Legislative Planning for 2008
Medical Society of the State of NY
1
MSSNY Committee on
Legislation and Physician
Advocacy
S...
Legislative Planning for 2008
Medical Society of the State of NY
2
Welcome and Introduction
of Guests
George O. Stasior, M...
Legislative Planning for 2008
Medical Society of the State of NY
3
Recap of 2007 LEGISLATIVE
SESSION: Was MSSNY
Successful...
Legislative Planning for 2008
Medical Society of the State of NY
4
Lobby Day 2007:
Guests
Legislative Planning for 2008
Medical Society of the State of NY
5
MSSNY Secured $130M allocation for Excess
program.
MS...
Legislative Planning for 2008
Medical Society of the State of NY
6
MSSNY Secured introduction of legislation (A.8066,
Tow...
Legislative Planning for 2008
Medical Society of the State of NY
7
Defeated a proposed $400 increase in the physician reg...
Legislative Planning for 2008
Medical Society of the State of NY
8
Managed
Care
 Enacted into law: C.451
(S.3986, Hannon/...
Legislative Planning for 2008
Medical Society of the State of NY
9
Managed
Care
 Enacted into law: C.451 (Continued)
 Pr...
Legislative Planning for 2008
Medical Society of the State of NY
10
Public Health
 Accreditation for Practice Performing
...
Legislative Planning for 2008
Medical Society of the State of NY
11
Public Health
 Requires HIV Testing of Defendant in
S...
Legislative Planning for 2008
Medical Society of the State of NY
12
Public Health
 Physician Shortage
 A.3389 (Koon)/S.4...
Legislative Planning for 2008
Medical Society of the State of NY
13
Non-Physician
Practice
 Defeated several measures inc...
Legislative Planning for 2008
Medical Society of the State of NY
14
Other Coverage
Issues
 Mental Health Parity
 A.9263 ...
Legislative Planning for 2008
Medical Society of the State of NY
15
Anticipated Areas ofAnticipated Areas of
Legislative A...
Legislative Planning for 2008
Medical Society of the State of NY
16
 Civil Justice Reform/Regressive Liability Legislatio...
Legislative Planning for 2008
Medical Society of the State of NY
17
CIVIL JUSTICE REFORM
&
REGRESSIVE LIABILITY
PROPOSALS
Legislative Planning for 2008
Medical Society of the State of NY
18
Liability
Environment
 14% Increase NOW Brings Aggreg...
Legislative Planning for 2008
Medical Society of the State of NY
19
Number of Lawsuits Filed Remains High
Currently:
62% S...
Legislative Planning for 2008
Medical Society of the State of NY
20
Strategy for 2008
 MSSNY will work closely with Dinal...
Legislative Planning for 2008
Medical Society of the State of NY
21
Strategy for 2008
 MSSNY will provide Dinallo/Daines ...
Legislative Planning for 2008
Medical Society of the State of NY
22
Strategy for 2008
 Oppose Regressive Liability Bills
...
Legislative Planning for 2008
Medical Society of the State of NY
23
Strategy for 2008
MSSNY working with many industry pa...
Legislative Planning for 2008
Medical Society of the State of NY
24
NYS BUDGET & THE RE-
AUTHORIZATION OF THE
HEALTH CARE ...
Legislative Planning for 2008
Medical Society of the State of NY
25
Budget Exigencies Continue To Exist
Health Care Refo...
Legislative Planning for 2008
Medical Society of the State of NY
26
Strategy for 2008
Work with Dinallo/Daines Task Force...
Legislative Planning for 2008
Medical Society of the State of NY
27
Managed Care Reform
Legislative Planning for 2008
Medical Society of the State of NY
28
Consolidation within the Managed Care Industry
Continu...
Legislative Planning for 2008
Medical Society of the State of NY
29
Managed
Care
Strategy for 2008
 Work with Attorney Ge...
Legislative Planning for 2008
Medical Society of the State of NY
30
Non-Physician
Practice
 Series of Bills Introduced To...
