner Application</a>&nbsp;was introduced. The WPA is a standardized application that is accepted by most physician organizations, hospitals, and health plans and throughout the state. Changes to the application include:</p>
<ul>
<li>Updated attestation question regarding a practitioner's physical and mental health conditions. After years of discussions and input from numerous organizations, the credentialing committee overseeing the form revisions settled on a more streamlined question that still meets regulatory agency requirements to inquire about a practitioner's mental health status.</li>
</ul>
<ul>
<li>A new section that asks for contact details for the monitoring program the practitioner is enrolled in but does not ask for any details around the condition or circumstances that led to being admitted into the monitoring program or the practitioner's current status with the monitoring program. This ensures that no practitioner PHI ends up on the WPA.</li>
</ul>
<h3>Washington licensing applications newly updated</h3>
<p>The Washington Medical Commission has updated its <a href="https://wmc.wa.gov/licensing/applications-and-forms">licensing questions</a> to remove potentially invasive or stigmatizing language around mental health. The commission changed the question to an attestation and provided information about the Washington Physicians Health Program. These new updates follow changes in 2019 removing the requirement for applicants to disclose mental health or substance use disorder information resulting from new "safe haven" provisions.
</p>
<p>The WSMA gives special thanks to Washington Physicians Health Program Executive Medical Director Chris Bundy, MD, MPH, a strong physician advocate who helped provide guidance to both the Washington Medical Commission and the credentialing standardization committee on the changes to these forms.</p>
<p>These combined changes represent significant progress in decreasing barriers to help-seeking for physicians and physician assistants in our state and furthers WSMA's vision to make Washington the best place to practice medicine and receive care.</p>
</div> | 1/25/2023 3:47:14 PM | 1/27/2023 12:00:00 AM |
| wsma-advocacy-critical-to-removal-of-buprenorphine-prescribing-barriers | WSMA Advocacy Critical to Removal of Buprenorphine Prescribing Barriers | Advocacy | Shared_Content/News/Membership_Memo/2023/january-27/wsma-advocacy-critical-to-removal-of-buprenorphine-prescribing-barriers | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/buprenorphine-butrans10mcg-645px.jpeg" class="pull-right" alt="Butrans packets" /></div>
<h5>January 27, 2023</h5>
<h2>WSMA Advocacy Critical to Removal of Buprenorphine Prescribing Barriers </h2>
<p>The passage of the omnibus spending package in December included a significant policy priority of the WSMA and addiction treatment professionals: a provision to remove federal barriers to medications for opioid use disorder and increase access to life-saving treatment that prevents overdoses and supports recovery.</p>
<h3>About the Mainstreaming Addiction Treatment (MAT) Act</h3>
<p>The Consolidated Appropriations Act for 2023 included key provisions from the Mainstreaming Addiction Treatment Act (H.R. 1384/S. 445), legislation supported by the WSMA intended to address America's worsening overdose crisis. The MAT Act:</p>
<ul>
<li>Removes the X-Waiver registration requirement, so all physicians and nonphysician practitioners with a standard controlled medication license can prescribe buprenorphine for opioid use disorder just as they prescribe medications for other chronic conditions.</li>
<li>Removes the patient limits for prescribing buprenorphine for opioid use disorder.</li>
<li>Removes the special Drug Enforcement Administration "X" prescribing number. Physicians can use their standard DEA controlled substance license number to prescribe buprenorphine for opioid use disorder.</li>
<li>Removes the counseling referral and ancillary services requirement.</li>
<li>Removes the X-Waiver training requirement.</li>
<li>Removes the list of health care practitioners who can prescribe buprenorphine for opioid use disorder.</li>
</ul>
<p>See <a href="https://drive.google.com/file/d/1OwOAvy3oEs5DUtKAToS8irT4ZWApdezV/view">this brief for details</a> on these provisions.</p>
<h3>WSMA's critical early leadership and support</h3>
<p>The WSMA and a coalition of Washington stakeholders played a critical role in getting the MAT Act the attention it deserved at the federal level. Many stakeholders, including academic institutions, law enforcement, and other medical and recovery associations, signed on in support thanks to WSMA's early leadership on the policy, giving Washington state the broadest coalition of state-based organizations supporting the MAT Act.</p>
<p>This state coalition was pivotal in gaining federal support for the bill, in particular from the many Washington state lawmakers in Congress who have an outsized influence on health policy, including Sen. Patty Murray, Rep. Cathy McMorris Rodgers, and Rep. Kim Schrier, as well as Washington's key party leaders, Rep. Suzan DelBene, Rep. Pramila Jayapal, and Rep. Derek Kilmer, who have significant influence on legislation that passes the House. We are grateful to these lawmakers, each of whom supported and prioritized the MAT Act because they knew that it was important for physicians and health care professionals in the state.</p>
<p>The WSMA is especially grateful for the leadership and advocacy of Lucinda Grande, MD, Olympia addiction medicine physician, who authored Resolution C-15 on behalf of the Thurston-Mason County Medical Society, which called on the WSMA to support federal efforts to eliminate the buprenorphine waiver requirement. The resolution was passed by the 2019 WSMA House of Delegates and provided the policy underpinning for WSMA's advocacy on the issue.</p>
<h3>Resources for prescribing buprenorphine</h3>
<p>The Substance Abuse and Mental Health Services Administration has developed a <a href="https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf" target="_blank" rel="noreferrer">buprenorphine quick start guide</a> and <a href="https://www.samhsa.gov/sites/default/files/quick-start-pocket.pdf" target="_blank" rel="noreferrer">pocket guide</a> for all physicians and practitioners seeking to prescribe buprenorphine. We encourage physicians in active practice to familiarize themselves with this guidance and consider, when appropriate, prescribing buprenorphine to prevent painful withdrawal symptoms associated with opioid use disorder, just as you would prescribe medications for other chronic conditions.</p>
</div> | 1/26/2023 2:19:23 PM | 1/27/2023 12:00:00 AM |
| wsma-continues-engagement-with-the-states-health-care-cost-transparency-board | WSMA Continues Engagement with the State's Health Care Cost Transparency Board | Advocacy | Shared_Content/News/Membership_Memo/2023/january-27/wsma-continues-engagement-with-the-states-health-care-cost-transparency-board | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/stethoscope-dollar-sign-645x425px.jpeg" class="pull-right" alt="stethoscope in the shape of a dollar sign" /></div>
