Established in 1844, our Journal is one of the oldest in the country. To learn more about the Journal and how to submit articles, please visit https://lsms.org/page/JLSMS.
Legislative, Legal and Regulatory Affairs
What’s inside?
Legislative Update
2
COL Requests Legislation on Prior Authorization - Claims Denials Urgently Needed - Patient Portal and Other Resources Fiscal Session Information - White Coat Wednesday Announced Physician Advocacy - Session Planner - Text Alerts (Capitol Canary) Legal News
4
Amicus Brief on Flavored Cigarettes Noncompete Comment Reminder Regulatory Update
6
LSBME
7
LA State Board of Nursing
6
- Prescribing CDC for Chronic Pain Management - Prescribing CDC for Obesity Treatment LA Board of Pharmacy
6
US Drug Enforcement Agency
7
NEW Resource for Members
8
To get politics out of medicine, physicians have to get into politics!
1
UPDATE
Legislative Update
Cover Story: LSMS Council on Legislation votes to seek legislative remedies for prior authorization issues. The LSMS Council on Legisla Ɵ on (COL) met on February 13 to discuss the upcoming legisla Ɵ ve session and our agenda. Joining COL members were members of the LAMPAC Board and the LSMS Board of Governors. Sta ff briefed the group on expected legisla Ɵ on before discussing what—if any— legisla Ɵ on LSMS should consider reques Ɵ ng. Following a very robust conversa Ɵ on surrounding the increased problems related to prior authoriza Ɵ on, sta ff was directed to request authors for two pieces of legisla Ɵ on: 1. Requiring that peer reviews of denied prior authoriza Ɵ ons for medical care be conducted by a Louisiana licensed physician in the same specialty as you. 2. Crea Ɵ ng a guarantee of payment for services provided with prior authoriza Ɵ on. Legisla Ɵ ve authors for both bills have agreed to push the issue. This will be a big ask, and we will need everyone of you who has been impacted to assist. We will push out Calls to Ac Ɵ on, but please DO NOT WAIT...start now by communica Ɵ ng to your legislator that prior authoriza Ɵ on has only go Ʃ en worse and that you need relief. Furthermore, it is impera Ɵ ve that we have hard copy evidence of services that were authorized and subsequently not paid. Please send (pa Ɵ ent data redacted) copies of your authoriza Ɵ ons, claims and denials to gova ff airs@lsms.org.
Engage Your Patients! Your patients are the ones who suffer most due to prior authorization. Please download the flyer at right to assist them in communicating their experiences with their legislators. Member Resource
2
Legislative, Legal and Regulatory Affairs
2023 Louisiana Legislative Session The 2023 legisla Ɵ ve session in Louisiana will be “ fi scal only,” meaning legislators may only fi le 5 bills of a general subject ma Ʃ er. Both LSMS requested bills fall into this category—as does scope of prac Ɵ ce,
liability, vaccines and many more issues you will want to watch. Session Convenes on April 10. White Coat Wednesday is May 17. Session Adjourns on June 8.
Registration is Open!
Register Today!
White Coat Wednesday
Last year, over 100 physicians a Ʃ ended White Coat Wednesday in Baton Rouge. Registra Ɵ on is open to any Louisiana licensed physician, resident or medical student. Bring your white coat on May 17 th and help us advocate for physicians, pa Ɵ ents and the prac Ɵ ce of medicine! LSMS uses Capitol Canary to send our Calls to Ac Ɵ on. This system also matches you with your legislator so you can easily connect with them on your issues. Please add lsms.org , sendgrid.net and p2a.co to your safe domains list. A Quick Reminder...
Visit the LSMS Action Center to Message your legislators!
3
UPDATE Legal Update
LSMS joins in Amicus Brief The Louisiana State Medical Society joined in support of an amicus brief in the ma Ʃ er of R.J. Reynolds Vapor Company v. FDA . The case involves the marke Ɵ ng and sale of fl avored e-cigare Ʃ es. The issue in the case is whether the Food and Drug Administra Ɵ on (FDA) acted lawfully when it denied marke Ɵ ng approval for electronic nico Ɵ ne delivery systems (ENDS)— colloquially called “electronic cigare Ʃ es” or “e-cigare Ʃ es” featuring non- tobacco fl avors. This case is one of many similar cases in federal circuit courts around the country involving the same legal ques Ɵ on presented by di ff erent ENDS manufacturers. The amicus brief opposes R.J. Reynolds Vapor Company's request for a stay of the FDA's decision to halt further marke Ɵ ng and sale of its ENDS products. The amicus brief provides the court with addi Ɵ onal evidence of the nega Ɵ ve impact of fl avored ENDS products, especially on young people. Click here to read the full amicus brief.