Legislative Planning for 2008
Medical Society of the State of NY
31
Public Health
 Influenza and Vaccine Supply
 Healthy...
Legislative Planning for 2008
Medical Society of the State of NY
32
Enhance
Quality
 Protect Integrity of Quality Assuran...
Legislative Planning for 2008
Medical Society of the State of NY
33
Federal Issues
 SGR Reform and SCHIP
 Pay For Perfor...
Legislative Planning for 2008
Medical Society of the State of NY
34
Sometime in November, 2007: Structure of Budget
Annou...
Legislative Planning for 2008
Medical Society of the State of NY
35
Discussion of County MedicalDiscussion of County Medic...
Legislative Planning for 2008
Medical Society of the State of NY
36
Timeline for Program Development
September 28, 2007: ...
Legislative Planning for 2008
Medical Society of the State of NY
37
Resolutions Referred by the 2007
House of Delegates
 ...
Legislative Planning for 2008
Medical Society of the State of NY
38
We Look Forward to Seeing You
on October 16th.
Thank Y...
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Legislative Planning for 2008 Medical Society of the State of NY

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Legislative Planning for 2008 Medical Society of the State of NY

  1. 1. Legislative Planning for 2008 Medical Society of the State of NY 1 MSSNY Committee on Legislation and Physician Advocacy September 11, 2007 George O. Stasior, MD, ChairGeorge O. Stasior, MD, Chair Robert J. Hughes, MD, Vice ChairRobert J. Hughes, MD, Vice Chair
  2. 2. Legislative Planning for 2008 Medical Society of the State of NY 2 Welcome and Introduction of Guests George O. Stasior, MD, ChairGeorge O. Stasior, MD, Chair Robert J. Hughes, MD, Vice-ChairRobert J. Hughes, MD, Vice-Chair
  3. 3. Legislative Planning for 2008 Medical Society of the State of NY 3 Recap of 2007 LEGISLATIVE SESSION: Was MSSNY Successful? Gerard L. Conway , Esq. Senior Vice-President & Chief Legislative Counsel
  4. 4. Legislative Planning for 2008 Medical Society of the State of NY 4 Lobby Day 2007: Guests
  5. 5. Legislative Planning for 2008 Medical Society of the State of NY 5 MSSNY Secured $130M allocation for Excess program. MSSNY defeated Regressive Liability Bills-one of which was introduced in closing days of Session: Legislation to impose pre-judgment interest (S.6365, Maltese, et al) Legislation to Eliminate the Limitations on Attorney Contingency Fees (S.790, DeFrancisco) Legislation to Expand “Wrongful Death” Damages (S.54, DeFrancisco/A.5856, Weinstein) Liability Environment
  6. 6. Legislative Planning for 2008 Medical Society of the State of NY 6 MSSNY Secured introduction of legislation (A.8066, Towns/S. 4149, Volker) to establish medical courts pilot program MSSNY representative (Dr. Richard Peer) to serve on Dinallo/Daines Medical Liability Reform Task Force MSSNY instrumental in creation of provider coalition for Reform -comprised of representatives from Specialty Medical Societies, HANYS, GNYHA and certain group practices MSSNY Driving re-creation of NYCJR Campaign and involvement of broad business and private sector of NYS Liability Environment
  7. 7. Legislative Planning for 2008 Medical Society of the State of NY 7 Defeated a proposed $400 increase in the physician registration fee Assured continuation of ‘physician prevails’ language under Preferred Drug Program and defeat of proposed inclusion of anti- depressants on PDL Secured additional $3M and re-appropriation of $6M for physician HIT/education Secured $1M additional reimbursement to physicians who provide home medical care NYS Budget
  8. 8. Legislative Planning for 2008 Medical Society of the State of NY 8 Managed Care  Enacted into law: C.451 (S.3986, Hannon/A.8128, Gottfried)  Requires plan to pay for pre-authorized services unless it is discovered patient was not insured when service was rendered provided that plan asserts this defense within 120 days after date care provided.  Permit patient to seek independent external appeal when plan denies request for access to out of network specialist and patient’s physician believes treatment is “materially different” from the care available in network.