<h5>January 27, 2023</h5>
<h2>WSMA Continues Engagement with the State's Health Care Cost Transparency Board </h2>
<p>The WSMA has monitored and participated in the work of the state's <a href="https://wsma.org/wsma/advocacy/health_care_cost_transparency/wsma/advocacy/health_care_cost_transparency/health_care_cost_transparency.aspx?hkey=a9ff53b5-1080-43e7-9b48-1fec039ce9c6">Health Care Cost Transparency Board</a> throughout 2022, attending meetings and submitting comment letters when warranted. The WSMA continues to collaborate, primarily with the Washington State Hospital Association, to submit feedback reflecting our concerns over various aspects of the board and its established benchmarks.</p>
<p>Last month, the WSMA worked with WSHA to submit a <a href="javascript://[Uploaded files/News and Publications/newsletters/2023/hcctb-annual-report-comment-letter-final.pdf]">comment letter</a>&nbsp;on the board's first annual report, which was submitted to the Legislature in advance of the 2023 legislative session, highlighting our shared concerns not reflected in the report. More recently, the WSMA partnered with WSHA, the Association of Washington Health Plans, and the Washington State Medical Group Management Association to submit a <a href="javascript://[Uploaded files/News and Publications/newsletters/2023/hcctb-inflation-letter.pdf]">comment letter</a>&nbsp;to the board over concerns with inflation, suggesting a more meaningful and achievable benchmark considering the economic challenges we are facing.</p>
<p>The WSMA will continue to engage with the board and other stakeholders and will keep members apprised of developments.</p>
</div> | 1/26/2023 2:19:28 PM | 1/27/2023 12:00:00 AM |
| 2023-legislative-session-update-week-3 | 2023 Legislative Session Update: Week 3 | Advocacy | Shared_Content/News/Latest_News/2023/2023-legislative-session-update-week-3 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/791757558"><img src="/images/Newsletters/latest-news/2023/jan/legislative-update-week-3-2023.png" alt="Legislative Update logo for the week of January 23, 2023" /></a>
</div>
<h5>January 23, 2023</h5>
<h2>2023 Legislative Session Update: Week 3</h2>
<p>WSMA Associate Director of Legislative and Political Affairs Alex Wehinger gives an update on bills related to abortion access scheduled for hearings in the Legislature this week. <a href="https://vimeo.com/791757558">Watch the video</a>.</p>
<h3>Join us at the WSMA Legislative Summit for a panel discussion on abortion in Washington</h3>
<p>Sen. Karen Keiser (D-Des Moines); WSMA President-Elect and OB-GYN Nari Hesmati, MD; and Planned Parenthood State Director Courtney Normand will join us at the Legislative Summit next Friday, Feb. 3 in Olympia for a panel discussion on the state of abortion in Washington. The meeting is free for WSMA members - <a href="https://wsma.org/wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">register today</a>.</p>
</div> | 1/24/2023 4:24:18 PM | 1/23/2023 12:00:00 AM |
| 2023_legislative_session_update__session_begins | 2023 Legislative Session Update: Session Begins | Advocacy | Shared_Content/News/Latest_News/2023/2023_legislative_session_update__session_begins | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><a href="https://vimeo.com/manage/videos/664371043"><img src="/images/Newsletters/latest-news/2023/jan/Legislative_Update_Jan16_2023.png" alt="WSMA Legislative Update logo - Session Begins" /></a>
</div>
<h5>January 17, 2023</h5>
<h2>2023 Legislative Session Update: Session Begins</h2>
<p>WSMA Director of Government Affairs Sean Graham gives an update on WSMA's budget and legislative policy priorities on behalf of physicians, physician assistants, and the house of medicine as the 2023 Washington state legislative session begins. <a href="https://vimeo.com/789504092">Watch the video</a>.&nbsp;</p>
<p><strong>Come to Olympia on Feb. 3 for the 2023 WSMA Legislative Summit!
</strong></p>
<p>After several years of virtual gatherings, the Legislative Summit, WSMA's annual "doctors' day on the Hill," will take place once again in person at the state Capitol on Feb. 3. Don’t miss this chance to share your perspective with your local legislators and help amplify WSMA’s budget and legislative priorities—and don’t forget to wear a white coat! The meeting is free for WSMA members—<a href="[@]wsma/events/wsma_legislative_summit.aspx">register today</a>.</p>
</div> | 1/17/2023 12:13:15 PM | 1/17/2023 1:47:43 PM |
| wsma-highlights-medicaid-and-prior-authorization-priorities-as-legislative-session-gets-unde | WSMA Highlights Medicaid and Prior Authorization Priorities as Legislative Session Gets Unde | Advocacy | Shared_Content/News/Membership_Memo/2023/wsma-highlights-medicaid-and-prior-authorization-priorities-as-legislative-session-gets-unde | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2023/january/wa-state-flag-capitol-645x425px.png" class="pull-right" alt="Washington state flag flying in front of capitol building" /></div>
<h5>January 13, 2022</h5>
<h2>WSMA Highlights Medicaid and Prior Authorization Priorities as Legislative Session Gets Underway</h2>
<p>The 2023 state legislative session began this Monday. The primary responsibility for the Legislature during the 105-day long session will be to negotiate a two-year budget to fund the state's operating expenses, and, as with every session, hundreds of legislative policy proposals will be under consideration by lawmakers.</p>
<p>While the WSMA will engage on a variety of issues impacting the house of medicine, our priority fiscal and policy issues as determined by member feedback are as follows:</p>
<p>Budget priorities:</p>
<ul>
<li>Across-the-board Medicaid reimbursement rate increases.</li>
<li>Health care workforce, system capacity, and physician residency funding.</li>
<li>Foundational Public Health Services.</li>
<li>Taxes.</li>
</ul>
<p>Legislative priorities:</p>
<ul>
<li>Standardizing the prior authorization process.</li>
<li>Ensuring access to abortion and reproductive health care services.</li>
<li>Preventing numerous inappropriate scope-of-practice increases.</li>
<li>Addressing gun violence.</li>
</ul>
