Regional Leads Subcommittee Meeting Follow-up
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Regional Leads Subcommittee Meeting Follow-up
Thank you to everyone for the great feedback today. Below are a few notes and next steps on the issues discussed. If anyone has questions or concerns, be sure to email me directly at kdaley@hhs.com.
Horizon NJ BCBS – We discussed the updated policy from Horizon for LANE codes. While the updated language is a win, we are planning to hold on doing anything until we get any notice that there has been a downcode per the new policy. We would like to have an example to share with CMS if they violate prudent layperson. Dr. Brault did share an email that no one from QCDC has experienced any issues as of yet. The FHP committee is also supposed to discuss. Since you all will be together this weekend it might be good to talk about this issue. If we want data, maybe we should consider a survey in a few months to give time for the policy to play out.
Patient Cost Share Bill in Texas – Aron and Kevin provided an update to the subcommittee on the meet they had with Rep. Gonzalez’s office on HB 4046. As a reminder, this is the bill language for patient cost sharing that Bing Pao has been spearheading. We are waiting for the bill to get assigned to a committee, but we will be the lead supporters on the bill. This means we will need to provide in-person testimony and target committee members once the bill is assigned to committee. Also, Dave and Aron suggested working with the local ACEP chapter, which Aron shared that Michael Grimes, a lobbyist Aron works with, is also the lobbyist for the chapter. More to come on this issue.
The committee discussed several other bills outlined in the agenda. There is a Medicaid bill in New Mexico that the group was supportive of that says that Medicaid reimbursement rates health care services will be set at the higher value between 200% of the corresponding Medicare reimbursement rate or the determined regional average commercial rate. There is also a surprise billing bill that the committee is opposed to that mirrors the bill that passed in Colorado which changes the provider reimbursement from 2017 claim information to recent claim info that represents more recent information, which will likely be decreased reimbursements that could significantly impact our community. Dave shared the impact he has faced in Colorado. Kevin is reaching to the sponsor for a meeting to get more insight on the supporters of the bill and allow us to share our concerns.
The committee also discussed an Arizona surprise billing bill that is target towards patients rights. If a patient has a surprise billing issue with their insurer and they reach out to their provider, the provider must provide a written response guiding them to helpful information on the states website. This is more of a customer service issue that an added burden to your offices. The committee decided to be neutral on the bill. There was one miscellaneous in Tennessee that would change current employments regulations for EPs, and other specialists. Aron shared that this bill has been filed every year for a couple cycles now. The committee is standing neutral on this bill as well.
Lastly, Aron shared that Florida’s AI bill is moving forward. He also provided the bill number so we can start tracking and engaging. Kevin is reaching out to Toni Large in Florida who is the lobbyist for the local chapter to see how we can help.
If there are any other thoughts or questions, you may also post here in EmPowered or email me.
Everyone have a safe trip to Colorado!
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