Advocacy Update - April 2019

With Governor DeWine’s budget now in front of them, the Ohio Legislature is getting down to substantive policy work.  New proposals are emerging that will impact patients, doctors and the practice of medicine.  Hear a review of some of the early key issues before the Legislature for consideration. Any CMA physician is welcome to join the Public Policy Committee to provide your input on these, or other, issues of interest.

To help understand the Ohio Legislature, it is helpful to know a bit about how they operate -- especially their biennial calendar.  The current two-year term began in January of this year and will conclude December of 2020. The biggest single legislative act they undertake is a two-year budget, which needs to be passed by June 30th. In addition to allocating 35 billion dollars in general revenue funds, this 1800+ page document includes policy initiatives on a wide-ranging list of topics.

Governor DeWine has introduced his budget, and the legislature is focused on that, while other legislative topics have begun to circulate for consideration:

  • Governor’s budget: maintain funding for Medicaid expansion. While this issue has some controversy in Washington as some to want to repeal Obamacare, the Medicaid expansion portion of this issue seems to have a political majority, for now, in Ohio

  • Governor’s budget – one policy proposal would require Ohio regulated health plans to offer telemedicine coverage, with the reimbursement rates to negotiated by parties. Employers are concerned, especially about facility charge add-ons. Outcome of this issue is uncertain.

  • Price transparency – while there is no formal legislation yet, this is an issue that everyone generally agrees in concept is a good thing; however, how to achieve this goal is the challenge. Providers believe that the insurance companies hold the key information - details of patients plan contact provisions. Without this information it is many times completely impractical for providers to have the correct information for patients. Insurance plans want providers to be on point for providing prices. Discussions are on-going about certain procedures and types of information. If any physician has good experiences with sharing pricing information with patients, contact us with your experience.

  • Out of network legislation. Another issue without formal legislation; however, this issue has real focus around emergency type situations when it appears that patients have limited choice. Proposals floating around based on Medicaid and/or Medicare rates, or average regional rates, etc. Lots of details to be worked out here.

  • Scope of practice issues:  Physicians general position has evolved to be supportive if a team approach is utilized in the law, with patient interests protected by their physician’s training being reflected as the team leader. Last year physicians supported expanded scope for PA’s; however, it looks like physicians will oppose 2 items introduced so far for CRNA’s and APRN’s who are interested independent practice and expanding prescribing authority. Psychologists may also seek expansion to include certain prescribing authorization.

Before leaving legislative topics, I would remiss to not talk about the recently passed heartbeat bill. Abortion is one of the most controversial policy issues in America and it is no surprise that physicians do not have a uniform position on abortion. What has emerged at the CMA is some common ground around evidence-based policy and the issue of increased criminalization of physician actions that are consistent with standards of care in their specialty. CMA supports evidence-based policy and opposes criminalization provisions. The heartbeat bill is headed to courts to resolve its Constitutionality. This has been the strategy and hope of the proponents all along. Many are concerned for Ohio’s climate for practicing medicine and attracting new physicians under these provisions. Over the next several years we will see how this plays out.

One final related topic has to do with our Franklin County legislators. The CMA has a program where we seek to have small group meetings between doctors and individual legislators to build relationships and discuss issues of the day. These are informal conversations, many times over breakfast. We welcome new doctors to this program.

If any of this captures your interest, Dr. Cotton and Dr. Costa welcome new committee members at any time.

Our next meeting is June 13th, hope to see you there.

AdvocacyMalcolm Porter