Legislators Turn Out for Meeting on Family Physician Workforce Crisis
The 2010 Indiana General Assembly
Health Care Reform resources at the AAFP
Questions and answers about the Patient Protection and Affordable Care Act are available on a new web page from the AAFP.
Find out how the new legislation will affect PCPs, the practice of medicine, physician payment, family physicians as small business owners, academic family medicine, and patients.
Click here now to read more.
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Health Care Reform: How and When? - 3/22/2010
Yesterday evening the U.S. House of Representatives held the last vote to pass the “Patient Protection and Affordable Care Act.”
The bill, although not perfect, may be the first step to improving the American health system. Most of the reforms in the bill will be rolled out incrementally in the next five years, though some pieces of the statute will be implemented in the closer future.
This health care reform bill is not a complete package. We are still awaiting a permanent fix to the Medicare Sustainable Growth Rate formula and medical malpractice reform. Family physicians know the current American health system is complex and true reform will not be complete with this bill. The Academy will maintain its vigilance overseeing the roll out of this act and ensuring Congress returns to finish what was missed.
Positive Impacts of Health Care Reform to Family Physicians and the Family Physician workforce
Effective 2010 there will be financial support for the development of training programs that focus on primary care models such a medical homes and team management of chronic diseases. There is also an immediate reauthorization of Title 7 which provides funds for the training of family physicians.
Effective 2011-2015 Medicare will provide a 10% bonus will be paid to primary care physicians who practice in health professional shortage areas.
And, effective 2014 Medicaid coverage will be expanded to all with incomes up to 133% of the federal poverty level. On the same time line as the expansion of Medicaid coverage, Medicaid payments will increase to Medicare rates for primary care services provided only by primary care physicians. It is pivotal that this section of the health care reform bill be implemented; otherwise newly insured Medicaid patients will be unable to find physicians to take them, the Academy is watching this provision carefully.
Positive Impacts of Health Care Reform to your Patients
Effective 90 days after enactment a national high risk pool to provide health coverage to individuals with pre-existing medical conditions will be implemented. The pool will last until 2014, in 2014 the prohibition of pre-existing condition exclusions goes into effect for all individual and group health plans.
Effective 6 months after enactment health plans will no longer be able to rescind coverage except in cases of fraud, and pre-existing conditions for children will be prohibited. New individual and group plans will no longer have lifetime limits; however existing plans will be grandfathered in until 2014 when their lifetime limits must be eliminated.
Legislators Turn Out for Meeting on Family Physician Workforce Crisis
6/14/10 - IAFP Breaking Point Project Wins 2nd Award: AAFP State Government Advocacy Award
The IAFP headquarters is thrilled to announce that the American Academy of Family Physicians selected the Indiana Chapter for the 2010 Leadership in State Government Advocacy Award.
The purpose of the Leadership in State Government Advocacy Award is to recognize outstanding Chapter contributions to further family medicine through legislative accomplishments or initiatives, or the support of public policy efforts. Three awards were given nationally for small, medium, and large chapters. Indiana is considered a large chapter.
The award honors the Indiana chapter’s project “Breaking Point” a multimedia advocacy campaign which raised awareness and offered solutions to the critical shortage of family physicians in Indiana. This is the second award for “Breaking Point” which was also chosen as the winner of the Indiana Society of Association Executives Star Award of Excellence for Best Government Affairs Program.
The AAFP will bestow the award to the IAFP during our Annual Convention in French Lick, IN. The IAFP has also been honored with the opportunity to speak about the success of the “Breaking Point” project at the AAFP’s 2010 State Legislative Conference.
12/9/09 - Indiana Academy of Family Physicians Wins Indiana Society of Association Executives’ 2009 Excellence in Government Affairs Program STAR Award for “Breaking Point”
The headquarters office is extremely excited to announce to our membership that the IAFP was selected as this year’s winner of the Indiana Society of Association Executives’ Star Award of Excellence for Best Government Affairs Program. ISAE’s Star Awards are the organizations top awards and recognize association activities, professionals, and programs that are making a difference.
Your Academy's director of legislative and region affairs, Meredith Edwards, accepted the award on behalf of the IAFP’s members and staff at a ceremony on December 3 at the Artsgarden, downtown Indianapolis.
The award recognizes our work on the Breaking Point Video and Report. Read more below...
Legislators and IAFP leadership were in attendance when the IAFP released its paper and video “Breaking Point”. The video and paper on the family physician shortage were released during the IAFP’s Family Medicine Legislative Breakfast on March 4th, 2009. The IAFP was happy to host seventeen legislators, hailing from all around Indiana and all four caucuses.
At the breakfast the IAFP’s video was shown, and copies of the video and paper were provided to every legislator. The paper and video explain why primary care is important for a healthy society, and why family physicians are best trained to provide this care. But most importantly the video and paper highlight what the IAFP believes to be essential to solve the Indiana family physician shortage: payment reform, loan forgiveness and scholarships, The Indiana University School of Medicine expansion, and changes within IUSM program.
At the end of the breakfast, the IAFP called on the legislators to support Senate Bill 393 and House Bill 1138, both bills create a loan forgiveness program for primary care physicians who practice in Indiana, and are an excellent first step in solving the issue.
The reception to the information was excellent, with most of the legislators staying long past the end of the breakfast to spend time speaking with individual physicians and the IAFP staff. The IAFP staff has continued to hear back positive remarks about our message.
You are welcome to read the IAFP’s paper (PDF file, 321 KB) and to view the video.
View the Family Medicine Legislative Breakfast Gallery here (PDF file, 167 KB)
The 2010 Indiana General Assembly Sine Die
Around 1 a.m. Saturday, March 13th, the Indiana General Assembly finished the 2010 short session. It was not until late Friday that both the House and Senate came to an agreement on two major bills that had held session for the last eight days, SB 23 Unemployment Insurance and HB 1367 Education.
