Practice Expansion Battles Expected to Reignite on Beacon Hill

BY RONNA WALLACE
MMS LEGISLATIVE CONSULTANT

The Massachusetts State Legislature is back in session, meeting informally after ending its 2013–14 session with a flurry of activity in July. It was a busy time for the MMS, advocating for issues of importance to physicians while playing defense, battling issues that would negatively impact physicians and their patients.

The MMS waged a successful battle against a slew of scope-of-practice bills. The proposals would have allowed nurse practitioners, nurse anesthetists, nurse midwives, and lay midwives to practice independently and expanded the scope of practice for optometrists and podiatrists. The MMS opposed these measures as contrary to the physician-led, team-based model of health care, and because of potential threats to patient safety. The MMS is grateful that ultimately the legislature agreed with the physician community. The MMS will face a battle on this priority issue again in the next session and is actively exploring filing legislation promoting the physician led, team-based approach to health care delivery.

Patient Access to Drug Treatment Expanded

Chalk up a big win for patients! Responding the growing epidemic of prescription drug abuse and heroin deaths, the state legislature acted on a compromise bill to increase patients’ access to drug treatment services. Chapter 258 of the Acts of 2014 will require public and private insurers to cover at least 14 days of inpatient detoxification and post-detox care, eliminate prior authorization requirements and prohibit utilization review procedures from kicking in until seven days after entering treatment. It also encourages the use of abuse-deterrent opioids by requiring pharmacists to substitute abuse-deterrent medications unless directed otherwise by a physician. Thanks to MMS advocacy, the bill clearly states that medical necessity of drug abuse treatments is to be determined by the treating clinician, not the insurer. The Massachusetts Association of Health Plans fought hard against the bill, arguing unsuccessfully that it would increase cost and encourage unnecessary inpatient care.

New Faces on Beacon Hill

So what can we expect on Beacon Hill next year? Well, to some extent, that’s up to you — the voters. The November elections will very likely result in a changed environment when the legislature returns, as an unusually high number of legislators have left office over the past two years. Since the last state elections in 2012, 29 House members and 7 senators have stepped down, including former state representative Marty Walsh, now Mayor of the City of Boston. The heavy turnover will add to a dramatic reshaping of the House and Senate for the 2015–2016 session.

Here’s what we do know: Sen. Therese Murray, D-Plymouth, has reached her term limit as Senate president and is expected to end her 22-year-long career in the Senate when her term expires at the end of the year. Assuming his re-election, Majority Leader Stanley Rosenberg, D-Amherst, is expected to take over as Senate president. Rep. Robert DeLeo, D-Winthrop, will begin his final two-year term as speaker of the House. New Senate leadership and new faces in both branches will mean new chairmanships and committee assignments. That process will likely play out through January, pushing the budget process and hearing season out towards the spring. Add a new governor, attorney general, state treasurer, secretary of Health and Human Services, and other administrative officials into the mix and all bets are off — especially if a Republican wins the corner office in what looks to be a fierce campaign.

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