2012 Legislative Agenda

• As Medicaid enrollment is expected to grow and the commonwealth faces an expected $500 to $750 million shortfall in the Medicaid budget, it is critical for Virginia to protect its Medicaid provider network. Our health care system is already strained to provide care to existing Medicaid enrollees.

• Virginia’s office-based physicians supported 90,464 jobs in Virginia (AMA Economic Impact Study 2009). In addition, Virginia’s office-based physicians created a total of $21.5 billion in direct and indirect economic output in 2009.

• If cuts to Medicaid provider payments are enacted, many physicians would have to make difficult business decisions like reducing staffing, compensation and benefits for their employees, not to mention the increased difficulty patients would have in finding the care they need.

• Physicians remain committed to a collaborative patient-centered team approach to health care, as well as a willingness to assess the impact of any scope of practice changes on patient care and quality before offering our support or opposition. Balancing the nexus among health care workforce capacity challenges, providing quality patient care and ensuring access to care is a top priority for MSV.

• Physician Assistants: MSV will support efforts by physician assistants (PA) to change the physician to PA supervision ratio from 1:2 to 1:6. MSV supports this initiative in which PAs will still work under the leadership and supervision of a physician.

• Nurse Practitioners: MSV will support legislation crafted after a series of talks with the Virginia Council of Nurse Practitioners (VCNP) over the last two years. VCNP will seek a bill that outlines a team-based care model designed to help improve access to physician and NP care and reduce paperwork. The changes will emphasize a consultative and collaborative approach between physician and NP with the physician providing leadership and management of the care team. Other changes will be made to provide NPs more flexibility to treat patients in nursing homes and free clinics, as well as an increase in the physician to NP management ratio from 1:4 to 1:6.

• MSV supports establishing a statutory definition of surgery to clearly define what constitutes surgery, who may perform surgical procedures on patients, and which regulatory mechanisms are appropriate to ensure patient safety and quality. Defining surgery in the Virginia code will accomplish this without unnecessarily restricting physicians or other professionals from practicing to the appropriate limits of their education and training.

• MSV and member physicians have been active participants in the Virginia Health Reform Initiative, which most recently has focused on health benefit exchanges. MSV continues to work to ensure that physician and patient interests are represented and heard as changes are considered to improve Virginia’s health insurance and health care delivery systems.

• MSV is prepared to address any legislation that would be harmful to patients and the physician community. Often such legislation is well-intentioned, but may have unintended consequences that will affect patient care or quality.