MMA News
MMA Helps Shape Health Care Reform
After working with lawmakers to eliminate a problematic payment provision, the MMA supported the House health care reform bill that passed in April.
If the House proposal becomes law, it would provide new payments to support medical homes and chronic disease management, push aggressive public health programs to reduce obesity by 50 percent by 2020 and tobacco use by 2 percent by 2011, and set a goal of increasing the state’s insured rate from 93 percent to 98 percent by 2013.
The MMA supported the House bill but did not support the Senate version because it included a controversial payment reform proposal known as Level 3. The Level 3 plan resembles capitated payment plans of the past and would hold providers accountable for the total cost and quality of care provided to patients.
The Level 3 provision was deleted from the House bill after the MMA and physicians expressed concern that the payment mechanism could result in a consolidation of providers.
The MMA worked with the author of the House bill, Rep. Thomas Huntley, DFL-Duluth, to replace Level 3 with a provision that would allow providers to develop bundled or package prices for treating chronic conditions. Huntley also agreed to slow the implementation of any controversial payment reforms if they became law.
“This was a positive step forward that improved the House reform bill,” says Dave Renner, the MMA’s director of state and federal legislation.
Aside from the Level 3 provision, the Senate bill is similar to the House version. In mid-April, Gov. Tim Pawlenty said he still wanted health care reform that would provide more transparency and control costs, although he had concerns about the cost of public program eligibility increases.
The MMA continues to work with legislative leaders as they hammer out a compromise bill. It will likely take the rest of the session, which is scheduled to end on May 19, to find a compromise between the competing proposals. Complicating matters is the fact that health care reform has been intertwined with the battle over solving the budget deficit. Gov. Pawlenty proposed using money from the Health Care Access Fund to fix a budget shortfall. DFLers proposed using those funds to finance health care reform.
As Session End Nears, What's Still Possible?
Lawmakers have until May 19 to wrap up their work, which mostly means passing large omnibus bills that include a host of measures put forward during the session. The following are some of the MMA-supported provisions that still had a chance of becoming law in late April:
- Strengthening Minnesota’s Graduated Drivers License law by restricting what drivers younger than 18 years old can do during the first six months after receiving their license.
- Requiring all children 8 years of age and younger to use booster seats. Currently, child-restraint systems are only required for children younger than 4 years.
- Making not wearing a seat belt a primary offense. This would allow officers to stop drivers for not wearing seat belts.
- Establishing a registry of language interpreters who have met certain educational, training, and proficiency standards. The state would also develop an interpreter certification program that would be implemented by 2012.
Governor, Lawmakers Enter Final Budget Negotiations
The MMA continues to closely watch the endgame of the debate about how to address Minnesota’s $935 million budget deficit.
At stake is whether lawmakers will raid the Health Care Access Fund to balance the budget, hit physicians treating patients on public programs with a 3 percent pay cut, or do neither.
By April, the House and Senate had both passed proposals for eliminating the deficit that did not tap the Health Care Access Fund. This was in stark contrast to Gov. Tim Pawlenty’s plan to take nearly $400 million from the fund during a three-year period.
A 10-member conference committee started meeting in early April to come up with a compromise omnibus budget bill that would address state spending for health care, education, and other areas.
Of the three proposals, the House budget bill was the most favorable to physicians because it neither used money from the Health Care Access Fund nor cut physician payments.
The Senate budget bill included a 3 percent cut to provider payments for care for fee-for-service patients enrolled in Medical Assistance, General Assistance Medical Care, and MinnesotaCare.
Although technically limited to fee-for-service payments, the cut would have a broader effect because payments made by the Prepaid Medical Assistance Program, the state’s managed care plan, are derived from the fee-for-service rates.
The fee-for-service cut would apply to all inpatient and outpatient providers except dentists and mental health providers.
The cut would save the state about $16.5 million between fiscal years 2009 and 2011.
The MMA sent an Action Alert! to physicians in April urging them to tell their lawmakers that the reimbursement cut should be stricken from the bill. (Physicians have not received a rate increase for providing care to patients on public programs in nine years.)
The MMA was also fighting provisions in the Senate budget bill that would add prior authorization requirements for about 20 procedures and a $5 increase to licensing fees. The MMA opposes the licensing fee increase because its ostensible purpose is to pay for implementing electronic application systems. Physicians already have such systems in place.
Nominate a Colleague for Outstanding Achievment
Nominations are being accepted for the 2008 MMA Outstanding Achievement Awards, which honor physicians and medical students in Minnesota who have made significant contributions to their profession, in their practice, or to the world around them. Nominating someone you know is a great way to let them know that you appreciate their efforts—and to shine the spotlight on their work.
The awards will be presented at the MMA’s 155th Annual Meeting, September 17-19 in St. Paul.
You can nominate a colleague for these awards:
- Community Service Award—for physicians with outstanding records of serving their communities
- MMA Medical Student Award—for participating members of the MMA Medical Student Section who demonstrate leadership
- Physician Leadership in Quality Award—for Minnesota physicians who have advanced quality and safety in health care
- Minority Affairs Meritorious Service Award—for physicians who provide outstanding service to minority populations
- Physician Communicator Award—for physicians who have shown excellence in communicating with the public through published or broadcast work
For more information and a nomination form, turn to p. 62, visit the news section of the MMA’s home page at www.mmaonline.net, or contact Vickie Westling at vwestling@mnmed.org or 612/362-3764. All nominations must be received by July 9, 2008.