Senate Budget: Strong On Opioids, Weak on Out-of-Network Billing

VSTW

MMS NEWS AND ANNOUNCEMENTS

Final call! Please renew your MMS membership by May 31
If you haven't renewed yet, here's why our members say it matters: The MMS gives you a voice. We strongly oppose the American Health Care Act as it moves to the Senate. The non-partisan Congressional Budget Office reports that the AHCA would significantly impact the ability of millions of Americans to access quality health care here in the Commonwealth and across the country. Insurance coverage for tens of millions of Americans and funding for basic wellness programs are at risk. Lend your support and voice as we fight for policies and legislation that will preserve patients’ access to care. Please renew or join, right now. Thank you to our many members who have renewed. We appreciate your continued support.


MMS Advocacy Updates 

State Budget: Senate supports SIFs but diverges from MMS on out-of-network billing
The Senate has passed a state budget with implications for several issues that are important to the Medical Society:

  • The Senate adopted a budget amendment supported by the MMS to study whether supervised injection facilities (SIFs) could work in Massachusetts. The amendment would direct the Department of Public Health (DPH) to partner with law enforcement and medical professionals to conduct a feasibility study focusing on the public safety and public health impacts. New MMS policy speaks to the potential value of SIFs in engaging individuals with opioid addiction in ways that reduce overdose mortality, decrease the harms associated with drug use, and increase referrals to addiction treatment.
  • Another successful budget amendment supported by the MMS would create a Prevention and Wellness Trust to promote evidence-based community preventive health initiatives.
  • The MMS helped defeat an amendment that would have established a ceiling of 160 percent of Medicare rates on provider reimbursements for services rendered to Group Insurance Commission (GIC) members and prevent physicians from seeking excess charges from patients.

The Senate supported two initiatives in the budget that the MMS opposes:

  • An amendment addressing Out-of-Network or “surprise” billing would base reimbursement to OON physicians at nontransparent contracted rates, giving health insurers the upper hand in contract negotiations. It would also empower the Health Policy Commission to set rates for non-contracted physician services every five years. The MMS is firmly committed to seeking a solution to the issue of OON reimbursement, but has strong concerns about the Senate proposal. The MMS supports the Price Variation Commission’s recommendation that the Health Policy Commission convene a broad based Working Group to look more closely at this issue and does not believe that the budget is the appropriate venue for that discussion.
  • The MMS opposed the Senate’s inclusion of the “Glaucoma Bill” in the Senate budget. “Expanding optometrists’ scope of practice in the Senate budget is misguided, unnecessary, and potentially dangerous for the citizens of the Commonwealth,” wrote the MMS in a letter to all senators. “Glaucoma is a complex, blinding eye disease that should be treated by eye physicians, not optometrists.” Only three other states allow optometrists the scope of practice that would be allowed by this language.

The discussion now moves behind closed doors to a Conference Committee charged with reconciling the House and Senate passed budgets. The MMS will be actively urging the Conference Committee to include the SIF language and Prevention and Wellness Trust in the final budget and to reject the OON and Optometry provisions.  


Extra! Run, Don't Walk, to These Events

Men's health: Does steroid use affect cardiac health long-term? What's the best way to talk about gun safety? 
Do you treat male patients? The 2017 Men’s Health Symposium will set you up to answer their questions and confidently discuss sensitive topics. Is "male menopause" a thing? Can marijuana affect men’s fertility? At The Many Facets of Men’s Health: Clinical Conversations Impacting Your Patients, our speakers will update you on clinical best practices and research advances affecting four key health issues: male fertility, marijuana use (we’ll cover legislative policy shifts), gun violence and safety, and nutrition and physical conditioning. The symposium takes place at MMS Headquarters, Waltham, on June 15, 2017; registration and information, including CME designation. Watch Theodore Macnow, MD, pediatric emergency medicine physician, outline what this symposium can do for you (1-minute video).

