As we approach September, it is time to reflect on our first dedicated year of grassroot advocacy. Our lobbyist has been with us for almost a year- a year full of challenges and opportunities. The rest of the year will keep us busy, but in a good way.
Here is an update on grassroots advocacy activities that have occurred since our last newsletter article and a strategy moving ahead.
FALLING BACK INTO ACTION: CO-PAYMENT ACCUMULATOR
Our lobbyist has been quite busy working with our colleagues at the state and federal level to enact legislation to prevent Accumulator Adjustment Programs within certain state regulated plans. Brian Henderson, CSRO Government Relations Director, and Ms. Shoemaker continue to meet to discuss state strategy. For sake of reference, PRS and CSRO are active partners in the PA Make All Copays Count Coalition (Coalition). The Coalition has recently commenced meetings with key House and Senate Insurance Committee staffers, and the staff of Senator Judy Ward (sponsor of the Senate bill) to attempt to move these bills within the state legislature.
The Society has been seen as a crucial partner in this endeavor. Our lobbyist has personally touched base and within a group setting with key members of the Pennsylvania Insurance Department (DOI) to solicit their input on the directive. Draft amendments by DOI were circulated to Senator Ward’s office, Representative Gleim’s office (sponsor of House Bill 1644), and to Coalition members for their review and comments. After careful deliberation by the Coalition, it was decided that the DOI amended version is unacceptable. Areas that are non-negotiable for Coalition members include exceptions language and the addition of “Creditable Drug Coverage” provisions. Next steps include the Coalition forwarding enacted co-pay accumulator language from Arizona to DOI for their input as a potential alternative and collaborating with Senator Ward’s staff to assist in moving the bill out of committee. Although enactment of this bill will be an uphill battle, we will keep fighting. Updates will be given as available.
For more information, or to obtain copies of Senate Bill 196 and House Bill 1664, check out the advocacy section of our website.
FALLING BACK INTO ACTION: COVID-19 AND RELATED LEGISLATIVE ISSUES
In our last newsletter article, we were cautiously optimistic that COVID would be taking a downturn as more and more individuals were getting vaccinated. However, now we are dealing with the Delta variant, third booster shots, controversial discussions on mandatory vaccinations and masking in schools, and how to tackle COVID during an upcoming flu season.
On the federal level, the Biden Administration continues to extend the Public Health Emergency Declaration. If it is in place, any federal rulemaking or policies that were relaxed or initiated during the pandemic remain in effect. We will continue to advocate for those policies that have assisted in providing patient care (such as Medicare coverage of telemedicine) to continue throughout the duration of the declaration is over and/or beyond if applicable. Our national colleagues at ACR, CSRO, AMA and other national medical specialty organizations are keeping on top of these important issues and will continue to engage their state organizations to jump into action.
However, at the state level, there is much work to do in this regard. The state legislature enacted legislation that required a constitutional amendment change to limit any governor’s authority to declare a Public Health Emergency (PHE) to 21 days- regardless of the issue. All state regulatory and policy relaxations and/or changes would have to be vacated after the PHE. For sake of education, a Pennsylvania constitutional change must be voted on by voting citizens of the commonwealth prior to being enacted. This past spring, the referendum was on the state primary ballot and got a majority vote. This constitutional change has made Pennsylvania the only state limiting their governor’s powers during a public health emergency (or any emergency declaration for that matter).
So, what does that mean for PRS? The end of our state’s PHE is September 30. Our lobbyist is reviewing the significant impact of these changes to our members and will provide an analysis. After initial review, temporary regulation relaxation on the use of telemedicine, relaxed hospital practice privileges for those not on hospital staff, relaxed collaboration between CRNPs, PAs and other non-MD providers, and delayed state medical license renewals are just a few crucial directives that will end on September 30. Our colleagues at PAMED, along with various coalition partners, are taking the lead on grassroots advocacy efforts. PRS is involved in many of these coalition meetings to advocate for the continuation of these key initiatives to ensure that our patients do not have a disruption of service or face additional barriers to obtain care. Be prepared to fall into action as soon as we need you.