LSMS Submits Comments to FTC Regarding Non- Compete Agreements
The Louisiana State Medical Society (LSMS), represen Ɵ ng over 6,000 physicians, fully supports the proposed rule to ban non-compete clauses. In Louisiana non-compete clauses are currently being used in physician employment contracts with no expira Ɵ on date and with terms that have forced many physicians to leave their pa Ɵ ents, their community and even our State. In other words, because there is no limit on Ɵ me given by a physician to invalidate the clause, a doctor who has been employed for 10, or even 20, years who resigns or is terminated must
leave their home for two years in order to con Ɵ nue the prac Ɵ ce of medicine. They are coerced and expected to make a life Ɵ me career commitment to that corpora Ɵ on. The enforcement of non-compete provisions nega Ɵ vely impacts the pa Ɵ ent-physician rela Ɵ onship by disrup Ɵ ng the con Ɵ nuity of care. The physician-pa Ɵ ent rela Ɵ onship is deeply personal. Pa Ɵ ent care should be priori Ɵ zed above corporate interests. Pa Ɵ ents deserve to have
(Con Ɵ nued on page 5)
4
Legislative, Legal and Regulatory Affairs
provided—helps other businesses grow through their own purchasing and through the purchasing of their employees. Each dollar in direct output applied to physician services supports $1.85 in economic ac Ɵ vity in Louisiana. Physician-driven economic ac Ɵ vity is greater than legal services, home health care, higher educa Ɵ on, and nursing home and residen Ɵ al care. Physicians are responsible for 119,515 jobs, $8.9B in wages and bene fi ts, $647M in state and local taxes paid, and total economic ac Ɵ vity of $19.9B to the State of Louisiana annually. We should not allow corpora Ɵ ons to u Ɵ lize non-compete clauses to place pro fi t before pa Ɵ ent care or hinder economic liberty; thus we strongly support the proposed rule to ban non-compete clauses. We encourage each of you to submit personal comments in support of the rule. If you would like assistance in dra Ō ing or reviewing your comments please contact Lauren Bailey, Vice President of Legal A ff airs, at lbailey@lsms.org.
(Con Ɵ nued from page 4)
freedom of choice and access to their chosen physician. We concur with the 2005 opinion of the Tennessee Supreme Court sta Ɵ ng “Public policy considera Ɵ ons such as the right to freedom of choice in physicians, the right to con Ɵ nue an on-going rela Ɵ onship with a physician, and the bene fi ts derived from having an increased number of physicians prac Ɵ cing in any given community all outweigh the business interests of an employer.” Beyond their role in safeguarding the health of our communi Ɵ es, physicians in Louisiana are a major driver of the state economy, spurring economic growth and crea Ɵ ng jobs across all industries. Through the crea Ɵ on of jobs with strong wages and bene fi ts paid to workers across the state, physicians empower a high -quality, sustainable workforce that generates state and local tax revenue for community investments. Physicians’ economic output—the value of the goods and services
To submit comments, click the “comment box” in the center of the page here h Ʃ ps://www.regula Ɵ ons.gov/docket/FTC-2023-0007/document The proposed rule can be found here h Ʃ ps://www. Ō c.gov/system/ fi les/ Ō c_gov/pdf/p201000noncompetenprm.pdf The fact sheet is available at h Ʃ ps://www. Ō c.gov/system/ fi les/ Ō c_gov/pdf/ noncompete_nprm_fact_sheet.pdf.