  9. 9. Legislative Planning for 2008 Medical Society of the State of NY 9 Managed Care  Enacted into law: C.451 (Continued)  Prohibits a health plan from denying payment for lack of pre- authorization for a surgical or other invasive treatment requiring sedation performed at the same time a pre-authorized procedure was performed provided.  Requires health plans and hospitals to continue to abide by the terms of a contract for two months following termination by either party, or renewal, which benefits the staff physicians and patients who become “pawns” during these often high-profile disputes.
  10. 10. Legislative Planning for 2008 Medical Society of the State of NY 10 Public Health  Accreditation for Practice Performing Office-Based Surgery (C.365) • Bill crafted by physician-directed Advisory Panel in conjunction with DOH. • Practices must be accredited by July 14, 2009. Must begins reporting Adverse events on January 14, 2007.  Healthy Schools Act • A.8698 (Nolan), and S.5892 (Saland): Each would establish nutrition standards for schools, Each Passed one House. Compromise expected in future.
  11. 11. Legislative Planning for 2008 Medical Society of the State of NY 11 Public Health  Requires HIV Testing of Defendant in Sexual Assault Cases (C. * ) • Requires testing of defendant accused of sexual assault.  Making HIV Testing Routine  A.9195 (Gottfried)/S.6326 (Hannon)- Would require physicians to routinely offer HIV tests to patients but continues written informed consent requirements. Passed Assembly; remains in Senate Health Committee.
  12. 12. Legislative Planning for 2008 Medical Society of the State of NY 12 Public Health  Physician Shortage  A.3389 (Koon)/S.476 (Bonacic)- Would provide a tax credit to physicians who provide specialty medical services in designated specialty shortage areas. Passed Senate; remains in Assembly Health Committee.  S.4914(Johnson)- Would provide tax credit for medical student loan interest expenses. Remains in Committee in Senate.  A.7605 (Pretlow)- Transfers unspent funds from undersubscribed to oversubscribed physician scholarship programs within State Education Department to facilitate more scholarship awards to medical students. Remains in Committee in Assembly.
  13. 13. Legislative Planning for 2008 Medical Society of the State of NY 13 Non-Physician Practice  Defeated several measures including:  Dentists performing cosmetic surgery (A.7044, Morelle)  Collaborative drug therapy management (S.2426, LaValle/A.3933, Canestrari)  Podiatrist expansion (S.1443, Libous/A.3168, Pretlow)  Naturopathy (S.2790, LaValle/A. 4510, Libous)  Optometry (S.4519, Libous/A.8001, Paulin)  Pharmacy immunization (S.1312, Fuschillo/A.2140, Paulin)  Chiropractor equal pay (S.1150(Johnson)/A.2830, Lentol)
  14. 14. Legislative Planning for 2008 Medical Society of the State of NY 14 Other Coverage Issues  Mental Health Parity  A.9263 (Morelle)/S.6234(Seward)- Clean up bill which among other things, changes the outpatient coverage from "twenty days of active treatment" to "twenty visits“. C.502  A. 8617(Tonko)/S.5929(Morahan); Would apply parity to governmental programs. Passed Assembly; remains in Senate Rules Committee.