<p>In anticipation of session, the WSMA turned to the <a href="[@]Shared_Content/News/Press_Release/2022/access-to-care-will-continue-to-diminish-in-washington-without-intervention-new-survey-reveals">media</a> to begin making the case for its top two fiscal and policy priorities. In <a href="https://www.yakimaherald.com/opinion/guest-commentary-washington-legislators-must-prioritize-medicaid-funding/article_e1cb5f20-7a87-11ed-9a88-77d5a78d2c84.html">editorials</a> and <a href="https://komonews.com/news/local/washington-state-hospital-association-wsha-cut-services-financial-losses-bed-revenue-survey-cardiac-cancer-emergency-department">earned</a> <a href="https://app.criticalmention.com/app/#clip/view/d184d7de-e6ba-42f5-a000-61c57500c9aa?token=fb894da5-a101-41e8-b8a5-82a8fe619df6">media</a>, the WSMA has highlighted how low Medicaid reimbursement and health plan prior authorizations result in barriers to care for patients and further strain outpatient practices struggling with workforce shortages, inflation, ongoing disruptions of the pandemic, and now a <a href="[@]Shared_Content/News/Membership_Memo/2022/december-23/omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cut">2% reduction in Medicare reimbursement</a>.</p>
<p>The WSMA will be engaging a full-court press to advocate for these two priorities throughout session. We will keep members apprised of developments and opportunities for engagement. For weekly session updates delivered to your inbox, members may subscribe to the WSMA Outreach &amp; Advocacy Report, published weekly, by emailing Alex Wehinger at <a href="mailto:alex@wsma.org">alex@wsma.org</a>. If you are passionate about direct advocacy, come to <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">Olympia on Feb. 3 for the 2023 WSMA Legislative Summit</a> and join your like-minded colleagues and peers from across the state as we take our advocacy message directly to legislators.</p>
</div> | 1/12/2023 3:02:35 PM | 1/13/2023 12:00:00 AM |
| governor-releases-budget-proposal-for-2023-2025-biennium | Governor Releases Budget Proposal for 2023-2025 Biennium | Advocacy | Shared_Content/News/Membership_Memo/2022/december-23/governor-releases-budget-proposal-for-2023-2025-biennium | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/spring-wa-capitol-645x425px.jpeg" class="pull-right" alt="Washington state capitol building in spring" /></div>
<h5>December 23, 2022</h5>
<h2>Governor Releases Budget Proposal for 2023-2025 Biennium</h2>
<p>Last week Gov. Jay Inslee released his budget proposal, kicking off negotiations around the next two-year state spending plan and signaling the approach of the legislative session that begins on Jan. 9. Spanning $70 billion in spending, the governor's proposal would increase state spending by around 12% and does not rely on new tax increases. </p>
<p>In announcing his budget, Inslee highlighted proposed investments in housing and homelessness, climate change, and behavioral health, including $50 million to address the opioid epidemic-including funding to support the <a href="https://wsma.org/wsma/resources/opioids/better_prescribing_better_treatment/wsma/resources/opioids/better_prescribing_better_treatment/better_prescribing_better_treatment.aspx?hkey=b6fb0ec0-8bc2-4e53-bf4c-9f148599cbeb">Better Prescribing, Better Treatment</a> program, the joint initiative of the WSMA and the Washington State Hospital Association to inform physicians' prescribing patterns.</p>
<p>The budget aligns with other WSMA priorities, including proposed funding and associated policies to ensure access to abortion services and to address gun violence, and proposed investments in our health care workforce, most notably the creation of 400 new nursing slots and a public health degree program at Washington State University.</p>
<p>Investments are also proposed to support access to health care coverage for undocumented immigrants ($19 million); fund public health and winding down COVID-19 services ($120 million); and to increase capacity in the health care system by raising Medicaid rates for long-term care facilities and facilitating discharge of patients from hospital settings (more than $300 million across multiple appropriations). </p>
<p>State revenues have remained strong in the wake of the COVID-19 pandemic, yielding around $1.5 billion more than was expected through 2025. Collective bargaining agreements the governor recently struck with state employee unions consumed some of that capacity, however, limiting investments in new programs. One of those agreements stipulates that for care delivered in state employee health plans, ARNPs will be reimbursed at the same rate as physicians. The WSMA has opposed this policy in recent years when it's been proposed as legislation and the collective bargaining agreement represents a potential end-run around the Legislature.</p>
<p>While Gov. Inslee's budget does not raise taxes, it does propose new spending in the form of bonding capacity to support $4 billion in investments in housing and to address homelessness. This would require a referendum to voters. The budget also relies on revenue from the state capital gains tax that was adopted in the 2021 session and is currently the subject of a legal challenge pending the state Supreme Court.</p>
<p>WSMA's top budget priority for the 2023-25 state fiscal cycle is an across-the-board rate increase for professional services delivered in the Medicaid program. Increasing Medicaid rates to Medicare levels would cost the state an estimated $134 million annually, leveraging $290 million in federal funds for a total annual investment of $423 million. While this funding was not included in the governor's budget, we will be advocating for its inclusion in legislative spending plans, which will likely be released in early April and finalized before session is scheduled to adjourn on April 26.</p>
<p>If you're interested in staying plugged in to the WSMA's work in Olympia, you <a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/legislative_summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">can register for the 2023 Legislative Summit</a> taking place on Feb. 3, and receive our weekly Outreach and Advocacy Report by emailing WSMA's Legislative Coordinator Chelsea Thumberg at <a href="mailto:chelsea@wsma.org">chelsea@wsma.org</a>. </p>
</div> | 12/22/2022 2:58:00 PM | 12/23/2022 12:00:00 AM |
| omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cut | Omnibus Bill in Congress Includes 2% Medicare Physician Payment Cut | Advocacy | Shared_Content/News/Membership_Memo/2022/december-23/omnibus-bill-in-congress-includes-2-percent-medicare-physician-payment-cut | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/medicare-barcode-645px.jpeg" class="pull-right" alt="Medicare barcode" /></div>
<h5>December 23, 2022</h5>
<h2>Omnibus Bill in Congress Includes 2% Medicare Physician Payment Cut</h2>
<p>Despite calls from the American Medical Association, the WSMA, and the physician community, the must-pass omnibus spending deal struck by congressional leaders this week will apply a 2% cut in 2023 and at least a 1.25% cut in 2024 to physician Medicare reimbursements.</p>