5
UPDATE Regulatory Update
LA State Board of Nursing Promulgates Scope Increase for Nurse Practitioners At its mee Ɵ ng on December 12, 2022, the Louisiana State Board of Nursing approved an amendment to remove barriers preven Ɵ ng all Advanced Prac Ɵ ce Registered Nurses (APRNs) from prescribing controlled substances in connec Ɵ on with the treatment of chronic or intractable pain and obesity . The rule change allows all categories of Advanced Prac Ɵ ce Registered Nurses with prescrip Ɵ ve authority and controlled, dangerous substance authority to administer Food and Drug Administra Ɵ on (FDA) and Drug Enforcement Administra Ɵ on (DEA) approved controlled substances for chronic pain or intractable pain and obesity. LSMS will oppose this e ff ort! In Louisiana the four categories of APRNs include Cer Ɵ fi ed Nurse Midwives, Cer Ɵ fi ed Registered Nurse Anesthe Ɵ sts, Clinical Nurse Specialists and Nurse Prac ƟƟ oners. The Board is currently accep Ɵ ng wri Ʃ en comments on the proposed revisions. These comments must be submi Ʃ ed by March 10. The LSBN website is www.lsbn.state.la.us. LA State Board of Pharmacy Continues Discussions on Pediatric Vaccinations and Collaboration During its February mee Ɵ ngs of commi Ʃ ees and subsequent Board mee Ɵ ng, the Louisiana Board of Pharmacy discussed allowing pharmacists to administer vaccines to pediatric pa Ɵ ents older than 7. The Board did not choose to push the issue at the legislature, but did suggest the professional associa Ɵ ons may do so. We remain commi Ʃ ed to opposing any legisla Ɵ on that seeks to achieve this goal. The Board did advance a regulatory proposal on “prescrip Ɵ ons,” which includes changes that would allow pharmacist to prescribe. Currently, this can not occur without legisla Ɵ ve ac Ɵ on but would preposi Ɵ on them to do so should the legislature agree. You can read the e ff orts by visi Ɵ ng their “regulatory projects” page and scrolling down to 2023-01 ~ Prescrip Ɵ ons. The LBP website is www.pharmacy.la.gov.
6
Legislative, Legal and Regulatory Affairs
LA State Board of Medical Examiners Advisory Committee Recommends Rules Overhaul for Physicians Assistants The Physician Assistant Advisory Commi Ʃ ee has held numerous mee Ɵ ngs over the past several months. Responding to comments by the physician assistants’ organiza Ɵ ons, the commi Ʃ ee has reviewed and recommended comprehensive changes to PA standing rules. LSMS sta ff con Ɵ nues to watch and will comment as the formal rules are presented. If you have an interest in watching the commi Ʃ ee mee Ɵ ngs, they can be viewed at the LSBME’s website by going to the advisory commi Ʃ ees page. The LSBME website is www.lsbme.la.gov. US Drug Enforcement Agency Addresses CDS prescribing through telemedicine The US DEA has announced proposed permanent rules for the prescribing of controlled medica Ɵ ons via telemedicine. These rules seek to extend many of the fl exibili Ɵ es adopted during the public health emergency with appropriate safeguards. Telemedicine consulta Ɵ ons will not be a ff ected if: • the prescribing of controlled medica Ɵ ons is not involved. • an in-person medical examina Ɵ on of a pa Ɵ ent was previously conducted. • A referring medical prac ƟƟ oner conducted an in-person exam of the pa Ɵ ent prior to referring the pa Ɵ ent to another prac ƟƟ oner. The proposed rules further safeguard a narrow subset of telemedicine consulta Ɵ ons—those by a medical prac ƟƟ oner that has: never conducted an in-person evalua Ɵ on of a pa Ɵ ent; AND that result in the prescribing of: • a 30-day supply of Schedule III-V non-narco Ɵ c controlled medica Ɵ ons; • a 30-day supply of buprenorphine to treat opioid use disorder. The release: DEA Announces Rules for Permanent Telemedicine Flexibili Ɵ es
The summary: Telemedicine Rules Summary The highlights: Telehealth Prac ƟƟ oner Narra Ɵ ve
7
UPDATE
Member Resources
Prepare for Session! Use this handy planner to help focus your meeting thoughts and find your legislative representatives.
Engage Your Patients! If you have patients who want to learn more about how politics affects healthcare and physicians, this is a new publication. If your patients find it useful, let us know so we can expand it! LSMS Regional Legislative Directory We’ve provided legislative contact information for your use. It’s arranged by alphabetical order and also broken down into LSMS districts to help you locate the legislators in your area.
Baton Rouge area members , LAMPAC endorsed candidate Louise Hines Myers’ judicial elec Ɵ on is nearing. Please remember to vote! Elec Ɵ on Day is Saturday, March 25. Early Vo Ɵ ng is March 11-18 (except Sunday) www.louiseforjudge.com
8
Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8Made with FlippingBook Digital Publishing Software