Advocacy Update - May 2020

CMA Public Policy Consultant, Malcom Porter, is back with another Advocacy Update.

Like most areas of life today, COVID-19 has dominated the public policy world

Public health and economic recovery items are the focus what little activity there is in federal and state governments. Many “regular” items have been shoved to the back burner…and we are not sure when they will return. 

Federal - COVID-19

As our healthcare system adjusted to the public health emergency, tremendous financial strain has been placed on doctors and health systems.  In response, the federal government target some financial assistance to doctors with CARES Act payments made to physicians per Medicare fee-for-service formula. These payments did not help everyone and had their flaws; however, they did provide some needed financial support for many doctors.

Potential future legislation under discussion in Washington has additional items for consideration, although the outcomes are yet to be determined:

  • Medicare Accelerated Payment Program revisions

  • Increase Medicaid rates to Medicare fee-for-service rates

  • Require ERISA health plans to cover telehealth at rates comparable to Medicare levels

State - COVID-19

In Ohio, on May 1st the Governor opened healthcare for all procedures and tests that do not require overnight hospitalization. Allowing procedures requiring overnight stay will be determined at a future date as supplies of PPE’s and hospital capacities are monitored.

Issues under consideration for future legislation include prospective Medicaid payments and potentially increased professional liability protections.

A special note about the State Medical Board and changes to CME’s: It is important to be clear that CME requirements have not been waived, however the deadline for any enforcement has been extended until March 1 of 2021.

Also, the Ohio House has passed legislation that would limit the Governor and Health Director’s ability to issue emergency orders during a state of emergency. The Governor has promised to veto the legislation as it passed the House. Additionally, early indications from the Ohio Senate are that they are not interested to consider this bill anytime in the near future.

 State - non COVID-19

Details of Ohio’s legislative calendar are to be determined, but in general, the legislature will be holding some level of hearings and voting floor sessions for the next month or so, and generally will not be Columbus very much until after the November election.

Legislators returned this week for a few hearings, but it was not normal, as they adjusted procedures for public health compliance. It is not clear that the committee hearing process can work on a large scale if Legislators want to maintain the advised public health practices.

Issues not related to COVID-19 or Ohio’s economic recovery will be challenged to get much legislative attention: 

  • Surprise billings: this bill did get a hearing this week: organized medicine supports a path forward to include arbitration to resolve disputes and has concern that now is not the time to introduce a major change in business operations.

  • Other bills that are in committee, that may be “treading water”:

    • Scope of practice:

      • APN independent practice 

      • Psychologist script authority

      • Physician Assistants   

    • MH insurance coverage parity

    • License reciprocity…exempt medicine, already have expedited process

    • Tanning ban for people under 18

    • Non-medical formulary switching prohibited (generics exempted)

    • Co-Pay Accumulator - don’t put patients in middle - this fight is between insurance and pharma

Future Issues:

What healthcare adaptations have been made that we want to keep after lifting of state of emergency? TBD. Items like tele-health provisions, etc.

Prior Authorizations: State House of Medicine coalition committed to follow up on the 2019 Q4 statewide survey: What further changes in PA law/regulation would be most impactful in supporting patients/doctors?

2020Elections

CMA intends to continue its program of interviewing officeholders and candidates of both parties for US Congress, Ohio House and Ohio Senate; however, the format and timing of this process remains uncertain.  More to follow when public health guidance is clearer for these kinds of meetings.

Have questions? Email malcolmjporter@aol.com

Advocacy, COVID-19Malcolm Porter