Legislative Roundup: Physicians, Patients and Politics

As lawyers, we look to case law precedent, but health law is heavily bound to the regulations and laws governing medicine. Because of this, those of us in Washington look to Olympia for making possible changes to our practice and how changes in the practice of medicine and law might impact our clients. Moreover, in these immediate years following the passage of the Affordable Care Act, we can see the Legislature making substantial changes as to how care is delivered and medicine is practiced in Washington state.

The Washington State Medical Association (WSMA) has put together a few takeaways from the 2015 legislative session.

• Telemedicine and transparency. Multi-year efforts to ensure reimbursement for telemedicine services (SB 5175) and improve health care transparency through an All-Payer Claims Database (SB 5084) have paid off. These important bills will help modernize our state’s health care delivery system.
  All payer claims database: The legislation, passed last year, only required Medicaid-level and state-level data. SB 5084 and the resulting APCD will enable consumers, employers, policymakers, and health care providers to gain access to cost and quality data that could lead to better informed health care purchasing decisions.
• Telemedicine: After several years of attempted passage, this bill will allow for physicians using telemedicine to get reimbursed for that service. Current law did not require that carriers reimburse for these services. Telemedicine has a great impact on the quality of medical care physicians can provide their patients, and an equally great impact on patient costs. And many rural areas of Washington state stand to benefit from reimbursement for telemedicine — a patient in Spokane could be seen by a physician in Seattle.

Bills, bills, bills. Each year, the WSMA tracks and responds to hundreds of health care bills and numerous budget items that have the potential to impact medicine in one form or another.

• Among the bills opposed by the WSMA was one to restrict a surgical technologist from performing his or her functions unless registered with the state, a bill to allow naturopaths to prescribe Schedule II-V drugs (SB 5815), a bill to mandate a lay letter to patients regarding breast density (SB 5040), and another to inappropriately expand scope of practice for dentists (SB 5621).
• Among other bills that failed to pass was a measure to remove the personal and philosophical exemption from the requirement to get vaccinated (HB 2009), a bill to require reimbursement for services provided to health benefit exchange enrollees who are behind on their premiums (SB 5430/HB 1626), a bill reducing distracted driving (SB 5656), and one providing Good Samaritans free infectious disease testing (HB 1353).

Among the bills successfully advocated by the WSMA was a bill requiring Medicaid managed care organizations to make good-faith efforts to contract with providers (HB 1652), and two bills addressing the use of benefit managers by insurers (HB 1183). (Note: the bill addressing pharmacy benefit managers (SB 5857) may pass with the final budget.)

Medical school established. Lawmakers enacted historic legislation (SB 1559) this session, allowing Washington State University to establish its own medical school. While the WSMA was neutral on this bill, they were very active on the broader issue of ensuring funding for graduate medical education (i.e., medical residencies) in an effort to address the pending physician shortage. The next hurdle in the concern over physician shortage is creating enough residency slots for graduates of the new school. Here’s a good article on rural physician shortage.

Medical marijuana. Another multi-year effort culminated in law this session with the adoption of a medical marijuana reform bill (SB 5052). WSMA advocacy resulted in a substantially improved final bill, removing elements such as requiring physicians to enter patients into a registry and establishing a standard of care in statute for authorizing medical marijuana.

Of course, the items showcased above are the position of one association in Washington state. Please take the time to look up the information on a particular bill by visiting www.leg.wa.gov, going to the “find bills” link and entering the bill number for more information.

Note: At the time of this writing, the Washington State Legislature had concluded the regular legislative session. However, because of stalled budget negotiations, the Legislature has now entered into a second Special Session. The sticking point is still the budget — how Washington state will spend its money.