<p>As the WSMA recently <a href="https://wsma.org/Shared_Content/News/Membership_Memo/2022/november-23/in-new-survey-practices-continue-to-grapple-with-economic-hardship?_zs=Pimae1&amp;_zl=dV3k8">reported to our members</a> and to <a href="https://wsma.org/Shared_Content/News/Press_Release/2022/access-to-care-will-continue-to-diminish-in-washington-without-intervention-new-survey-reveals.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927">the media and the public</a>, physician practices across the state are grappling with the economic hardship caused by workforce shortages and inflation. While the physician community was successful in staving off as much as an 8.5% cut in 2023, the WSMA is still deeply concerned about the impact a 2% reduction in Medicare reimbursement will have during a difficult time for practices and on the heels of a highly disruptive pandemic.</p>
<p>When adjusted for inflation, Medicare physician payments dropped by 22% from 2001 to 2021. With additional cuts in 2023, physicians simply cannot afford to operate under the current payment system. This latest disappointing news from Congress underscores the need for a comprehensive rethink of the Medicare payment system. The WSMA will be joining the AMA in seeking to reform the Medicare payment system in 2023 based on the principles of simplicity, relevance, alignment, and predictability. <a href="[@]wsma/advocacy/medicare_payment_reform/wsma/advocacy/medicare_payment_reform/medicare_payment_reform.aspx?hkey=d1a48c1c-af7b-4680-bd55-967338f3c977">Learn more about our plan for reforming Medicare</a>.</p>
</div> | 12/22/2022 2:50:30 PM | 12/23/2022 12:00:00 AM |
| wsma-economic-impact-survey-of-physician-practices | WSMA Economic Impact Survey of Physician Practices | Advocacy | Shared_Content/News/Latest_News/2022/wsma-economic-impact-survey-of-physician-practices | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/july/doc-patient-exam-room-645x425px.jpg" class="pull-right" alt="physician treating a patient" /></div>
<h5>December 19, 2022</h5>
<h2>WSMA Economic Impact Survey of Physician Practices</h2>
<p>Over the last several years, the WSMA and Washington State Medical Group Management Association have periodically conducted surveys to better understand the economic challenges facing physicians, their practices, and patients resulting from COVID-19. Feedback has been vital to our advocacy at the state and federal levels as we secured regulatory and financial relief for medical practices. </p>
<p>With the recission of COVID-19 proclamations and regulatory waivers and the 2023 legislative session on the horizon, the WSMA and the WSMGMA conducted a sixth survey to better understand how these issues have affected physicians and patients to inform our advocacy.</p>
<p>Results from this latest round of surveying clearly demonstrate that inflation and workforce shortages, as well as the ongoing COVID-19 pandemic, are still adversely impacting outpatient physician practices, and hindering patient access to care across Washington. Respondents also note that administrative tasks, such as prior authorization remain burdensome to their practices and further strain their limited staffing resources.</p>
<p>If actions are not taken to shore up the medical practice community, access to outpatient care in our state will be severely diminished over the next year. Patients will no longer be able to get care, at the right time, at the right place, creating even more pressure on our already overwhelmed hospitals.</p>
<p>During the 2023 state legislative session, the WSMA will ask the Legislature to raise Medicaid rates to Medicare levels, as physician groups and practices overwhelmingly believe that doing so will help stabilize finances while maintaining access for current Medicaid panels and even increasing to include more patients. In addition, the WSMA will help introduce legislation to rein in insurance carrier prior authorization practices, which would also relieve staffing challenges currently felt by most of the medical practice community.</p>
<p>Download the <a href="javascript://[Uploaded files/News and Publications/Latest News/2022/inflation-survey-final.pdf]">November 2022 practice economic survey results</a>.</p>
<h3>About the respondents</h3>
<p>Eighty-two physician practices responded, representing more than a thousand physicians and health care professionals that provide care to millions of Washingtonians.</p>
<ul>
<li>26% of survey respondents were solo practitioners.</li>
<li>44% were in practices of 2-10 physicians and</li>
<li>7% were in practices of 11-20 physicians.</li>
<li>12% of respondents represented practices of 21-50 physicians, and</li>
<li>11% represented practices with over 51 physicians.</li>
</ul>
<p>These represent smaller outpatient practices that are not affiliated with a hospital system and are often the only care provided in some communities, especially rural areas.</p>
<h3>Medicaid patients </h3>
<p>Most of these practices serve Medicaid patients (75%) in addition to commercial and Medicare patients.</p>
<h3>Staffing shortages have led to practice closures and reduction in services</h3>
<p>Regarding staffing, 89% of respondents said are having experiencing shortages. Of the respondents experiencing staffing shortages, 77% are experiencing challenges filling administrative staff positions, 75% are experiencing challenges filling medical assistant positions, 40% are having trouble filling nursing positions, and 33% are having trouble hiring physicians.</p>
<p>Staffing shortages have meant 46% of practices have had to reduce patience access. Almost 40% have had to reduce their office hours, as well as services and treatments offered to patients. One respondent noted that <em>"We will most likely close our Walla Walla office by the end of the year. We understand we are the only eye surgeon serving the low income."</em> If current staffing and financial trends continue, 51% of practices aren't confident they'll be able to provide the same level of patient access a year from now.</p>
<p>Other strategies to mitigate staffing challenges:</p>
<ul>
<li><em>Delayed well child care and chronic disease management.</em></li>
<li><em>Our waiting room is now where we see patients.</em></li>
<li><em>Limited number of new patients.</em></li>
<li><em>Closed on Friday, longer wait times for patients.</em></li>
<li><em>Delays in care and decreased access to services.</em></li>
<li><em>Cut back on clinic based testing and closed satellite office.</em></li>
<li><em>Increased workloads for staff which is causing burnout.</em></li>
</ul>
<h3>Inflation is impacting almost all practices </h3>
<p>Inflation is impacting practices: 51% of respondents said that inflation has had a significant impact on their practice, while 44% said that inflation has had some impact on their practice. Of those impacted by inflation, 89% noted the rising cost of labor. To mitigate the impact of inflation, over 30% of practices have reduced office hours, patient access, and services and treatments offered to patients.</p>
<p>What physician groups said about inflation:</p>
<ul>
<li><em>Our staff are getting lured away for high cash compensation and forsaking our generous benefits package to keep up with their short-term financial stressors of rising rents/transportation/food.</em></li>
