January 21, 2019

Key Issues - ACTION NEEDED

Two top priority issues are now before the legislature that need your support. See this week’s updates and how you can help.

Medicaid Reimbursement Rates

Del. Scott Garrett, MD and Sen. Emmett Hanger submitted budget amendments (303 #23h and 303 #4s) that would increase Medicaid reimbursement rates for physicians currently reimbursed below 75% of Medicare. The budget amendments will first be considered by the Senate Finance and House Appropriations Committees.  At this critical point, these committee members, as well as all members of the General Assembly, must hear from you to include the amendments in the final budget proposal.  This is a critical and urgent opportunity. Call and send a message now. Get more information on our website.

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Surprise/Balance Billing

On Thursday, MSV and physician specialty groups attended the House Commerce and Labor subcommittee balanced billing hearing. This year, balanced billing has been a hot topic before the General Assembly and legislators have considered prohibiting balanced billing altogether if the physician community did not develop a patient-friendly solution.

HB 1714 (Ware) would address emergency balanced billing; the bill would protect patients from balanced billing and ensure physicians are paid directly. In addition, the bill would pay providers a fair and reasonable amount. HB 1714 is supported by the entire physician community; MSV President, Dr. Richard Szucs, and Dr. Tricia Anest, MSV and VACEP member, testified in support of the bill. However, there are other bills supported by the insurance industry. If you have a relationship with a member of the House Commerce and Labor Committee, please reach out to our GA team.

Stay tuned for email legislative alerts that will have specific action steps to take to support these bills.

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Prior Authorization and Step Therapy

MSV supports SB 1607 (Dunnavant), a bill that would reform and streamline prior authorization for medications. The bill would also ensure payment for pre-approved surgeries and invasive procedures; during an approved procedure, if a physician provided appropriate additional medical care they would be reimbursed without requiring an additional authorization. This bill has been sent to the Senate Commerce and Labor Committee, but has not yet been scheduled for a hearing.

HB 2126 (Davis) is a step therapy reform bill that would create medically necessary exemptions to step therapy protocols and create an expedient exemption process for patients already on an effective treatment. This bill has not yet been heard, however, VCU first year medical students were at the Capitol advocating with several legislators this week on the issue.

Physician Assistants

HB 1952 (Campbell) and SB 1209 (Peake) were heard in the House Health, Welfare, and Institutions subcommittee and Education and Health Committee this week, respectively. Both bills would make administrative updates to Physician Assistant practice, bringing Virginia’s code in line with current Board of Medicine regulations.  MSV has been working closely with our Physician Assistant members as well as the Virginia Academy of Physician Assistants to support this effort.

Certificate of Public Need (COPN)

Bills have been filed for COPN ranging from complete repeal, to individual exemptions, to minor amendments to existing laws. SB 1526 (Sturtevant) would expedite the COPN process to permit additional psychiatric beds and facilities in the case of an emergency or crisis situation. SB 1614 (McDougle) would create a permitting process for endoscopic, urologic, and ophthalmic outpatient/ambulatory surgery centers. MSV maintains its position of modernizing the COPN process to support comprehensive reform that increases access to needed services, while still ensuring safety, quality, and the provision of charitable care.     

House of Medicine Wins

HB 1767 (Jones), SB 1543 (Surovell); Parents of Deceased Added as First Class Beneficiaries

This bill was favorably amended but would have expanded the list of beneficiaries who could recover in a wrongful death action; the bill proposed including the parents of the decedent if the decedent was providing them any support or services.  This change would apply to all wrongful death actions, including medical malpractice cases.

SB 1518 (Carrico) - Non-opioid pharmacological therapy and non-pharmacological therapy; health insurance coverage.

This bill would have directed the Boards of Medicine and Dentistry to develop regulations on opioid prescribing that already currently exist.  The MSV GA team spoke with the patron, explaining the current regulations, and he withdrew the bill.