What Does it Mean for Physicians Hospitals and Health Care Presenters Denny Maher MD JD Washington State Medical Association Taya Briley RN MN JD Washington State Hospital Association ID: 330286
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Slide1
The 2015 Legislative Session
What Does it Mean for Physicians, Hospitals
and Health Care?Slide2
Presenters
Denny Maher, MD, JD
Washington State Medical Association
Taya Briley, RN, MN, JD
Washington State Hospital AssociationSlide3
Objectives
Describe major policy and budget issues from 2015 legislative session
Identify key legislation affecting physicians, hospitals, and health systems
Consider how legislation will impact current practice
Understand issues not resolved by the legislature that may be the subject of ongoing policy debate Slide4
State Legislative EnvironmentSlide5Slide6
Ideas into Laws
Introduced
3390
Passed
604
Vetoed
6
Enacted
598
Percentage
18%
Last BienniumSlide7
Policy PrioritiesSlide8
WSHA
Proactive Policy Priorities
Successes:
Mental Health
Telemedicine
Pharmacy
Suspect and Inmate Care
All-Payer Claims DatabaseUnfinished Business:Work Force FlexibilityCrisis Standards of Care
www.wsha.org/policyadvocacy.cfm
Slide9
WSMA
Proactive Policy Priorities
Successes:
All-Payer Claims Database
Telemedicine
Mental Health
Scope of PracticeUnfinished Business:Grace Period FixNon-disciplinary Remedial ActionsGME FundingHealth Professionals Loan RepaymentMedicaid ReimbursementB&O TaxSlide10
Mental Health
In Re Detention of D.W.
Patient plaintiffs won, with WSHA and WSMA support
Short-term solutions
Long-term solutions
What would it take to get more psych beds and keep people out of inpatient treatment?Slide11
Support Mental Health System Improvements
SB 5649 passed:
Mandates data collection on ER cases when no bed available
Requires
regional support networks to administer an adequate network
of evaluation
and treatment services to ensure access to
treatmentExempts time prior to medical clearance from ITA timelines HB 1450 passed: Establishes mandatory outpatient treatmentRuling that bans ‘psychiatric boarding’ has health officials scramblingSlide12
Medical Practice Bills:
Scope of practice bills defeated
SB 5621 - Definition of dentistry
SB 5815 - Naturopath controlled substance prescribing
Mandatory reporting of breast density
SB 5040 defeated
Patient medication coordination
SB 5441 passedSurgical technologists requirementsSB 5049 defeatedSlide13
Telemedicine Payments:
SB 5175 Passed
Ensures payment
for services provided using
telemedicine technology
Includes “essential health benefits” requirement
Signed by Governor
Effective January 2017Slide14
Pharmacy Access:
SB 5460 Passed
Jointly supported by WSHA, WSMA and DOH
Allows hospitals to dispense “pre-pack” medications when pharmacies are not open
Changes burdensome licensing requirements for clinic pharmaciesSlide15
Radiology Benefit Managers:
HB 1183 Passed
Requires radiology benefit managers to register with the state
RBMs and PBMs not otherwise regulated
Hopefully will lead to regulation and use of accepted decision-making toolsSlide16
Suspect and Inmate Care:
SB 5593 Passed
Jointly proposed by WSHA and
law
enforcement
Requires that all law enforcement agencies guard hospital patients in law enforcement custody for violent or sexual crimes
Unless otherwise negotiated, payment for hospital services will be Labor & Industries (L&I) ratesSlide17
All-Payer Claims Database:
SB 5084 Passed
Broad coalition
Mandates that insurers contribute data
WSHA and hospitals can access quality data
Limited access to payment dataSlide18
Non-Disciplinary Remedial Measures:
HB 1135 Defeated
DOH request legislation
Would have allowed licensing boards to suggest education-based plans
Designed to improve patient safety
WSMA opposed after unfavorable amendments addedSlide19
Grace Period Fix:
HB 1626/ SB 5430 Defeated
Designed to fix reimbursement gap during “grace period”
Physician practices losing thousands of dollars
Hoping for interim work sessions to prepare for 2016 sessionSlide20
Issues WSHA Successfully Opposed
Levying a new 6% tax on hospitals
Prohibiting hospital partnerships
Mandating staffing regulations
Creating Extended Stay Centers with
no hospital regulations
Cutting Medicaid hospital clinic payments
Banning non-compete clauses for MDsReturning to psychiatric boardingDozens of others opposed or amendedSlide21
Issues WSMA Successfully Opposed
Changing definition of dentistry
Naturopath controlled substance
rx
Mandatory report of breast density
New requirements for surgical techs
Repeal of the PMP
Expanding beneficiaries in wrongful birth and wrongful life lawsuitsDozens of others opposed or amendedSlide22
New Medical School:
HB 1559 Passed
WSHA and WSMA were aggressively neutral
Amends
a
century-old
state statute that gave exclusive rights to provide medical education to
UWFocus on rural and community-based trainingFunding for accreditation process and startup?Funding for residency slots?Slide23
Budget: Where Are We Now?Slide24
Special SessionSlide25
Budget Chasm
Structural issues
Education funding
Class size initiative funding
State employee salaries and raises
Lean savings
Transportation budget
Health care issuesHospital Safety Net Assessment
Mental health capital
Mental health operating
Health Benefit Exchange budget
ResidenciesSlide26
To Tax or Not To Tax?Slide27
WSHA’s Position
Reasonable reforms and cuts
Responsible revenues to fund essential services
More equitable tax systemSlide28
Budget PrioritiesSlide29
WSHA Outstanding Issue:
SB 6045 - Hospital Safety Net Assessment Program
Extends program through SFY 2019 without ratcheting down
Maximizes federal match rate
Renews hospital contract
Senate version: Disproportionately benefits the state
House version: Shares
increase in benefits between state and hospitalsHow to fund residencies?Slide30
WSMA Outstanding Issues:
Enhanced Medicaid reimbursement
Not likely
Support for graduate medical education (GME)
Looks favorable
Repayment of health professional loans
Looks favorable
Avoid B&O tax increaseUncertainSlide31
Outstanding Issue for All: Mental Health Funding
Goals:
Sufficient funding to reduce or end psychiatric boarding for adults, adolescents and children
Resources need to be:
Statewide
Inclusive of inpatient and outpatient services
Include appropriate community support servicesSlide32
How You Can Help and Stay InformedSlide33
Resources
WSHA
www.wsha.org/policyadvocacy.cfm
WSMA
Legislative Action CenterSlide34
What Can You Do?
Respond to requests for action
Come to Olympia to testify or meet with your legislators
Schedule an in-district meeting; consider including your neighbors
Highlight your
care improvementsSlide35
What You Should Be Doing Now
Understand new opportunities
Example: Pharmacy pre-pack and licensing
Example: Telemedicine
Make sure partners are following new laws
Example: Designated Mental Health Professional reporting
Reach out to your local partners
Example: Law enforcement on guarding and paymentJoin WSMA and WSHA educational eventsWebcasts, Chelan, Annual MeetingSlide36
Possible
Non-Legislative Solutions
Charity care application
and notification
Community benefit
Non-compete clauses
Observation statusSlide37
Feel free to contact us if you have questions or would like additional information.
Taya Briley, RN, MN, JD
General Counsel
WSHA
TayaB
@wsha.org
206/216-2554Denny Maher, MD, JD Director of Legal AffairsWSMAdenny@WSMA.org206/956-3640