Physicians To Meet With Lawmakers On Insurance Reform

And Team-Based Healthcare Regulations

  • Tuesday, February 17, 2015

The Tennessee Medical Association, the state’s largest professional group for physicians with more than 8,000 members statewide, has announced its top priorities for the 2015 legislative session ahead of its annual Day on the Hill on March 3. 

Atop the list of doctors’ legislative focus is a bill that would reduce health insurance companies’ ability to change reimbursement terms in the middle of a contract. TMA gained traction with its Payer Accountability bill in 2014 and has continued discussions with insurance companies during the past several months to try to reach a compromise. It will be the first law of its kind in the U.S. if TMA is successful this session. 

“Our goal with Payer Accountability is the same as it was last year – stability and predictability for medical practices,” said Dr. Ron Kirkland, a Jackson physician and chairman of TMA’s Legislative Committee. “In no other industry are contracts so lopsided toward one party to essentially allow them to change payment at any time, for any reason. We want to level the playing field, especially for smaller physician groups and solo practitioners, and prohibit insurance companies from using their typical ‘take it or leave it’ approach. It’s a pretty straightforward business issue.” 

The TMA will also introduce the Tennessee Healthcare Improvement Act of 2015, which is designed to support the state’s vision for a more efficient and effective team-based healthcare delivery model, said officials. TMA is advocating for a "physician-led, coordinated care approach that leads to high-quality patient outcomes at the lowest possible cost." 

Other notable items on TMA’s legislative agenda:
·         TennCare Payment Reform – TMA has been actively engaged in TennCare payment reform since the state received its first grant in 2013 for the Tennessee Healthcare Innovation Initiative. TMA physicians and staff continue to work with the Haslam Administration and TennCare Bureau to advocate for fundamental improvements to the program implementation, specifically around episodes of care reporting, to help make the initiative successful.

·         Addiction Treatment Act of 2015 – For a number of years the legislature has tried to address Tennessee’s prescription drug abuse epidemic by placing regulations on those writing the prescriptions, without properly addressing issues related to appropriate medical intervention. TMA’s bill seeks to remove barriers to identifying those who need treatment and ensure that they have access to available treatment options.

·         Improving access to quality, affordable healthcare – TMA supported Governor Haslam’s Insure Tennessee plan and will continue to serve as a resource for legislators as the debate continues around how to best provide insurance coverage for the state’s working poor.

·         Telemedicine – A coalition of several interested parties, including the TMA, will continue to advocate for improved access to telemedicine services for Tennessee patients by filing a bill addressing telemedicine. The most recent iteration of draft rules from the Board of Medical Examiners significantly reflects TMA’s advocacy efforts during the past year.

·         Biosimilars – TMA is working with the pharmaceutical industry to make sure physicians’ concerns are addressed in a bill allowing for the substitution of biosimilar medications. TMA supports the allowance of biosimilars for drugs the FDA has deemed interchangeable, as long as there is communication back to the physician when a change is made. 

These and other issues will be part of discussions between physicians and lawmakers during TMA’s annual Day on the Hill on Tuesday, March 3.

“It is important for legislators who make important decisions that affect healthcare in this state to hear directly from physicians," said Dr. Kirkland.  "Our lawmakers need to know how their votes impact patient care, and no one is more qualified to educate them on the issues than the men and women who take care of patients every day. We hope to have a lot of white coats on Capitol Hill on March 3." 

Physicians interested in participating in Day on the Hill can sign up online at tnmed.org/dayonthehill.

Visit tnmed.org for more information about TMA’s legislative advocacy.

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