<li><em>Supply chain disruptions, we can't get flu test kits, off and on shortages or syringes or medications.</em></li>
<li><em>Payroll taxes, office equipment, supplies, malpractice insurance, property upkeep, and business taxes. Just to mention a few. I currently have my business for sale, it's become too much for a private practice to stay in business.</em></li>
<li><em>Inflation is going up. Payment from insurers is going down or staying flat. This trajectory in not sustainable to recruit and retain physicians to our specialty in the long term.</em></li>
<li><em>We raised our rates where we were able to, but insurance payments have not kept pace with inflation.</em></li>
<li><em>Stopped services where reimbursement did not keep up with cost of goods used.</em></li>
<li><em>Work harder and longer. Seeing 30+ patients per day per doctor at times.</em></li>
<li><em>Limiting Medicaid patients.</em></li>
</ul>
<h3>Ideally, practices should have 18 weeks' (roughly four months) worth of days "cash on hand"</h3>
<p>Defined as the number of days their organization can pay its operating expenses with current cash available, 93% of practices responded with having less than 4 months days cash on hand. Over half of practices report that their days cash on hand is down since November of 2021. Of those who reported that their cash on hand was down, 83% attributed it to staffing shortage or inflation.</p>
<h3>Access to care for Medicaid patients is threatened</h3>
<p>Of practices that see Medicaid patients, 46% have had to limit the number of Medicaid patients they see due to the practice's current financial statement. Furthermore, several respondents who haven't had to limit the number of Medicaid patients note it is a possibility in the future.</p>
<ul>
<li><em>We will have to limit should funding continue not to match inflationary increases.</em></li>
<li><em>Not yet, but soon going that route.</em></li>
<li><em>That could happen. That's what other practices are doing.</em></li>
<li><em>We had a much larger number of Medicaid patients, but due to very poor financial return, we had to stop taking any new Medicaid patients, as well as turning away others that once were patients, but we hadn't seen within a year. We were going broke and didn't want to close our clinic.</em></li>
<li><em>We have always had open access to all children, but for the first time in our 42-year history we are not taking new patients. We are unable to attract MDs to fill vacancies because we cannot compete with larger institutions that either do not take Medicaid or cap the number of Medicaid patients at a low rate.</em></li>
<li><em>We had to discontinue providing eyewear to our Medicaid patients through the state plan. The payment of $20 per pair of eyewear was resulting in a substantial net loss.</em></li>
<li><em>This remains the toughest population for us to see, primarily because the reimbursement is so low.</em></li>
</ul>
<h3>Without support patient access will suffer over the next year</h3>
<p>Medical practices were asked if they will be able to provide the same level of patient access a year from now if staffing and financial trends continue. Just over 50% said they are not confident.</p>
<h3>Medicaid rate increase a commonly cited solution</h3>
<p>When asked if raising Medicaid rates to Medicare levels would be sufficient to maintain current Medicaid patent caseload, 63% said that would be sufficient; 37% said they would be able to increase their Medicaid caseloads.</p>
<ul>
<li><em>If (Medicare and Medicaid) rates were the same, we would consider increasing our caseload.</em></li>
<li><em>Medicaid reimbursement has not increased in 20 yrs. Wages have changed dramatically.</em></li>
<li><em>Variance in reimbursement (between Medicaid and other payers) is no longer sustainable.</em></li>
<li><em>Increase in reimbursement for patient care would be helpful to keep on track with the other costs due to inflation.</em></li>
</ul>
<h3>Prior authorization an enormous burden for medical practices</h3>
<p>Without prompting by the survey, several respondents noted the toll administrative burden and prior authorization requirements contribute to economic and staffing challenges:</p>
<ul>
<li><em>Work to increase reimbursement and cut red tape. Prior authorizations are a killer for staff.</em></li>
<li><em>Help to improve prior authorization used as tactic to delay and deny care. Payer abuse in paying for approved services. Improve Medicaid rates to Medicare rates.</em></li>
<li><em>Decrease administrative burdens and barriers which add to cost of overhead and do not add value to practice, i.e., prior authorization, poor EHR interoperability, regular insurance audits, increasing reimbursement for primary care, reimbursement for nutritional counseling, improving access to MHP.</em></li>
<li><em>Commercial payers need to jump in and help by ending the onerous prior authorization processes. This alone would free up hours of precious staff time.</em></li>
</ul>
</div> | 12/19/2022 12:11:28 PM | 12/19/2022 12:00:00 AM |
| action-alert-how-you-can-help-cancel-medicare-payment-cuts | Action Alert! How You Can Help Cancel Medicare Payment Cuts | Advocacy | Shared_Content/News/Membership_Memo/2022/december-9/action-alert-how-you-can-help-cancel-medicare-payment-cuts | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/medicare-cta-1-645x425px.png" class="pull-right" alt="Protect patient access to care illustrated graphic" /></div>
<h5>December 9, 2022</h5>
<h2>Action Alert! How You Can Help Cancel Medicare Payment Cuts </h2>
<p>If Congress fails to act soon, physician Medicare payments will be cut by 4.5% on Jan. 1, 2023, due to regulatory changes enacted by the Centers for Medicare and Medicaid Services. Cuts of this magnitude would severely impede patient access to care and place further strain on an already stressed practice community. When adjusted for inflation, Medicare physician payments have dropped by 22% from 2001 to 2021. Physicians simply cannot afford to operate under the current payment system.</p>
<p>We have been raising the red flag over these cuts for months-and lawmakers are beginning to listen. But we need to keep the pressure on. The "lame duck" session of Congress is always a chaotic time with numerous priorities and interests vying to be included in the final must-pass package. It's urgent that the physician community push back on these cuts and ensure that physicians and patients don't get lost in the end-of-year shuffle.</p>
<p><strong>What can you do to help cancel the cuts:</strong></p>
<ol>
<li>Contact your lawmakers through this link and share it with your colleagues: <a href="http://www.bit.ly/PhysicianMedicare">www.bit.ly/PhysicianMedicare</a></li>
<li>Share this link with your patients: <a href="http://www.bit.ly/PatientMedicare">www.bit.ly/PatientMedicare</a></li>
<li>Reach out to your member of Congress to schedule a meeting/phone call.
