Legislative News

Pending Legislation of Interest - 2009 Massachusetts Legislative Session

7/13/2009

House Bill 1093 – An act authorizing health
care professionals to negotiate with health care
insurers and providing for the duties of the
Attorney General. Filed by Rep. Perone of
Worcester.

This bill provides an avenue for groups of health
care providers to directly negotiate with health
insurers on such things as:
-UR criteria / QA programs
-Clinical practice guidelines
-Formularies
-Methods and timing of payment, fee
schedules, payment and claims policies
-Administrative procedures
-Credentialing standards for selection,
retention and termination of participating
health care professionals

There is a section that creates one negotiator
and the bill does not require that negotiator to
report back to interested parties before cutting
the deal. Also has a State allowed exemption
from Federal anti trust laws by putting the
owness on the state attorney general.

This is a dangerous piece of legislation.

------------------------------------------------------

Senate bill 1321 – An act relative to increasing
access to primary care physicians in the
Commonwealth. Filed by Senator O’Leary from
Cape and Islands.

Seeks to increase access by limiting the number of
Medicaid patients a physician may have on their
panel. The purpose of this and legislation like this
around the country is to deter the creation of
“Medicaid mills”; practices that take on unlimited
numbers of Medicaid patients, provide poor care
and get millions in reimbursement. Though the
intent of the legislation is to protect patients,
as it is written it has the potential to limit a NP
PCP practice. If Medicaid counts NP patients in
collaborating MD’s panel it could decrease access
and limit our PCP status. Law would forbid a
physician to collaborate because it would put him
over the patient quota.

Another implication is that they may try and limit
NP panels. If that is the case, we should be allowed
to manage the same number of patients as the
physicians.

------------------------------------------------------

House bill 978 – An act to streamline the
physician credentialing process.

This time asking to only cover ED, anesthesia,
pathologists who are hospital based. It also
established a board of key stakeholders, including
MMS and BCBS. NPs are not included on this board.
The board can then choose to expand this expedited
credentialing to other groups of physicians.
Filed by Rep. Mariano of Norfolk County in the House
and then Senator Moore (Worcester) and Senator Tucker
(Middlesex and Essex) have filed similar bills in the
Senate.

We have always had the opinion that preferential
credentialing for physicians creates unfair advantages
and violates the anti trust laws. The language in this
type of legislation must include all providers.

------------------------------------------------------

Senate Bill 575: An act relative to increasing
access to primary care physicians for Mass Health
patients. Filed by Senator O’Leary (Cape and
Islands.

This bill asks that physicians who see Mass health
patients in their practice be granted an income tax credit,
up to 15%. Nurse practitioners who function as primary
care providers should be included and be eligible for this
same tax credit.

------------------------------------------------------

House Bill 2085: An act relative to nurse
anesthetists. Filed by Rep. Kahn (Middlesex).

This legislation opens Chapter 94c, the law
dealing with prescriptive practice. It proposes to
change the definition of advanced practice nurse
to include nurse anesthetists and midwives. The
supervisory language still exists. There are some
other language changes that need to be
monitored closely, as once this law is opened,
anyone can propose further language changes.