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TMA Releases 2015 Legislative Agenda Calling for Payer Accountability, Team-based Health Care Regs

Press release from the Tennessee Medical Association; February 17, 2015:

NASHVILLE – 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 arbitrarily 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. 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. 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,” said Dr. Kirkland.

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.

Haslam Releases 2015 Legislative Agenda

Press release from the office of Tennessee Gov. Bill Haslam; February 10, 2015:

Bills include last-dollar scholarships to community college for adult learners 

NASHVILLE – Tennessee Gov. Bill Haslam today filed legislation that is reflected in his FY 2015-16 budget proposal. The bills are a result of the governor’s continued focus on more Tennesseans earning a post-secondary credential, supporting teachers across the state and building a more customer-focused, efficient and effective state government.

“These legislative proposals build on the Drive to 55, our effort to raise the percentage of Tennesseans with a degree or certificate beyond high school from 32 to 55 by the year 2025.  We know that just reaching high school graduates won’t be enough to reach our goal, so we’re specifically looking to get adults with some college credit to go back and earn their degree,” Haslam said.

“Along with including $100 million in the budget for teacher salaries, the proposals are also aimed at supporting educators in meaningful ways, and we are always looking for ways to recruit, reward and retain the best and brightest to serve in state government.”

The governor’s legislation, sponsored by Senate Majority Leader Mark Norris (R-Collierville) and House Majority Leader Gerald McCormick (R-Chattanooga), includes:

  • The Community College Reconnect Grant pilot program would use a one-time payment of $1.5 million in lottery funds in the FY 2015-16 budget proposal to provide last-dollar scholarships to adults with some college credit to attend a community college. In Tennessee there are nearly 1 million adults with some post-secondary credit but no degree, and this is an additional component of the governor’s Drive to 55 initiative.
  • The Educators’ Liability Trust Fund would provide personal liability coverage to teachers free of charge. While many teachers are covered through their school districts’ insurance plans, the governor heard from many in his conversations around the state that they are concerned they’re not adequately covered and teachers end up paying for liability protection at their own expense. This year’s budget proposal includes a one-time appropriation of $5 million to establish the fund to provide coverage.
  • The Revenue Modernization Act would help keep Tennessee a low tax state by leveling the playing field between in-state companies and out-of-state companies doing business in Tennessee. The proposal would also seek to close certain loopholes by adapting to changes in the way products are bought and sold. The proposed legislation includes:
    • Addressing “nexus” in sales and use, franchise and excise, and business taxes;
    • Adopting market-based sourcing of services to determine which state counts the sale of service for tax purposes when a company conducts business in more than one state;
    • Making Tennessee’s tax structure more competitive with surrounding states by changing the way a multi-state company’s income and net worth is taxed for franchise and excise purposes;
    • And allowing the use of software and video games being accessed remotely to be subject to sales tax as if they had been purchased or downloaded.
  • The Compensation Enhancement Act continues the administration’s focus on recruiting, retaining and rewarding a talented state government workforce by adapting longevity payments to help implement the market- and performance-based compensation plan. Since the governor took office, $139.4 million has been allocated in the state budget for salary increases, and the FY 2015-16 budget proposal includes another $47.7 million for salary increases. Under the proposal, executive branch employees would receive a permanent increase to their base salary equal to half of the longevity payment due, effective July 2015. The remaining half of the longevity payment would be reallocated to the state’s General Fund and then used to fund market- and performance-based salary increases.
  • The State Health Insurance Reform legislation aims to address the rising state employee retirement health care costs and give the state flexibility to offer more competitive total compensation packages and to design benefits for state employees. Key changes include:
    • The state would have the flexibility to offer a defined contribution or defined benefit to current employees for pre-65 retiree health insurance, reflecting the practice of most large private sector employers, and state and local education employees hired after July 1, 2015, would not be eligible for pre-65 retiree health insurance;
    • The State Insurance Committee would have the flexibility to change the percent subsidy that is given to the active state employees by offering one basic health plan;
    • After July 1, 2015, no part time state employee may be eligible for any insurance plan while current employees working 1,450 hours or more per year will be grandfathered into the plan;
    • The state would not offer Medicare Supplement Insurance under the state and teacher insurance plans for employees hired after July 1, 2015.

The governor previously filed the following three pieces of legislation in January: the Tennessee Teaching Evaluation Enhancement Act, Protection of Volunteer-Insured Drivers of the Elderly (PROVIDE) Act, and the Tennessee Promise Implementation Adjustments Act.