<ul>
<li>Download the AMA'sCancel the Cuts Action Kit: <a href="http://www.bit.ly/MedicareActionKit">bit.ly/MedicareActionKit</a></li>
<li>Contact <a href="mailto:PoliticalAffairs@ama-assn.org">PoliticalAffairs@ama-assn.org</a> if you need help connecting with your member of Congress or need tips on how to effectively communicate your message and prepare for your meeting.</li>
</ul>
</li>
</ol>
<p>Time is running out. <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=/campaigns/96014/respond">Contact Congress now</a> and demand that they protect patients and practices by canceling these devastating Medicare cuts in their entirety before the clock strikes zero.</p>
</div> | 12/8/2022 2:18:17 PM | 12/9/2022 12:00:00 AM |
| cms-announces-rulemaking-to-improve-prior-authorization | CMS Announces Rulemaking to Improve Prior Authorization | Advocacy | Shared_Content/News/Membership_Memo/2022/december-9/cms-announces-rulemaking-to-improve-prior-authorization | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/administrative-burden-645x425px.jpeg" class="pull-right" alt="administrative burden illustration" /></div>
<h5>December 9, 2022</h5>
<h2>CMS Announces Rulemaking to Improve Prior Authorization </h2>
<p>In a breaking development this week, the Centers for Medicare and Medicaid Services announced the commencement of rulemaking to streamline prior authorization.</p>
<p>The proposed rule shares many elements of the Improving Seniors' Timely Access to Care Act (S. 3018/S.R. 3173)<em>, </em>national legislation for improving prior authorization supported by the American Medical Association and the WSMA. Rule provisions include concepts such as tightening turnaround times and use of an electronic portal among others and would apply to Medicaid and Medicare Advantage plans. <a href="https://www.cms.gov/newsroom/press-releases/cms-proposes-rule-expand-access-health-information-and-improve-prior-authorization-process">Read the CMS press release for details</a>.</p>
<p>Prior authorization is a top advocacy priority for the WSMA and we continue to push at all levels for improvements to the process in the interest of expediting access to care for patients and relieving administrative burden for physicians. We're pleased to see CMS take action on the issue with rulemaking.</p>
<p>At the state level, the WSMA has been formulating legislation for the 2023 legislative session that would effect similar improvements to prior authorization among state-regulated health plans. WSMA staff is assessing how our legislative proposal intersects with the draft CMS rule. We will continue highlighting this issue in Olympia and the "other" Washington and will keep members apprised of developments.</p>
</div> | 12/8/2022 10:29:58 AM | 12/9/2022 12:00:00 AM |
| prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-priorities | Prior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative Priorities | Advocacy | Shared_Content/News/Membership_Memo/2022/december-9/prior-authorization-abortion-access-medicaid-rates-top-list-of-2023-wsma-legislative-priorities | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/december/ls-2018-01-245-straightened-645x425px.jpeg" class="pull-right" alt="Capitol building" /></div>
<h5>December 9, 2022</h5>
<h2>Prior Authorization, Abortion Access, Medicaid Rates Top List of 2023 WSMA Legislative Priorities</h2>
<p>WSMA's government affairs team will highlight these and other WSMA legislative priorities during a webinar on <a href="https://us06web.zoom.us/meeting/register/tZApc-ugqz4pE9IXUUHeiTCjN4q1HKfMfLvo">Tuesday, Dec. 13, at noon</a>. The hour-long session will serve as an opportunity for WSMA members to preview the 2023 state legislative session that begins in January and learn more about WSMA's legislative priorities and the health care policy landscape. Members are encouraged to participate-there will be time during the session for you to provide feedback on any concerns or issues you or your practice are facing. Register for the webinar <a href="https://us06web.zoom.us/meeting/register/tZApc-ugqz4pE9IXUUHeiTCjN4q1HKfMfLvo">online</a>.</p>
<p>Medicaid reimbursement, prior authorization, and ensuring access to abortion and reproductive health care services will also be among the priority fiscal and policy issues that will be the focus of the 2023 WSMA Legislative Summit, scheduled for Feb. 3, in person at the Capitol. We hope you will don your white coats and join us in Olympia to help advocate for these WSMA legislative priorities-<a href="[@]wsma/events/legislative_summit/wsma/events/wsma_legislative_summit/Legislative_Summit.aspx?hkey=795731a5-79ba-45b0-b78b-b9dfbfc336e5">registration for the Feb. 3 event is free</a> (lunch will be provided).</p>
</div> | 12/8/2022 10:30:03 AM | 12/9/2022 12:00:00 AM |
| board-of-naturopathy-moves-forward-with-non-surgical-cosmetic-procedures-rulemaking | Board of Naturopathy Moves Forward with Non-Surgical Cosmetic Procedures Rulemaking | Advocacy | Shared_Content/News/Membership_Memo/2022/november-23/board-of-naturopathy-moves-forward-with-non-surgical-cosmetic-procedures-rulemaking | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/mortar-pestle-645x425px.jpeg" class="pull-right" alt="mortar and pestle" /></div>
<h5>November 23, 2022</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>Board of Naturopathy Moves Forward with Non-Surgical Cosmetic Procedures Rulemaking</h2>
<p>Despite overwhelming opposition from the physician community and a division within the naturopathic community, the Washington State Board of Naturopathy voted to move forward with its years-long effort to include non-surgical cosmetic procedures within their scope of practice. The proposal was slimmed down to focus on the use of botulinum toxin. Previous iterations included the use of dermal fillers and other inert substances.</p>
<p>The board will likely revisit this rulemaking during a <a href="[@]wsma/advocacy/legislative___regulatory/understanding_the_regulatory_process/wsma/advocacy/legislative_regulatory/understanding_the_regulatory_process/understanding_the_regulatory_process.aspx?hkey=0695da42-202f-458b-8127-cbfc07207c56">CR-102</a> hearing at its Feb. 10 meeting. The WSMA will attend the meeting to again share our patient safety concerns and our positions that the rulemaking is inconsistent with naturopathic medicine and that the Legislature should set a profession's scope of practice. The board is still receiving public testimony on this issue, and we encourage physicians and physician assistants to share their opposition to the proposal by emailing <a href="mailto:susan.gragg@doh.wa.gov">susan.gragg@doh.wa.gov</a>.</p>
<p>The WSMA would like to thank WSMA President Katina Rue, DO; Chris Chambers, MD; Andrea Kalus, MD; Kendra Bergstrom, MD; and Kate Impastato, MD, for delivering expert testimony on this issue, and for clearing their schedules to accommodate the meeting on short notice. We'd also like to thank the Washington Academy of Eye Physicians and Surgeons, Washington Society of Plastic Surgeons, Washington State Dermatology Association, and the American Academy of Dermatology for their continued partnership on this rulemaking.</p>
