The 152nd General Assembly reconvenes on January 9, 2024. MSD physicians have been engaged in critical health care issues to ensure legislators are ready for session in January. A “pre-file” of legislation was released by the House of Representatives on December 14th. There are two new bills and one substitute bill for MSD to review related to health care that will be critical to monitor in the coming year.  

Meeting with Speaker Longhurst

MSD held a critical meeting with the newly appointed Speaker of the House, Valerie Longhurst. Speaker Longhurst shared her visions for a well-oiled Legislative machine, including ways to avoid last minute legislation during an election year. The Speaker’s top priority and passion is mental and behavioral health. MSD shared the 2024 legislative priorities with her including, Prior Authorization, Primary Care Reform, Physician Workforce, and Educational Transparency. Speaker Longhurst expressed interest in how the state tackles workforce issues, a challenge for many industries. Our physicians shared that it is a multi-prong initiative including reimbursement, liability, removing mandated education, and expansion of loan requirements. For more information on current legislation, please check out the Delaware General Assembly. 

Delaware Pre-Authorization Reform Act of 2023

MSD, along with the Delaware Healthcare Association (DHA), authored a bill to significantly reform the prior authorization process. SB 10, the "Delaware Pre-Authorization Reform Act of 2023," was introduced on June 8. In the off session, MSD is spear-heading working meetings with Senator Townsend, the bill sponsor, DHA, payors, physicians, and critical stakeholders to ensure bill is ready to be discussed in committee at the opening of the session. The Association of Health Insurance Plans (AHIP) and the American Medical Association (AMA) have both provided feedback and comments on the bill. While AHIP is relying heavily on existing language of the signed Pennsylvania Prior Authorization Bill, representatives from the AMA believe that the bill is a good start but can be improved to enhance timelines and patient protections. MSD is scheduling a meeting with member physicians and Senator Townsend later this month to ensure the legislation is ready for the 2024 legislative session.

Primary Care Reform

Primary Care Reform remains a strategic priority for MSD. Our physicians have continued crucial conversations with Senator Townsend, the bill’s sponsor, in the off-season about concerns in the delays of implementation of SB 120. The Primary Care Reform Collaborative (PCRC) of the Delaware Health Care Commission (DHCC) has proposed a model based on a PMPM amount with a Standard Quality Incentive (SQI) (E&M codes) and prospective Continuous Quality Incentive (CQI) (value-based care transformation) components. The other consideration that Delaware is looking at is applying for a new CMMI grant, but will most likely not be an early adopter of the new AHEAD model.

MSD is coordinating a roundtable of member Primary Care physicians to meet with the bill sponsor before the end of the year. The MSD Primary Care Subcommittee is working to ensure that Primary Care has a seat at the table in reviewing the models and metrics that effect reimbursement.

Alzheimer's Disease and Other Dementias Mandatory Education

In late October, MSD met with Senator Mantzavinos, the bill sponsor for SB 283 (151st General Assembly) and its sister bill, SB 185, related to continuing education for the “diagnosis, treatment, and care of patients with Alzheimer’s disease or other dementias.” MSD made it clear that legislation regarding regular CME education is not the ideal pathway to improving patient care. SB 185 delays the implementation of SB 283 “to allow the Division of Professional Regulation (DPR) more time to implement these requirements.” During the meeting, MSD member physicians, staff, and lobbyists discussed pros and cons of this legislation. Due to the growing aging population in Delaware, the Senator is open to considering changes to the legislation. MSD will be seeking additional time with the bill sponsor in the new year to address a valuable one-time education for the physicians of Delaware. If you have any feedback regarding the topics of “diagnosis, treatment, and care” related to CME, please contact Lisa Gruss at Lisa.Gruss@medsocdel.org.

Access to Mammograms

HB 253 is a bill that would update the Delaware Code relating to mammograms. This Act’s goal is to increase access to mammograms for women 40 years of age and older. Although MSD applauds the bill sponsor, Representative Williams, for their initiative to make preventive care more accessible to all, the bill lacks details regarding follow-up to abnormal results and liability. Dr. Varipapa will be writing a letter to the bill sponsor on behalf of MSD regarding our concerns. We encourage physicians to also reach out to their local legislator regarding concerns about this bill. 

Educational Transparency

MSD hosted a small work group of Delaware physicians and stakeholders to address Educational Transparency (Title Misappropriation) and what they would like to achieve through legislation. In Delaware, legislation exists regarding the use of the word “doctor” in the clinical setting. However, with the growth of the digital age and advertising, additional clarity is needed within the legislation to ensure transparency to the patient, as well as their safety. The bill sponsor, Representative Minor-Brown, has agreed to work with MSD regarding legislation to ensure clarity in introduction of non-physician doctors to patients, as well as truthful and transparent advertising. However, non-physician degreed doctors would be able to continue to use their earned title. A follow-up meeting is being scheduled for mid-January with the bill sponsor.        

Did you know?

You don’t have to be on the MSD Government Affairs Committee to be active in advocacy. If you would like to support MSD by testifying or being onsite at a Legislative Session, please contact Lisa Gruss with your area of interest (mental health, prior authorization, insurance, etc.) and what days of the week are better for you!  Please let us know if you would just like to learn more about the legislative process. 

The Delaware Student Loan Repayment Program is one of several programs in the state to support physician and health care workforce challenges. The Health Care Provider Loan Repayment Program (HCPLRP) offers medical education debt relief for new primary care health care professionals who agree to practice in underserved areas of the state, committing to an initial contract term of two years. The Delaware Health Care Commission (DHCC) is responsible for the administration of the program and may award education loan repayment grants to new primary care health care professionals, up to $50,000 per year, for a maximum of four years. 

Both Doctors of Medicine (MD) and Doctors of Osteopathic Medicine (DO) are eligible for the program and Specialties include Family Medicine, Internal Medicine, Pediatrics, Psychiatry, Geriatrics, and Obstetrics/ Gynecology. Other non-physician degrees are eligible as well. There is a three-part application process: Employer Application, Health Care Practitioner Application, and Loan Information & Verification.  

For more details on specific legislation, or if you have other questions, please contact Mark B. Thompson, MHSA, Executive Director at 302-444-6958, Mark.Thompson@medsocdel.org or Lincoln Willis, lobbyist at 302-632-9898 or Lincoln.Willis@TheWillisGroupLLC.com.

MSD actively monitors all health-related legislation and maintains an active and visible presence in Legislative Hall on your behalf.

The Medical Society of Delaware Legislative e-Updates are a benefit to our members, providing information on legislative activity of interest in the 152nd General Assembly in Dover.