MDNews - Central New York

++++++++++++++++++++++++++++++++++++++++++++ ONONDAGA COUNTY MEDICAL SOCIETY + + ++++++++++++++++++++++++++++++++++++++++++++ +++ +++ Major Physician Issues in Proposed State Budget By Gerald N. Hoffman T HE STATE BUDGET for the fiscal year beginning April 1 is now the major focus of activity in Albany. On Jan. 17, Gov. Andrew Cuomo released his proposed budget, which is in the hands of the state Senate and the state Assembly. One of the key players in the annual battle of the budget is state Sen. John DeFrancisco of Syracuse, who chairs the Senate's Finance Committee. That committee and the Assembly Ways & Means Committee are charged with oversight responsibil- ity in the budget process. Of course, Senate Majority Leader Dean Skelos and Assembly Speaker Sheldon Silver will exert their influence and power as this process goes forward. Many physicians are disappointed that, as the Medical Society of the State of New York (MSSNY) has pointed out, "the bud- get does not contain the medical liability reforms that were in the governor's pro- posed 2011–12 budget." This was not a surprise since the Medicaid Redesign Team, which had recommended a cap on awards for non-economic damages a year ago, did not include a cap in its recommendations to the governor this year. It was encouraging, however, that the proposed budget continues the Excess Liability Program at the same level as for the current year. MSSNY's Committee for Physician Health also would receive its same appropriation, $990,000. MSSNY noted that "several but not all of the Medicaid Redesign Team [MRT] recommendations were included in the budget." What was "not included in the proposed budget were the recom- mendations of the MRT, which would eliminate the requirement for a written practice agreement and collaborative relationship between a nurse practitioner and physician. Another proposal recom- mended by the MRT but also not included in the proposed budget would have allowed physicians to determine the number of PAs they will supervise. Currently, physicians are restricted by law to supervising two PAs in private practice settings and up to six in Article 28 settings." Another item in the governor's proposed budget would establish a New York Health Insurance Exchange, as required by the federal health care reform law. The governor would establish a board to oper- ate the exchange. The board, according to the governor's plan, would consist of the state superintendent of insurance, the state commissioner of health and seven others. MSSNY had been hopeful that the budget bill would require that a practicing physician be appointed to the board. The governor does not mandate this requirement. MSSNY commented that "importantly" the proposed budget would mandate that health plans providing cover- age as part of the health exchange must comply with existing state law providing physician and patient protection. Other recommendations of the Medicaid Redesign Team that made the cut and were in Gov. Cuomo's budget package were provisions to allow general authoriza- tion for drugs subject to the Preferred Drug Program and extending regulations limiting reimbursement for potentially preventable conditions and complications to outpatient settings. State legislative leaders want to pass an on-time budget in a year when all state senators and members of the Assembly are up for reelection. On Feb. 2, the Onondaga County Medical Society's governing body held its annual State Legislative Reception and Roundtable Discussion. The governor's proposed budget and MSSNY's 42-page Legislative Program for 2012 were among the items covered at this event. MSSNY's Legislative Advocacy Priorities for 2012 are: 1. Support liability premium relief by enacting substantive civil justice reform. 2. Oppose regressive liability measures. 3. Realign insurance p a yme n t methodologies. 4. Oppose scope-of-practice expansion for non-physician providers. 5. Enhance quality of care. After 32 years on the job, I still dream about how much more effective physi- cians' organizations would be in Albany if the vast majority of physicians became an effective part of lobbying efforts to pass significant legislation in the best inter- ests of patients and physicians, and to oppose those measures that would make matters worse. Paid lobbyists, who for MSSNY are very talented and dedicated professionals, know full well that their efforts each year could be much more productive with increased participation of physicians, family members and staff. I would love to see my dream come true. Gerald N. (Jerry) Hoffman is Executive Vice President of the Onondaga County Medical Society and is co-author of two books, "Medical Malpractice Insurance, A Legislator's View" and "The History of Local Medical Care, 1806–2006." ■ MDNEWS.COM ■ MD NEWS Central New York | 5

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