<p>If you have questions or thoughts on this rulemaking, please contact <a href="mailto:billie@wsma.org">WSMA Associate Policy Director Billie Dickinson</a>&nbsp;at <a href="mailto:billie@wsma.org">billie@wsma.org</a>.</p>
</div> | 11/23/2022 11:28:19 AM | 11/23/2022 12:00:00 AM |
| in-new-survey-practices-continue-to-grapple-with-economic-hardship | In New Survey, Practices Continue to Grapple with Economic Hardship | Advocacy | Shared_Content/News/Membership_Memo/2022/november-23/in-new-survey-practices-continue-to-grapple-with-economic-hardship | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/stethoscope-dollar-sign-645x425px.jpeg" class="pull-right" alt="Stethoscope in shape of a dollar sign" /></div>
<h5>November 23, 2022</h5>
<h2>In New Survey, Practices Continue to Grapple with Economic Hardship</h2>
<p>Results from a new survey from the WSMA and the Washington State Medical Group Management Association make clear that physician practices and clinics in Washington continue to face severe economic strain, putting at risk the ability of patients to access care in communities across the state.</p>
<p>Throughout the pandemic, the WSMA and the WSMGMA have jointly conducted economic impact surveys of physician clinics in Washington state to gauge the impact of the pandemic and pandemic-associated pressures on patient access to care and to help inform our advocacy on behalf of the physician community.</p>
<p>A few key highlights from the latest survey, which featured responses from 82 physician practices:</p>
<ul>
<li>89% have experienced staffing shortages due to COVID-19. Of those:
<ul>
<li>77% are experiencing challenges filling administrative staff positions.</li>
<li>75% are experiencing challenges filling medical assistant positions.</li>
<li>40% are having trouble filling nursing positions.</li>
<li>33% are having trouble hiring physicians.</li>
</ul>
</li>
<li>46% have had to reduce patient access. Almost 40% have had to reduce their office hours, as well as services and treatments offered to patients.</li>
<li>93% have less than four months days cash on hand. Industry standard is 18 weeks.</li>
<li>51% said that inflation has had a significant impact on their practice, while 44% said that inflation has had some impact on their practice. Of those impacted by inflation:
<ul>
<li>89% noted the rising cost of labor.</li>
<li>Over 30% have reduced office hours, patient access, and services/treatments offered to patients in response.</li>
</ul>
</li>
<li>Just over 50% are not confident they'll be able to provide the same level of patient access a year from now.</li>
<li>46% have had to limit Medicaid panels due to their financial situation. The most commonly cited solution: increasing Medicaid reimbursement rates to Medicare rates.</li>
</ul>
<p>Thank you to the practices that responded to the survey. The WSMA will use these data points as a snapshot of what is happening in practices across the state in its discussions with policymakers.</p>
</div> | 11/23/2022 11:19:36 AM | 11/23/2022 12:00:00 AM |
| 2023-medicare-part-b-final-rule-features-expected-payment-reductions | 2023 Medicare Part B Final Rule Features Expected Payment Reductions | Advocacy | Shared_Content/News/Membership_Memo/2022/november-11/2023-medicare-part-b-final-rule-features-expected-payment-reductions | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/medicare-barcode-645px.jpg" class="pull-right" alt="Medicare barcode graphic" /></div>
<h5>November 11, 2022</h5>
<h2>2023 Medicare Part B Final Rule Features Expected Payment Reductions</h2>
<p>The Centers for Medicare &amp; Medicaid Services has released the <a href="https://www.federalregister.gov/public-inspection/current">final rule for the CY 2023 Medicare physician fee schedule</a>. As expected, the rule contains provisions that, when combined with other cuts to the program, amount to about a 10% reduction in Medicare physician payments starting Jan. 1. The WSMA, the American Medical Association, and much of organized medicine are strongly opposing these cuts and urging congressional intervention before the end of the year. Join your voice to ours by <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fcampaigns%2f96014%2frespond">contacting your congressional representatives today</a>.</p>
<p>In the rule, the 2023 Medicare conversion factor will be reduced by approximately 4.48% from $34.61 to $33.06. This incorporates the budget neutrality adjustments, which are required by law to ensure payment rates for individual services don't result in changes to estimated Medicare spending, the required statutory update to the conversion factor for 2023 of 0%, and the expiration of the 3% supplemental increase to physician fee schedule payments for 2022.</p>
<p>In addition to the final rule's 4.48% reduction for physician services, congressional Pay-As-You-Go rules require an automatic 4% cut in the program starting in 2023 as a result of new federal spending having nothing to do with physicians. Unless <a href="https://physiciansgrassrootsnetwork.org/be-heard?vvsrc=%2fcampaigns%2f96014%2frespond">Congress acts by the end of the year</a>, cuts in physician Medicare payments will total 8.42% in 2023, which would severely impede patient access to care due to the forced closure of physician practices and put further strain on those that remained open during the pandemic.</p>
<p>In other top lines, courtesy of the Medical Group Management Association, the final rule:</p>
<ul>
<li>Finalizes implementation of provisions of the Consolidated Appropriations Act, 2022 that extend the application of certain Medicare telehealth flexibilities for an additional 151 days after the end of the COVID-19 public health emergency, such as allowing telehealth services to be furnished to patients in their homes.</li>
<li>Extends flexibilities to permit split/shared E/M visits to be billed based on one of three components (history, exam, or medical decision-making) or time until 2024.</li>
<li>Expands access to behavioral health by permitting marriage and family therapists, licensed professional counselors, and others to furnish behavioral health services under general, instead of direct, supervision.</li>
<li>Maintains the MIPS performance threshold at 75 points for the 2023 MIPS performance year/2025 payment year.</li>
<li>Adds five new MIPS Value Pathways related to nephrology, oncology, neurological conditions, and promoting wellness for voluntary reporting beginning in 2023.</li>
<li>Creates an advanced incentive payment pathway for certain low-revenue, new entrant accountable care organizations to bolster participation in the Medicare Shared Savings Program.</li>
</ul>
