Page 9 - Delaware Medical Journal - May 2016

PRESIDENT’S PAGE
DOROTHY M. MOORE, MD
MSD President Dorothy M. Moore, MD is an Ophthalmologist who practices at Delaware Eye MD Associates in Wilmington.
Legislative Efforts
Did You Know...?
Welcome May. The trees are in bloom and the legislature in Dover is in full swing. As you may recall, the Delaware General Assembly is a bicameral legislature composed of 21 State Senators and
41 Representatives in the Delaware House of Representatives. With the end of the 148th, two-year legislative session looming on June 30th, and often really the wee
hours of July 1st, we are gearing up for an increased Advocacy presence in Dover. Any bills not passed by this state’s constitutional cutoff will “die” and need to be reintroduced next session after the 2016 elections. With
a total of nine days in session in May and just 12 days in June, a lot needs to get done in a relatively short amount of time. Our lobbyists and staff work tirelessly during those last weeks of the session on our
behalf to represent us both proactively and reactively. Remember: we were the fourth most active advocacy group in Dover in 2015, advocating not just for ourselves but for our patients and the health of the citizens of Delaware.
There are a number of outstanding bills and anticipated legislation that that will impact the practice of medicine and thus is very important to be aware of as we wrap up the session. There are dozens of bills we track
on your behalf and a complete listing is available on Pages 152-156 of this issue of the Delaware Medical Journal. The priorities can really be broken into three broad categories this year: (1) Insurance Data and Coverage; (2) Opiates; and (3) Scope.
INSURANCE DATA AND COVERAGE
Prior Authorization Transparency: For years we have all struggled with the frustration of having to jump through the proverbial hoop the get appropriate tests for our patients, causing needless delays in the care they need and increasing their stress. We have been told that this is to prevent unnecessary testing, but the appeals
are anecdotally almost always granted. Reliable data to evaluate the effectiveness of these programs is elusive and brings
into question the cost of this to both the patient and their physician. This legislation, authored by MSD, requires that the prior authorization programs include written and published clinical criteria, notice to changes in policy, and aggregation and publication of statistics of prior authorization programs. It also contains language that would eliminate retrospective denials of a prior authorization once issued. Representatives Baumbach and Bentz have agreed to champion this bill for us in the House and Senator Margaret Rose Henry will take
the lead in the Senate. This is our biggest priority this year! Please speak with your Representatives and Senators to join as co- sponsors and vote for this crucial bill.
Other bills in this category include oral health coverage, Personal Injury Protection (PIP) Insurance and All Payer Claims Database (APCD). We also anticipate legislation on balance billing to surface this session.
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