Connecticut State Medical Society 2010 Legislative Agenda

Health-Care Reform

CSMS has played an integral role in efforts at the state and federal level to establish meaningful health-care reform. We continue to assert that successful health-care reform will be achieved when everyone has access to health care services and not just insurance coverage. Every citizen deserves access to the highest quality of appropriate medical care. CSMS will continue these efforts, seeking to endorse and work for successful programs that ensure the availability of medical services for all Connecticut residents. Critical components of a comprehensive reform continue to be:
• Transparency in all transactions related to patient care and reimbursement.
• Access must be available statewide and services and benefits fairly distributed.
• Quality medical care must be delivered. Prevention and disease management must be cornerstones.
• Funding. Comprehensive quality patient care must be fully funded and allow funding to follow the patient, resulting in enhanced portability.

Fairness in Contracting and Transparency

CSMS continued to make significant progress in 2009 on this issue, successfully lobbying for legislation that limits unilateral changes during contract periods, expanding the transparency and availability of fee schedules and limited insurers’ ability to inappropriately take back payments made to physicians. CSMS will continue its legislative efforts to strengthen the position of physicians within the marketplace, allowing them to better serve their patients and community. The following will be legislative priorities for CSMS:
• Enact state exemptions from federal laws to allow physicians to negotiate as a group to strengthen their contracting abilities. Benefits would include the ability to seek opportunities to implement electronic medical record systems, cover increased liability insurance costs and support recruitment of new physicians.
• Establish stronger statutory guidelines for acquisitions and mergers of health insurance companies
• Establish transparency of medical costs funded by premium dollars
• Shorten timely payment periods for clean electronic claims
• Establish a statutory definition of network adequacy and strengthen provider directory adequacy requirements
• Allow for the assignment of benefits by a patient to the physician for allowable out-of-network benefits
• Clarify balance billing laws
• Ensure rating systems and pay-for-performance measures are based on sound medical standards rather than economic factors.
• Oppose the use of tiered and limited networks.
• Allow physicians to limit panel size based on insurance payor or insurance product
• Prohibit insurers from denying payment for pre-authorized services.
• Prohibit arbitrary bundling and downcoding

Professional Liability Insurance

Connecticut physicians continue to struggle with the cost and availability of professional liability insurance. Success can be seen in the fact that almost all policy-makers understand that successful health-care reform must at a minimum acknowledge the significant impact this issue has on the overall cost and availability of health care. CSMS has consistently supported common-sense reforms to our tort system and to the manner in which such claims are adjudicated; and it will continue to do so. Changes to the system that could prove beneficial are:
• The establishment of special health courts.
• Pre-trial screening panels.
• Expansion of pre-trial mediation requirements
• Immunity for physicians providing volunteer or pro bono services.
• Expanded protections for physicians providing mandated care such as services required under EMTALA
• Review and strengthening of peer-review laws.
The current system is expensive and often negatively impacts our health care system, increasing costs through defensive medicine. CSMS will seek to implement and support any measure aimed at mitigating the pressure felt by physicians through the lack of availability and affordability of professional liability insurance. It is the position of CSMS that due to the impact the current situation has on access to care in Connecticut, efforts to fix this problem must be part of the overall discussion of health-care reform.

Scope of Practice/Proper Use of Medical Professionals
Connecticut residents deserve the highest quality of health care delivered by trained and skilled professionals. We must work to ensure that non-physician health-care providers are able to practice to the fullest of their ability. However, in the interest of safety and quality within health care we must recognize that education and experience cannot be replaced by expansion of scope of practice through legislation.

Physician Workforce Issues
Connecticut continues to struggle to recruit and retain skilled physicians. CSMS will continue to fight for initiatives to make Connecticut more attractive to physicians. These include such items as:
• Reduce regulations that impede physician services such as those required by the Certificate of Need process
• Clearly define “surgery” in state statute
• Establish student-loan forgiveness and insurance-premium assistance programs for new physicians.
• Continue to address ER overcrowding and boarding issues

Medical Licensure for Uncompensated Care

Legislation should be enacted which validates other state licenses for medical providers seeking to provide uncompensated care in Connecticut on a limited basis

Criminal Background Check as a Condition of Medical Licensure

All applicants for medical licensure should be required to submit to a criminal background check. The Medical Examining Board should be granted the ability to use the results as a criteria when granting or denying a license.


CSMS is fully prepared to address these issues during the 2010 session of the Connecticut General Assembly. In addition, we will be vigilant in defending the practice of medicine from any incursions. For more information or to provide any comments, please do not hesitate to contact CSMS Vice President of Public Policy and Government Affairs Ken Ferrucci.

 

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