Ready to Spring into Action!
Paul Killian, MD - PRS Advocacy Chair & Deborah Ann Shoemaker - PRS Lobbyist
Seasonal change is always exciting. Spring is one of my favorite times of the year as it brings renewal, rebirth, and an awakening. Being able to take my dog for a walk, or even sit out on my deck often changes my outlook.
At the federal and state advocacy level, spring brings negotiations by legislators and their respective leadership on the passage of annual budgets that guide projects for the upcoming year. With Governor Wolf and President Biden being Democrats, budget proposals often get ripped apart by Republican leadership, citing excessive spending and/or unnecessary reforms that will only add to the overall state/national debt. Each party jockeys for their “wish list” and “legislative priorities” to be considered in exchange for votes. So, as you would guess, until the last vote is cast, it is anyone’s guess which bills will move into position during thistime. For that reason, as soon as we catch wind of any movement that affects our membership, we will ask for your grassroots advocacy support.
Here is an update on grassroots advocacy activities that have occurred since our last newsletter article.
SPRING INTO ACTION: CO-PAYMENT ACCUMULATOR
The timing is right to spring into action to pass legislation to prevent Accumulator Adjustment Programs within certain state regulated plans. And yes, your PRS leadership has taken an important role in moving this proposed legislation in the right direction.
Senate Bill 196 was reintroduced in early February. As this is one of the top priorities for both PRS and our national partners at CRSO and ACR, we jumped into action. We, along with CRSO, have joined the Make All Co-Pays Count Coalition. The Coalition focuses on the enactment of Co-Payment Accumulator legislation at the state and federal level. Our lobbyist has recently met with CRSO and the Immune Deficiency Foundation to discuss strategy and next step(s). As part of our grassroots advocacy efforts, we will be participating in a meeting with the state Department of Insurance and the Pennsylvania Insurance Federation to discuss the issue and any potential areas of mutual agreement. As this issue develops, we will provide member updates and opportunities for collaboration.
SPRING INTO ACTION: ASSISTING OUR FEDERAL PARTNERS AT ACR AND CSRO
With the advent of a new legislative session, and our dedicated focus on advocacy, we have made a concerted effort to assist our federal rheumatology partners.
Over the past few months, PRS has:
- Signed onto a joint letter highlighting existing/emerging concerns with Medicare’s Self-Administered Drug (SAD) list.
- Signed onto a joint letter urging COVID vaccinations for immunosuppressed patients.
- Signed onto a joint letter supporting HR 315: extending moratorium on Medicare sequester.
- Signed onto a joint letter supporting ACR’s Application for CDC Grant; and
- Signed onto letter with ACR expressing concern/opposition to July 2020 Office of the Inspector General’s (OIG) report/recommendation on excluding self-administered versions of Orencia and Cimzia in Medicare Part B payment calculation.
Our lobbyist meets regularly with the CRSO lobbyist to discuss advocacy priorities and to discuss state and federal issues. PRS is being seen by our federal partners as an invaluable resource, giving clinical expertise at the local level that can benefit all rheumatologists and their patients.
SPRING INTO ACTION: PRIOR AUTHORIZATION
Onerous and antiquated prior authorization policies for prescription medications and/or routine treatments have been in place as long as we can remember. The rationale that insurers use to institute these “cost saving and patient safety measures” (in their words) are just as outdated.
With the advent of COVID-19, the increased use of telemedicine and the relaxation of many prior authorization requirements, the timing is right to spring into action and get more prior authorization reforms enacted in the commonwealth.
Earlier this year, at the request of our friends at PAMED, PRS sent a member alert to seek co-sponsors. House Bill 225, and its companion bill in the Senate (Senate Bill 225) have been introduced in their respective chambers. Negotiations between insurers, the state insurance department, PAMED and other medical specialty/consumer stakeholders has begun. However, now it is time to spring into action.
The Prior Authorization Coalition, comprised of numerous consumer and provider advocates, will be holding a press conference on May 24th from 11 AM-12 PM at the state Capitol. Although this event will be patient focused, PAMED is looking for White Coats to stand with patients and families demanding reform. For more information, or to register, please check out PAMED’s website at www.pamedsoc.org or by contacting our lobbyist.
SPRING INTO ACTION: STEP THERAPY
House Bill 599 (Printer’s Number 568) was reintroduced in late February to address step therapy/non-medical switching. A coalition was created a few legislative sessions ago to address this issue. Although passage of legislation to eliminate step therapy is one of PRS legislative priorities, our lobbyist does not believe this bill is on the fast track. When House Bill 599 starts to move, we will ask members to spring into action.
SPRING INTO ACTION: ASSISTING OUR COLLEAGUES WITHIN PAMED
As a small fish in a bigger pond, we get the opportunity to work with our medical specialty colleagues within PAMED’s Total Excellence in Association Management (TEAM) department and PAMED in areas of mutual interest that benefit all physicians. PAMED has taken the lead on crucial legislative and regulatory initiatives, such as scope of practice expansion, medical malpractice, change of venue for liability actions, non-disclosure agreements and payer relations. We also can express our concerns at PAMED’s Specialty Leadership Cabinet (SLC) or at the annual House of Delegates (HOD). Although we do not have a dedicated representative this year at HOD, our voice can still be heard.
House of Delegates:
For example, we have been informed that our colleagues at the Pennsylvania Academy of Dermatology are looking to introduce a House of Delegate Resolution on the cost of pharmaceuticals/cost to patients. Our lobbyist expressed our desire to be involved via reviewing resolution/supporting as appropriate. As soon as we have details on this resolution or any others introduced that impact your work, we will forward it to members for action.
House Bill 681 (Printer’s Number 1187) was recently introduced in late February by Representative Toller Ecker to address non-compete agreements. It was amended in early April to include provisions related to restricted covenants. PAMED is doing the heavy lift, providing information to members and non-members alike highlighting why all physicians should be concerned with passage of this initiative. As of this writing, the bill rests in the House Appropriations Committee awaiting consideration. We have enclosed a copy of their talking points for your use. When Calls to Action are unveiled, we need to heed the call and get involved.
SPRING INTO ACTION: ADVOCACY RESOURCES ON OUR WEBSITE
PRS has officially sprang into action by dedicating a portion of our website to advocacy. Working closely with TEAM’s Marketing and Communications Department, Dr. Killian, and our executive director, our lobbyist drafted an action plan for this section.
Without giving too much away, we would like to provide members with regular legislative updates, access to our most current legislative watch list and pertinent information on our legislative priorities. It is also important to inform members on areas of collaboration with our partners at ACR, CRSO and PAMED.
Providing a one-stop shop for PRS advocacy will allow our members to be well-informed and ready to spring into action.
SPRING INTO ACTION: ATTEND OUR ANNUAL MEETING
Last, but not least, one of the best ways to get politically active is to educate our members about grassroots advocacy, our issues and how to get engaged. At our annual scientific meeting, scheduled for September 18-19, 2021, there will be a presentation on PRS advocacy. Closer to the meeting, we will provide details. Regardless of our method of meeting (in-person, hybrid, or virtual - still being hammered out at this time), we look forward to springing into action.
These are exciting times, full of opportunities to reinvigorate and renew your dedication to your patients and to your fellow rheumatology colleagues. As we are hopefully turning the corner in combatting COVID, it is time to spring into action. Please do not hesitate to reach out to our lobbyist via email (firstname.lastname@example.org) or to Dr. Killian at email@example.com if you have any questions, need more information, or want to get involved.