Health & Public Policy Committee Report - Winter 2002
By Robert McLean, M.D., FACP
Meeting with Rep. Nancy Johnson - The HPP Committee hosted Rep. Nancy Johnson in late August for a dinnermeeting which allowed us to discuss various health legislative issues for several hours. While the ACP's approach on details of many of the existing legislative proposals were different from those held by Rep. Johnson, she seemed to come away from our meeting with a greater sense of our physician perspective. In late September, Rep. Johnson as Chair of the Health sub-committee of the House Ways and Means Committee invited ACP as the only physician group to testify on pending Medicare regulatory reform legislation. The subsequent mark-up session made several substantial modifications to the bill that seemed to correspond to some concerns detailed by ACP President William Hall, MD, and the Johnson-Stark bill known as the "Medicare Regulatory and Contracting Reform Act of 2001" will clearly help physicians in the everyday practice of medicine if it moves through Congress as expected. Those attending our state Chapter meeting in late September enjoyed a review of the current legislative landscape given by Robert Doherty, the College's SVP, Gov. Affairs and Public Policy. He explained the change in legislative priorities since September 11 and subsequent desire to avoid divisive issues. Unfortunately, it would appear unlikely that a patient bill of rights will be a major topic this year.
State Activity - At the state level, we maintain a presence on the CSMS Legislative Committee that met in early October to establish an agenda for the state's legislative session in early 2002. While the State Budget passed in June did include a $3.9 million appropriation for reinstatement of dual eligible crossover payments to begin in July 2002, there was concern that expected state budget shortfalls now being recognized will allow the Governor and the Legislature to back out. Other legislative topics will likely include a push from large chain pharmacies to allow pharmacists to "collaborate" with physicians in management of several outpatient medications and be able to bill for these services (grave concern over this), possible medical liability reform due to concern over increasing malpractice jury awards and rapidly increasing malpractice insurance premiums, and, as always, efforts to regulate managed care regarding bundling, downcoding, and fairness in contracting. CSMS maintains an effective political presence in Hartford. I encourage our members to join CSMS for this important reason. I was made aware that only 11% of CSMS's total membership contributes to the Political Action Committee (PAC), a crucial arm of CSMS allowing it to be effective in representing the interests physicians throughout the state. Through CSMS, our Chapter is able to be better connected to the political process than we could otherwise afford. CSMS-PAC deserves your support. Our Chapter will try to establish more personal relationships with several key legislators from Hartford over the next few months at breakfasts being organized in different locations. Politicians respond to their local voters, and so we need more ACP physicians to help us. If you would like to join us for breakfast, please contact me (firstname.lastname@example.org).
Current Legislative Concerns - Most recently, the Center for Medicare and Medicaid Services (CMS, formerly known as HCFA) decided to cut Medicare physician payments 5.4% (while hospitals and home health are not facing across-the-board payment reductions) due to a flawed formula that ties physician payments to general economic indicators. There is legislation just introduced in the Senate in mid-November "The Medicare Physician Payment Fairness Act of 2001" (S. 1660) which would replace the 5.4% payment decrease with a 0.9% reduction. We need our legislators in Washington to hear that the 5.4% cut would be disastrous to many of our practices. A "Legislative Alert" on the topic is available at acponline.org, and I encourage everyone to look at the key points and fax a letter or e-mail to your representatives. I have made previous requests with minimal response. Other Chapters have compiled e-mail addresses of concerned physicians who receive e-mail alerts about urgent needs to contact politicians when issues or votes arise.