  15. 15. Legislative Planning for 2008 Medical Society of the State of NY 15 Anticipated Areas ofAnticipated Areas of Legislative Activity AffectingLegislative Activity Affecting Organized Medicine In 2008Organized Medicine In 2008 Gerard L. Conway, Esq. Senior Vice-President and Chief Legislative Counsel
  16. 16. Legislative Planning for 2008 Medical Society of the State of NY 16  Civil Justice Reform/Regressive Liability Legislation  Re-Authorization of the Health Care Reform Act (HCRA) and Budget Issues  Managed Care  Non-Physician Health Care Provider Scope of Practice  Public Health and Education  Enhancing Quality of Health Care  Federal Issues Legislative Agenda 2008 Legislative Agenda
  17. 17. Legislative Planning for 2008 Medical Society of the State of NY 17 CIVIL JUSTICE REFORM & REGRESSIVE LIABILITY PROPOSALS
  18. 18. Legislative Planning for 2008 Medical Society of the State of NY 18 Liability Environment  14% Increase NOW Brings Aggregate Cost Increases over six years to:  Surgeons: up 122-136%  Radiologists: up 112-122%  ED Physicians: up 122-136%  OB-GYNs: up 102-112%  Neurosurgeons: up 122-136%  Internists: up 112-122%  Severity Continues to Rise- Up 25% between 2001-2005  Random Nature of Awards and Verdicts- Occur even where no negligence proven
  19. 19. Legislative Planning for 2008 Medical Society of the State of NY 19 Number of Lawsuits Filed Remains High Currently: 62% Surgeons (all classes) sued with claims pending 67% OB-GYNs sued with claims pending 71% Neurosurgeons sued with claims pending (MLMIC insureds) Liability Environment Documented Physician Supply Problem 16% Decrease in Number of General Surgeons in NYC 8% Decrease in Number of Primary Care Physicians in North Country
  20. 20. Legislative Planning for 2008 Medical Society of the State of NY 20 Strategy for 2008  MSSNY will work closely with Dinallo/Daines Task Force to advocate for reform Alternate Resolution Forums Identification/Accountability of Medical Expert Witnesses Reduce Threshold for Periodic Payments Personal Asset Protection Clear and Convincing Evidence Standards Frivolous Lawsuits State-Funded Subsidy to defray costs to Physicians Continuation of the Excess Insurance Program Liability Environment
  21. 21. Legislative Planning for 2008 Medical Society of the State of NY 21 Strategy for 2008  MSSNY will provide Dinallo/Daines Task Force historical data regarding operational impact of Cap on Pain and Suffering in Other States Liability Environment
  22. 22. Legislative Planning for 2008 Medical Society of the State of NY 22 Strategy for 2008  Oppose Regressive Liability Bills Legislation to Permit the Awarding of Pre-Judgment Interest Legislation to Eliminate the Limitations on Attorney Contingency Fees Legislation to Expand “Wrongful Death” Damages Legislation to Create a “Date of Discovery” Rule for the Statute of Limitations Legislation to Expand Damages Against a Non-Settling Defendant when Another Defendant Settles Liability Environment
  23. 23. Legislative Planning for 2008 Medical Society of the State of NY 23 Strategy for 2008 MSSNY working with many industry partners and friends has raised close to $1M to inform and energize the public to weigh-in in support of Civil Justice Reform MSSNY working with Rubenstein and Associates on media campaign Liability Environment
  24. 24. Legislative Planning for 2008 Medical Society of the State of NY 24 NYS BUDGET & THE RE- AUTHORIZATION OF THE HEALTH CARE REFORM ACT (HCRA)
  25. 25. Legislative Planning for 2008 Medical Society of the State of NY 25 Budget Exigencies Continue To Exist Health Care Reform Act/Budget Issues Insurance Coverage Initiatives Reimbursement Reform Excess Medical Liability Program Physician Registration Fee/OPMC Public Health Initiatives Graduate Medical Education Indigent Care HCRA/Budget
  26. 26. Legislative Planning for 2008 Medical Society of the State of NY 26 Strategy for 2008 Work with Dinallo/Daines Task Force on Universal Coverage -Explore strategies to address problem of uninsured (public and private) Work with Daines on Reimbursement Reform for Physicians serving beneficiaries of public programs Ensure continued funding for Excess program at an adequate rate Target Resources to Address Physician Supply and Mal- Distribution Problems Obtain greater funding for physician-driven health information exchanges (HIEs) Ensure appropriate funding for Trauma Care Prevent taxation of medical services/increase in registration fees HCRA/Budget