<p>For more analysis of the rule's provisions, <a href="https://www.ama-assn.org/health-care-advocacy/advocacy-update/nov-5-2021-advocacy-update-spotlight-final-rule-2022-medicare?utm_source=SFMC&amp;utm_medium=email&amp;utm_term=1152021&amp;utm_content=21-9997+Advocacy+Update+Newsletter+110521&amp;utm_campaign=Advocacy_Email_Newsletter_AdvocacyUpdate&amp;utm_uid=8809453&amp;utm_effort=">see this AMA article</a>. Additional information about the final rule is available in the <a href="https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2023-medicare-physician-fee-schedule-final-rule?utm_source=email&amp;utm_medium=marketo&amp;utm_campaign=gov-washingtonconnection-oct-2022-regalert1031&amp;mkt_tok=MTQ0LUFNSi02MzkAAAGH1B53i5dWXBFoq6oxvHPyLpGNzdAQLASX61P5QkHiBNI8SoXosd1Z8l2xi4GQP6sqt18RwTR3U32mDW841r76RXp6PmAH2R_yonQD5eFwHQ">2023 Medicare Physician Fee Schedule Final Rule fact sheet</a>.</p>
</div> | 11/8/2022 4:11:47 PM | 11/11/2022 12:00:00 AM |
| election-update-democrats-signal-strong-showing | Election Update: Democrats Signal Strong Showing | Advocacy | Shared_Content/News/Membership_Memo/2022/november-11/election-update-democrats-signal-strong-showing | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/i-voted-stickers-645x425px.jpg" class="pull-right" alt="I Voted stickers" /></div>
<h5>November 11, 2022</h5>
<!-- **************************NEW ARTICLE****************************** -->
<h2>Election Update: Democrats Signal Strong Showing</h2>
<p>After months of buildup and drama, the 2022 midterm elections were held this past Tuesday, Nov. 8. Early returns show Democrats picking up a seat in our state's congressional delegation and maintaining wide majorities in both chambers of the Washington State Legislature. But "early" is the operative word as our state's mail-in voting system yields late ballot returns that can shift races substantially. The <a href="https://results.vote.wa.gov/results/20221108/">Washington Secretary of State's website</a> displays the latest results, and your WSMA will continue to provide election updates as late votes are counted (below results are current as of Thursday evening).</p>
<p>Top of mind for the WSMA are the two physician candidates in the field. Rep. Kim Schrier (D-8<sup>th</sup> Congressional District) was staked to a 52-48 lead in her swing district reelection effort. Lelach Rave, MD, a pediatrician running as a Democrat for an open seat in North Seattle's 46<sup>th</sup> Legislative District, was trailing in her race by a margin of 56-43.</p>
<p>In other high-profile races, Democrat Sen. Patty Murray defeated Republican challenger Tiffany Smiley, Democrat Marie Gluesenkamp Perez is leading Republican Joe Kent 51-49 in Southwest Washington's 3<sup>rd</sup> Congressional District, and Democrat Steve Hobbs is leading independent Julie Anderson by a margin of 49-47 for secretary of state.</p>
<p>If Tuesday's vote counts were binding, Democrats would be adding to their already wide majorities in Olympia, picking up one seat in the state Senate and three seats in the state House. After the first day of counting there were more than 600,000 votes yet to be counted, representing around 27% of the total ballots received. Recent experience shows that Republicans tend to vote later, and if the pattern holds it's likely many races will tighten and a few will flip, likely yielding a dynamic in Olympia that's similar to what we've seen in recent years.</p>
<p>Campaign themes were well-worn by the time voters cast their ballots, with Republicans focusing on concerns about inflation and public safety, while Democrats highlighted the importance of ensuring access to abortion and reproductive health care services. Republican hopes for a "red wave" were tempered by results in August's primary election that didn't live up to their expectations, though they still had aims of making gains in the state Legislature that don't look to be materializing.</p>
</div> | 11/8/2022 4:11:41 PM | 11/11/2022 12:00:00 AM |
| physician-feedback-needed-on-renewed-naturopath-scope-effort | Physician Feedback Needed on Renewed Naturopath Scope Effort | Advocacy | Shared_Content/News/Membership_Memo/2022/november-11/physician-feedback-needed-on-renewed-naturopath-scope-effort | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2022/november/mortar-pestle-645x425px.jpg" class="pull-right" alt="mortar and pestle" /></div>
<h5>November 11, 2022</h5>
<h2>Physician Feedback Needed on Renewed Naturopath Scope Effort </h2>
<p>The WSMA continues to push back on efforts of various nonphysician health professions to expand their scope of practice without commensurate training and patient safety protections in place. A key part of WSMA's defense on your and your patients' behalf is providing physician expertise to help educate policymakers on the patient safety implications of these efforts. One such recent effort is underway by the Washington State Board of Naturopathy. Learn more about the effort and how you can help.</p>
<p>For the past several years, the Washington State Board of Naturopathy has made an effort to <a href="https://content.govdelivery.com/attachments/WADOH/2020/12/31/file_attachments/1637208/WSR%2020-24-042.pdf" target="_blank" rel="noreferrer">expand naturopaths' scope of practice to include nonsurgical cosmetic procedures through the rulemaking process</a>. If adopted, this change would allow naturopaths to administer botulinum toxin, dermal fillers, and other inert substances for cosmetic purposes. The education and training required to perform these procedures would be decided by the Board of Naturopathy, which comprises naturopaths and public members without experience in these procedures. While their progress on this rulemaking was stalled by other projects, the board has indicated it plans to refocus on the nonsurgical cosmetic procedure rulemaking.</p>
<p>The WSMA partnered with the Washington Society of Plastic Surgeons, Washington Academy of Eye Physicians and Surgeons, and the Washington State Dermatology Association to submit an <a href="javascript://[Uploaded files/News and Publications/newsletters/2022/wsma-delegation-letter-on-non-surgical-cosmetic-procedures-rulemaking.pdf]">official comment letter</a>&nbsp;that outlines our opposition to this proposal. We appreciate the numerous physicians and other specialty organizations who have also submitted comments opposing this proposal.</p>
<p>The Board of Naturopathy is still accepting public comment on this rulemaking. More than anyone else, the board needs to hear from physicians like yourself who have experience with these procedures. We encourage you to share your opposition to this proposal by emailing your comments to <a href="mailto:susan.gragg@doh.wa.gov">susan.gragg@doh.wa.gov</a> in advance of their Nov. 18 board meeting. Should you have questions about the rulemaking process or how to best engage with the board, email WSMA Associate Director of Policy Billie Dickinson at <a href="mailto:billie@wsma.org">billie@wsma.org</a>.</p>
</div> | 11/8/2022 4:11:50 PM | 11/11/2022 12:00:00 AM |