Share your expertise with medical students
The Boston University School of Medicine Integrated Problems (IP) course depends on volunteer physicians to facilitate the small group problem-based learning sessions for second-year medical students. Your medical experience and expertise will be invaluable in developing the students’ clinical reasoning skills. The course is between September and November 2017. Join us for lunch to learn more on June 15, 2017; information and registration . If you can only call-in for the presentation, email ckoh@mms.org.


MMS Membership Benefits

Graduating medical students: Continue your free MMS membership

  • If you are staying in Massachusetts, talk with your residents-fellows residency program director about free MMS membership. Alternatively, ask your program coordinator to submit a 2017 program roster to activate the MMS benefits for you and your colleagues.

  • Beginning your training out of state? Maintain your membership through December 2018 at no cost. Watch your email inbox for more information.

  • Questions? Email groups@massmed.org or call (800) 322-2303, ext.7748.

Residents & fellows completing training in June 2017: Access your free MMS membership

  • The MMS offers free membership for your first year in practice. Maintain benefits like your New England Journal of Medicine subscription whether or not you’re staying in MA. For more information, contact mmsprocessing@mms.org or 800-322-2303 ext. 7495.
  • Supplementing training with a fellowship? Your new program coordinator can submit a 2017–18 roster to provide membership for you and your program colleagues. Watch your email inbox for details.
  • For more information, contact groups@mms.org or 800-322-2303 ext. 7748.


Educational Programs and Events
Unless otherwise noted, all events are held at the MMS Headquarters, 860 Winter St., Waltham, MA. View our full calendar of upcoming live CME activities. 

Managing Workplace Conflict: Improving Leadership & Personal Effectiveness
Thursday, June 8, 2017, 8:00 a.m.–6:00 p.m., June 9, 2017, 8:00 a.m-12:45 p.m. 

15th Annual Symposium on Men’s Health – The Many Facets of Men’s Health: Clinical Conversations Impacting Your Patients
Thursday, June15, 2017, 8:00 a.m.–12:00 p.m. 

Medical Care of Adults with Intellectual/Developmental Disabilities – Live Webinar

Friday, June 16, 2017, 12:00 p.m.–1:00 p.m. 

Norfolk County Safe Prescribing and Dispensing Conferences
Thursday, September 14, 2017, 8:00 a.m. – 3:30 p.m.

The above activities have been approved for AMA PRA Category 1 Credit™ 

Featured Online CME Activities – Risk Management Credit

The above activities have been approved for AMA PRA Category 1 Credit

See our full listing of risk management online CME activities.


This Week in Health Care

Senate agrees to study drug injection facilities
Looking to "throw the kitchen sink at the problem" of opioid overdoses, the Senate on Thursday afternoon adopted a budget amendment directing the Department of Public Health to study whether supervised injection facilities could work in Massachusetts.

Baby boomers beware: GOP's Medicaid cuts could hurt you later
Hundreds of thousands of Bay Staters could lose their health insurance if the Republican-authored American Health Care Act becomes law. Many others will see their out-of-pocket costs jump. And it's not just the poor who are at risk; it's also the elderly.

Tip no. 1 for taking charge of Mass. health care costs: Avoid the ER
Forty-two percent of emergency room visits in Massachusetts in 2015 were for problems that could have been treated by a primary care doctor, according to the state's Health Policy Commission.

Signature Healthcare to open new BI-affiliated cancer center
A seven-year project to bring a dedicated cancer center to Brockton is finally coming to fruition, with Signature Healthcare constructing its Beth Israel Deaconess-affiliated space slated to open this fall.

Mass. health insurers say they'll hike rates 'substantially' if Trump cuts subsidies
The warning comes from the Massachusetts Association of Health Plans: If the Trump administration eliminates the subsidies, insurers would lose an estimated $63 million in funding for the remainder of 2017, and another $125 million in 2018, insurers said.

