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Minutes of the Health & Public Policy Committee

April 5, 2000
Raffaello's
Hamden, CT

Attendance: Drs. Bernene, McLean, D'Avella, Haeseler, Mickenberg, Granata, Kerr, and Dolinsky. Guest: Mag Morelli (CSMS)

A. Federal Health Issues

The federal legislative landscape consisting of the below listed topics were reviewed. These topics have been chosen by the College as the focal issues for the upcoming lobbying Leadership Day in D.C. in May. Drs. McLean and Dolinsky will be representing our chapter and will report on how meeting with various legislators and staff are received. After the visit, Drs. Dolinsky and McLean will decide which legislator to invite to speak at our annual Chapter meeting in October.

  1. Patient Safety and College's support of IOM report
  2. Increasing Health Access
  3. Prescription coverage as Medicare benefit
  4. Patients' Bill of Rights - see Legislative Alert
  5. Physician Anti-trust protection - Campbell Bill

The group present wanted to emphasize that certain messages be heard by our legislators:

  • There are an alarming number of physician practices which are facing financial threats and may be forced to close. What will happen to all their patients? The amount of cost which must go toward administrative overhead in practices now is overwhelming.
  • The current state of our managed care system will seem to make medicine an unattractive field in the future.
  • There is tremendous intrusion into the delivery of care in our system, while at the same time there is tremendous threat from Medicare about fraud & abuse violations, when it is exceedingly difficult to keep up with changing rules and codes.

There are a number of other issues circulating, but it is uncertain what the level of interest will be at the federal level:

  1. Conquering Pain Bill of 1999
  2. Patient Medical Records Confidentiality
  3. All-payer funding for GME - tied in with Medicare debate
  4. Gun Control as public health measure

B. State health issues

Mag Morelli helped review the CSMS 2000 Legislative Agenda and what has transpired in the past few months:

  • Restore Medicaid funding for dual-eligibles: support for House Bill 5532 - Dr. Dolinsky wrote an op-ed which was published in the Hartford Courant on this topic, and he with other CSMS reps met with the editorial board of the Courant. It was not yet clear whether the paper would take a stance on the issue, and it appeared the biggest roadblock is Governor Rowland.
  • Oppose CON requirements for physician office surgery
  • Support statutory definition of Surgery - never got raised this year
  • Seek Additional Managed Care Reforms:
    • Further restrictions on use of mandatory formularies - a weak bill was raised, and the hope is that it will be defeated or not raised for vote and a better bill can be pushed next year
    • Establish fairness standards in physician contracting
    • Ensure managed care liability
    • Ban automatic downcoding of claims - a bill was to be reviewed in the Public Health Committee
    • Increase state protections of patient confidentiality

Other topics

There had been a meeting with HMO Directors in November, and our contacts with that group are still waiting to receive any drafts of formulary summary guides. It was emphasized that any work with such a group must be handled very carefully as we do not want to be viewed as endorsing the business practices of managed care plans. We must always be in the position of promoting better quality health care for our patients and a better practice environment for our physicians.

There was a lengthy discussion of how to enlist greater grass roots support. We should consider having postcards in our office reception rooms for patients to fill out and send to legislators (both Senate and House) on general issues of concern. When there is a particular bill about which we feel strongly, that is when an actual petition for signatures may be useful to even collect in our office.

To make our Chapter members more aware of our activity, the Governor's Council has recommended a brief "bullet" newsletter, and our Committee can place legislative updates which need to be timely there. As well, in an effort to promote truly improved quality of care delivered in our communities, we will create very brief "improved care points of the month" for this 1-2 page newsletter.