BY Sandra Jacobs, VITAL SIGNS EDITOR
As Massachusetts braces for another possible COVID-19 surge, recent legislative and other advocacy achievements of the Massachusetts Medical Society (MMS) continue to bolster physician practices and public health.
Theodore A. Calianos II, MD, FACS
“People don’t realize the breadth and bandwidth of our advocacy for the patients and physicians we serve,” says MMS Vice President Theodore A. Calianos II, MD, FACS. “The Society does it on a daily and weekly basis. There’s a whole team working at the
MMS to better the practice of medicine.”
“During COVID-19, almost all the emergency measures that have been put in place — legislative and regulatory relief, telehealth reimbursement, liability protection — have seen some input from the Massachusetts Medical Society,” adds Dr. Calianos, a plastic
surgeon on Cape Cod chosen by his peers as the Barnstable District Medical Society 2018 Community Clinician of the Year. “These [emergency measures] are all a major help to practicing physicians.”
Officers of the Society, the MMS Advocacy and Government Relations Department, and others worked with the state Board of Registration in Medicine, Department of Public Health (DPH), and Department of Insurance (DOI); members of Governor Baker’s administration;
government task forces; and legislators and their staffs.
“On each issue, it’s not an all-or-none situation,” explains Dr. Calianos, a former chair of the Committee on Legislation. “It’s having the discussion and having legislators and state officials take what you say and act on it in some fashion. Being there
and being heard is very important.”
Highlights of MMS advocacy related to the pandemic include the following:
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Advocating for payment parity for telehealth and reduced cost-sharing and prior authorization. When the state initially proposed coverage for COVID-19 care only, the MMS advocated successfully for coverage of all care.
A transition that many expected to take years occurred in weeks, allowing patients to receive care and keeping physician practices afloat.
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Helping to secure statutory professional liability protections for not only COVID-related care, but for all patient care during the pandemic.
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Accelerating licensing for international medical graduates.
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Enabling physicians to extend the prescription length for some medications and allowing call in of prescriptions,
rather than electronic prescribing.
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In the phased reopening of physician practices last spring, the MMS advocated successfully to set aside time delays in an initial state proposal for Phases 1 and 2, as well as to exclude a mandatory patient volume reduction that was initially
proposed for Phase 2.
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Consistent communication with state and federal lawmakers and other leaders regarding the priorities and concerns of frontline physicians, including PPE availability, testing, and financial needs.
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Representing the physician perspective with the DOI and securing health plans’ compliance with DOI guidance regarding testing reimbursement, policy change deadlines, telehealth coverage and payment, and coding considerations.
State officials received guidance on the reopening of medical practices from the MMS report “Considerations and Recommendations for Moving Forward Medical Practices in Response to the COVID-19 Crisis.”
In related work to assist health care providers, the MMS Practice Solution team created Tips for Expanding Practice During COVID-19.
Input from the MMS and the Massachusetts Health & Hospital Association illuminated “how the reopening could take place in a safe and rational manner,” Dr. Calianos says. “What we’ve done will give us the elasticity we need going forward — or for moving
backward if that’s needed.”
Relieving Administrative Burden
Other MMS advocacy work, before the pandemic’s arrival and ongoing work since, maintains focus on reducing physicians’ administrative burden, a known contributor to burnout and work dissatisfaction. Efforts include the following:
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Advocating with National Committee for Quality Assurance and State Quality Alignment Task Force to reduce quality measure reporting. Blue Cross Blue Shield of Massachusetts has reduced its total reporting measures by as much as 27 percent.
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Advocating for reduced and streamlined prior authorization processes with the Health Policy Commission, and continuing to pursue and recommend alternative solutions, including “gold carding” and e-prior authorization.
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Successfully reducing length of new physician license application by 50 percent.
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Securing electronic Massachusetts Controlled Substance Registration, resulting in shorter wait for initial application approval (fewer than five days) and a renewal process that can be achieved in minutes.
Other Public Health Initiatives
Inequities in health and access to health care made evident by the pandemic have added even greater urgency to the Society’s widespread public health advocacy, including the following:
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Participating in the state DPH’s COVID-19 Equity Advisory Group.
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Taking a leadership role in Food is Medicine Massachusetts, which advocates for education about healthy nutrition in preventing chronic illness.
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Co-founding Tobacco Free Massachusetts, leading the call to ban flavored tobacco and vaping products, which took effect this year.
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Continued advocacy for expanded access to substance use disorder care and services and safe injection facility/sites.
Preserving Changes through the Pandemic — and Beyond?
The MMS continues to advocate for institutionalizing a number of the temporary measures that began during the COVID-19 public emergency, particularly payment parity for telehealth services.
“As we continue to listen to members’ priorities and concerns, we encourage physicians to make their voices heard directly with government leaders, which has been very helpful during the pandemic,” says Leda Anderson, JD, legislative counsel to MMS Advocacy
and Government Relations. “We expect more opportunities for member advocacy in the months ahead.”
For more on recent MMS legislative and public health advocacy, see here.
Illustration by Chris Twichell