The IAFP is excited to report that we had a major success in stopping the abolishment of the Indiana Tobacco Prevention and Cessation agency (ITPC). The IAFP has had a mandate since 2004 to protect ITPC and its funding. SB 298, which contained the provision to eliminate the expert staff and independent board for the agency passed the Senate but failed to be heard in the House. During conference committee there were numerous threats to amend the language abolishing the agency into other bills, but ITPC's opponents were unsuccessful.
Other successes this session include stopping a push by the pharmacists to be able to prescribe and administer the shingles and pneumonia vaccines. The IAFP was also able to convince a legislator that requiring all physicians who take Medicaid to have an electronic medical record in their office by 2011 would be prohibitively expensive and would only make physicians think twice about taking Medicaid patients. Another Medicaid mandate was proposed to require all physicians who take Medicaid patients to have a $50,000 surety bond for the purpose of re-couping fines and overpayments. The IAFP stopped that language from passing.
In 2008 the IAFP Congress of Delegates requested the IAFP work to require universal carding for alcohol purchases in Indiana. With the passage of SB 75, the IAFP is pleased to have such a law now in Indiana.
For more details on the major bills the IAFP monitored and lobbied for on your behalf, see below.
Bills passed by the General Assembly...
Alcoholic Beverages (SB 75)
Among other things, the bill requires carding for all person (universal carding language) for carryout liquor purchases. Not carding is only defensible if the patron appears to be over 50. The bill passed through its second house without any amendments, and was signed into law by the Governor on March 12th. The passage of this bill satisfies IAFP 2008 mandate on universal carding.
Ephedrine and Medication Substitution (HB 1320)
This bill creates a legislative study committee to study how the state and retailers can better stop the sale of ephedrine and pseudoephrine that goes to the production of methamphetamines. It also changes the current Indiana statute on how much ephedrine or pseudoephrine an individual can purchase to be the same as the federal statute - 3.6 grams per day or nine grams in 30 days. The legislation requires retailers to post a warning sign that it is a criminal offense to purchase more ephedrine or pseudoephrine than state limit.
Dead bills...
State Administration (SB 298)
This bill, authored by Senator Luke Kenley came from the Governor's office and merges the retirement fund for employees who are paid by the government (state employees, teachers, firefighters, police, judges, prosecuting attorneys, etc.), as well as abolishes the Indiana Tobacco Prevention and Cessation (ITPC) executive board and transfers all duties and budget to the state department of health. The IAFP is feels it is unwise to disturb the current effective ITPC structure, and is worried about the future of the money allocated for tobacco prevention and cessation. The bill passed through the Senate, and through an uprising of support for ITPC the bill was not passed out of committee in the House. The sections of the bill pertaining to pensions were amended into House Bill 1205.
Various Health Matters (SB 175)
Among other provisions this bill requires the state department of health to start a lead-based paint poisoning prevention program and establishes procedures of local health department inspections. The bill included a provision that changes the punishment for physician noncompliance in reporting to the state birth/death registry a decision by the medical licensing board instead of an automatic misdemeanor. On second reading in the House Rep. Charlie Brown amended into the bill the prohibition of smoking in public places excluding casinos. The bill was sent to conference committee, but the conferees were unable to come to an agreement on what should be included in the bill.
Midwives (SB 232)
Last year the IAFP opposed a similar bill, which almost passed out of the Indiana House of Representatives. The IAFP expected this bill would return during the 2010 session and we are happy to report it failed to receive a hearing in committee. The legislation would allow the practice of certified non-nurse midwives in Indiana and sets the qualifications for licensure.
Insurer Access to Providers (HB 1022)
After a promising interim study committee, and positive house committee hearing, the IAFP was encouraged by the prospect of HB 1022 passing out of the House. The bill would have ended the unfair insurer practice of requiring physicians to continue taking patients from a particular insurer or close their patient panel to all new patients. These "open access clauses" which are common in many large insurer contracts prevent physicians from being able to manage their own practice payor mix. Unfortunately, the bill failed to be heard on the floor of the House and is dead.
Smoking ban in public places (HB 1131)
The IAFP has been supportive of House Bill 1131, the smokefree workplaces law. The bill passed through the House, but establishments that limited patrons to 18 and older, private clubs, and more were exempted from the law. The bill did not receive a hearing in its Senate Committee, but the language was amended into SB 175 during second reading in the House, and then into HB 1132 in conference committee. Both SB 175 and HB 1132 did not survive conference committee.
Health and Medicaid Fraud Matters (HB 1226)
HB 1226 would have originally required a $50,000 surety bond from every Medicaid provider for the purpose of recouping fines for fraud, and would have allowed the Attorney General's office to seize medical records of physicians based on allegations of abandonment, without giving the physician a hearing. The IAFP worked with the author and the Attorney General's office to remove these offending portions of the bill. HB 1226 failed to receive a hearing in the Senate, but the portion of the bill on the Attorney General's ability to store truly abandoned medical records was amended into SB 356, which has successfully passed both houses and has been sent to the Governor's desk.
Texting while driving (HB 1279)
At the 2009 Annual Meeting, the IAFP Congress of Delegates resolution urged the IAFP to take action on the issue of drivers distracted by wireless communication devices. This is the first year the IAFP has supported a ban on texting while driving, although the issue has been at the General Assembly several years. The bill passed unanimously out of the House Public Policy committee, and out of the House with a vote of 95-3, however it was assigned to the Rules and Legislative Procedures committee in the House, and disappointingly never received a hearing.