  27. 27. Legislative Planning for 2008 Medical Society of the State of NY 27 Managed Care Reform
  28. 28. Legislative Planning for 2008 Medical Society of the State of NY 28 Consolidation within the Managed Care Industry Continues –Today, 80% of Managed Care enrollees are enrolled in just seven HMOs In NYS, Managed Care Industry Profit is Up by over 93% between 2001 and 2005 Abusive Practices Continue –Tiering Programs Based on Cost and Not Quality (United, Aetna, Cigna) –Unfair Contract Amendments –Offensive Claims Processing Practices –Unacceptable Limitations on Non-Par Assignment Managed Care
  29. 29. Legislative Planning for 2008 Medical Society of the State of NY 29 Managed Care Strategy for 2008  Work with Attorney General, Superintendent of Insurance and Commissioner of Health to curb illegal and offensive contracting, claims processing and tiering practices.  Seek Legislative intervention – Collective Negotiation – Restrict Contract Amendments and Sale of Networks – Payment Assignability – Peer Review – All Products Clause Ban – Any Willing Provider – Physician Due Process – Hastening Payment Timeframe
  30. 30. Legislative Planning for 2008 Medical Society of the State of NY 30 Non-Physician Practice  Series of Bills Introduced To Inappropriately Expand Scope of Practice of Non-Physician Practitioners  Certified Nurse Practitioner  Dentists  Pharmacists  Certified Nurse Anesthetists  Optometrists  Naturopathy  Chiropractors  Registered Nurses  Genetic Counselors  Psychologists  Podiatrists
  31. 31. Legislative Planning for 2008 Medical Society of the State of NY 31 Public Health  Influenza and Vaccine Supply  Healthy Schools  Healthy Lifestyle  Public Health Preparedness
  32. 32. Legislative Planning for 2008 Medical Society of the State of NY 32 Enhance Quality  Protect Integrity of Quality Assurance Process – Protect against disclosure of statements made during peer review.  Mandate CME For All Physicians- Not Just Those Affiliated with Hospitals or Participating With MCOs.  Facilitate Utilization of Inter-Operative Health Information Technology By Physicians  Assure Physician Interests Incorporated in Properly Structured, State Initiated Pay for Performance Demonstrations
  33. 33. Legislative Planning for 2008 Medical Society of the State of NY 33 Federal Issues  SGR Reform and SCHIP  Pay For Performance  GPCI And Other Medicare Payment Reforms  ICD-10  Comprehensive Professional Liability Reform  Facilitate Purchase of Inter-Operative Health Information Technology By Physicians
  34. 34. Legislative Planning for 2008 Medical Society of the State of NY 34 Sometime in November, 2007: Structure of Budget Announced  January 2, 2008: Opening Day of Session  January 16, 2008: Deadline for Submission of Budget by New Administration Legislative Day: March 4, 2007  April 1, 2008: Budget Due Date June 19, 2008: End of Session (Anticipated) Important Dates
  35. 35. Legislative Planning for 2008 Medical Society of the State of NY 35 Discussion of County MedicalDiscussion of County Medical Society and Specialty MedicalSociety and Specialty Medical Society Legislative PrioritiesSociety Legislative Priorities George O. Stasior, MD, ChairGeorge O. Stasior, MD, Chair Robert J. Hughes, MD, Vice ChairRobert J. Hughes, MD, Vice Chair
  36. 36. Legislative Planning for 2008 Medical Society of the State of NY 36 Timeline for Program Development September 28, 2007: Draft program incorporating your suggestions mailed to Committee Members and Attendees. October 16, 2007: Meeting of State Legislative and Physician Advocacy Committee December 13, 2007: Council Consideration December 2007: Print Legislative Program December 2007/January 2008: Press Conference Important Dates
  37. 37. Legislative Planning for 2008 Medical Society of the State of NY 37 Resolutions Referred by the 2007 House of Delegates  Resolution 62: HMOs Decreasing Reimbursement & Patient Co-payments  Resolution 64: Ordering of Medically Indicated Diagnostic Tests By Specialists/Sub-Specialists  Resolution 90: Physician Reporting of Patients Who Should Not Drive  Resolution 104: United States Health Care and Gratuitous Privatization
  38. 38. Legislative Planning for 2008 Medical Society of the State of NY 38 We Look Forward to Seeing You on October 16th. Thank You!

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