FALL BACK INTO ACTION: PRIOR AUTHORIZATION
House Bill 225 and Senate Bill 225 were introduced early this legislative session related to prior authorization. PRS sent out a solicitation in late June, targeting members residing and/or laboring in senatorial districts of Senate Banking and Insurance Committee members to request an affirmative vote in committee. As a result of medical specialty collective grassroots advocacy efforts, Senate Bill 225 was voted out of the committee on June 25th with significant amendments. The bill now resides on the Senate calendar until they return in late September. For a copy of the amended version of the bill, feel free to ask our lobbyist or get a copy on our website.
FALL BACK INTO ACTION: ASSISTING OUR COLLEAGUES WITHIN PAMED
Our friends at PAMED have taken the lead on crucial legislative and regulatory initiatives, such as scope of practice expansion, medical malpractice, change of venue for liability actions, non-disclosure agreements and payer relations.
House of Delegates:
Although we do not have a dedicated representative this year at HOD, our voice can still be heard. Our colleagues at the Pennsylvania Academy of Dermatology have introduced a House of Delegate Resolution on non-medical switching. After careful review by Drs. Denio and Killian, we wholeheartedly endorsed their resolution.
Prior to the virtual HOD in October, Ms. Shoemaker will review all HOD resolutions and provide a comprehensive overview to determine if we want to comment and/or provide support to additional resolutions.
Other PAMED-Led Legislative Initiatives:
Informed Consent: Senate Bill 425 (NOW ACT 61 of 2021) was enacted quickly during this legislative session. A Quick Tip created by PAMED is enclosed for your review.
Scope of Practice: PAMED continues to keep on top of all attempts by non-physician providers to expand their scope in areas that do not reflect their clinical knowledge, medical education, and expertise. Our lobbyist will continue to keep us in the loop and prepare us to get engaged at the most appropriate times.
FALLING BACK INTO ACTION: ASSISTING OUR FEDERAL PARTNERS
PRS has made a concerted effort to assist our federal rheumatology, medical specialty and consumer-based partners when proposed policymaking affects our patients.
Over the past few months, PRS has:
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Signed onto CSRO joint letter Urging COVID Vaccinations for Immunosuppressed Patients.
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Signed onto CSRO joint letter Supporting HR 315: Extending Moratorium on Medicare Sequester.
- Signed onto joint letter supporting ACR’s Application for CDC Grant.
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Signed onto letter with ACR expressing concern/opposition to July 2020 Office of the Inspector General’s (OIG) report/recommendation on excluding self-administered versions of Orencia and Cimzia in Medicare Part B payment calculation.
- At the request of the Fracture Prevention Coalition, PRS signed onto a letter thanking US Senators Cardin and Collins for introducing S.1943 (Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021).
Our lobbyist and your leadership have participated and/or will be participating in the following grassroots advocacy efforts:
- Our lobbyist, PRS President Dr. Denio and other PRS members attended the Alliance of Specialty Medicine Virtual Capitol Day on Thursday, June 17. Although various topics and numerous medical specialties were represented during these day-long meetings, Dr. Denio had the opportunity to express appreciation/ask questions from Congressman John Joyce, MD, member of the Pennsylvania Congressional delegation.
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PRS Advocacy Committee Chair Dr. Killian forwarded an article to our lobbyist informing her that CMS intends to rescind the former Administration’s interim rule creating Most Favored Nation (MFN) for Medicare Part B recipients. A link to the article is included here: CMS nixes 'most-favored nation' pricing model for Medicare Part B (healio.com)
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CSRO’s State Society Advocacy Conference will be held VIRTUALLY on September 11. PRS President Denio and our lobbyist will be attending. Information is available on the CSRO website.
FALL INTO ACTION: ATTEND OUR ANNUAL MEETING
Last, but not least, one of the best ways to get politically active is to educate our members about grassroots advocacy, our issues and how to get engaged. At our annual scientific meeting, scheduled for September 18-19, 2021, there will be a presentation on PRS advocacy. Please check out our website for information or to register.
As we stated at the beginning of this article, 2021 is a year full of challenges and opportunities. To tackle our aggressive grassroots advocacy efforts on the state and national level, we can use all your help. Please do not hesitate to reach out to our lobbyist via email (dshoemaker@pamedsoc.org) or Dr. Killian at pjkill@hotmail.com if you have any questions, need more information, or want to get involved.
Happy Fall! See you at the PRS Annual Meeting!!!