Nurses work overtime, but by how much?
Roughly six months into contract negotiations with Baystate Franklin Medical Center, the nurses union requested payroll data to support its contention the staff is overworked. But a detailed review of the data shows a more nuanced picture.

Study says GOP plan would be blow to Mass.
Massachusetts, the state with the highest rate of residents with health insurance, could see its uninsured rate jump above 10 percent if the sweeping health care bill approved by the US House becomes law, according to a new analysis from the Urban Institute.

Doctor who faced retaliation for raising concerns about double-booked surgeries wins lawsuit
A prominent Boston neurosurgeon was illegally forced out of his previous job at a New York hospital for strongly objecting to a policy that allowed another surgeon to perform complex spine surgeries on two patients simultaneously, a judge ruled.

Program aimed to help seniors live smarter
Boston is aiming to make the city more user-friendly for senior residents. The Age Friendly Boston Action Plan 2017, developed in partnership with the AARP, the Tufts Health Plan Foundation and the University of Massachusetts at Boston, introduces a series of measures, including tax-relief programs, affordable housing, and crosswalk markers. Boston’s elder population is projected to approach 125,000 by 2030.

More companies seeking employees with autism
Major companies in the past few years have launched hiring initiatives aimed at recruiting people with autism spectrum disorder, adapting the interview process and work environments to meet their needs. In Central Massachusetts, where employers lament a shortage of qualified workers to fill jobs, a similar program is in the works.

Industry: Nursing homes at "crisis point" due to state underpayments
One out of every seven direct care staff positions in Massachusetts nursing homes is vacant, the number of deficiency-free homes has dropped since 2013, and half of the facilities have less than four days of cash on hand, according to advocates seeking more state support for nursing homes.

Suicide rate skyrockets among middle-aged men
The suicide rate in Massachusetts rose by 40 percent between 2004 and 2014, due in large part to the number of middle-aged men taking their own lives.

UMass Memorial and Harrington to join behavioral health forces
UMass Memorial will shuttle patients twice a day to various hospitals, including Harrington, where they can receive inpatient psychiatric services if UMass Memorial is at full capacity. UMass Memorial plans to close 13 of its 27 inpatient psychiatric beds and convert them for medical/surgical use on June 1, as scheduled.

Health care advocacy group names new leader after eight months
Amy Rosenthal will take over as executive director of Health Care For All, a Boston-based non-profit advocacy group that promotes affordable health care and broadening access, on June 26.

See how Brigham and Women's Hospital installed a 25-ton MRI machine
Brigham and Women's Hospital has installed what it calls one of the first of a type of high-powered MRI systems in North America in its new, $475 million clinical building in the Longwood area.

Opioid crisis strains school systems
In Falmouth Public Schools, 20 students have lost a parent in the last three years to drug overdoses, said Charles Jodoin, the district's director of student services. Seven parents from one elementary school died in 2016.

Steward merger would make it nation's biggest private for-profit hospital system
Steward announced a nearly $2 billion deal with IASIS Healthcare of Franklin, Tenn., which would make it the largest private for-profit hospital operator in the country. The merger would create a network of 36 hospitals across 10 states, with revenue of nearly $8 billion, Steward said.


Share on Facebook

New: Advertise With MMS

Increase your brand awareness and visibility to physicians and the general public through advertising space on the MMS website and several MMS email newsletters.

Read More »

Subscribe to e-Newsletters

Stay on the cutting edge of medicine by subscribing to free MMS e-newsletters. Choose from up to ten subject areas including physician and patient advocacy, public health, CME, daily health care news, and more. 

Sign Up »

NEJM Resident 360  Ad

MMSMediaWatch

FacebookTwitterLinkedInYouTube

Copyright © 2017. Massachusetts Medical Society, 860 Winter Street, Waltham Woods Corporate Center, Waltham, MA 02451-1411

(781) 893-4610 | (781) 893-3800 | Member Information Hotline: (800) 322-2303 x7311