Surprise billing (or balance billing) hurts patient recovery and undermines the health care process. Last year, MSV supported SB 1763, which would have prohibited balance billing for emergency care and required physicians be paid the regional commercial average payment directly. It would have strengthened the prudent layperson standard by requiring the plans to cover emergency care, regardless of the final diagnosis. Despite unified support from the physician, hospital, and patient communities, the bill was killed due to health plan opposition and lobbying.
MSV participated in a workgroup this summer with the governor’s staff and health plan lobbyists to discuss the merits of MSV’s plan versus a benchmarking standard. While the workgroup will be releasing a report before January, it is not expected to endorse any legislation.
MSV intends to sponsor and support a similar bill to 2019’s SB1763 this upcoming session to put an end to surprise billing in the Commonwealth and remove patients from the process.
This past summer, Governor Northam, MD convened a workgroup comprised of CEOs from several health care interest groups, including: MSV, Anthem, Mary Washington Hospital, Sentara, HCA, The Commonwealth Institute, and VCU Health, amongst others. The workgroup has met for over 50 hours discussing conditions, processes, and services concerning COPN. The workgroup’s goal is to come to a consensus on a plan for meaningful reform.
MSV remains committed to increasing access to care and decreasing costs for patients by reforming COPN.
In 2019, the General Assembly approved a budget that raised Medicaid reimbursement rates to 70 percent of Medicare rates for primary preventative-care related billing codes and emergency codes. There was also a provision that raised Medicaid rates for mental health providers up to 100 percent of Medicare rates.
Virginia’s Medicaid reimbursement rates remain well below other states. Other states that have expanded Medicaid have proven that when reimbursement rates increase, patient access increases. This summer, MSV sent a letter to Governor Northam, MD outlining the need for increased Medicaid rates to be a part of his budget.
In October, MSV staff met with Secretary of Health and Human Resources Daniel Carey, MD, to advocate for increased rates and provide additional supportive evidence of the need to bring Medicaid rates closer to parity with the health care market.
MSV awaits the governor’s budget announcement in the coming weeks and will work to amend the budget to meet this important policy goal.
Physicians are keystones of communities’ health care, but the shortage of rural physicians will become worse if we do not act.
MSV supports funding the Physician Loan Repayment program as part of a comprehensive approach that increases physicians in underserved areas. Physicians go into medicine wanting to make a difference in the lives of patients. By easing the burden of student loan debt, physicians can practice in underserved areas. Engaging physicians in rural health care early in their careers encourages their long-term commitment and has a positive economic impact in these communities.
MSV is expecting several bills that will attempt to expand scope of practice for pharmacists, naturopaths, and optometrists.
Notably, the Virginia Pharmacists Association is seeking to grant pharmacists the ability to diagnose and prescribe treatment for influenza and strep throat. MSV will oppose these bills and others that jeopardize patient safety and care quality. MSV will also seek out passionate and knowledgeable advocates at the General Assembly to validate the complexities of treating and diagnosing patients.
Get in touch with MSV’s Government Affairs team at email@example.com to learn how you can get involved.