Legislative Update

By Lauren Schmitt
Commonwealth Strategy Group

COPN Reform
The Governor’s COPN workgroup began meeting this summer and is mediated by Mark Rubin, who has a successful track record of finding consensus solutions for controversial issues. Dr. Claiborne Irby is the orthopaedic surgeon on the workgroup and there are two other physician representatives. The CEO of MSV, Melina Davis-Martin, is also on the group, along with hospital CEOs, health plan CEOs, patient advocacy representatives and other relevant stakeholders. The group is frequently meeting and the goal is to find consensus and recommend legislation to the Governor to introduce in the 2020 General Assembly session.

Surprise/Balance Billing
At the federal level, legislative and regulatory activity has dramatically increased in recent months. Competing bills in Congress have similar goals in reducing patient exposure to unexpected medical bills that result from gaps in insurance coverage and out-of-network health services. Most major physician organizations are supporting any measures that establish fair payment determinations, several taking the form of “baseball style” arbitration, known as Independent Dispute Resolution, where sides present their offers to settle out-of-network service disputes. Insurance companies have been pushing models that are based on regional average of their in-network rates. The negative net result of the insurance scheme is that it will extend in-network fee schedules to providers who are not under contract.

On the state level, VOS continues to work with MSV and other specialty societies on state-based solutions to protecting patients from insurance gaps and surprise bills. We are currently participating in the workgroup created in the budget that Secretary of Health and Human Resources, Dr. Dan Carey is convening to study Virginia’s role in the reform. We anticipate that this will once again be a top priority in the 2020 legislative session.

ORTHO-PAC
As mentioned, this is a critical election year and our PAC provides us access to candidates and the ability to compete in a crowded political field to get our issues heard. We have given out $42,500 in political contributions for the upcoming elections. Our current balance is $40,133. Thank you to everyone for helping build a strong ORTHO-PAC!