FMA targets “Insurance company and government bureaucrats” in 2015 wish list

Florida’s leading physician lobby released its 2015 legislative wish list during the first committee week of the year, and has made keeping “insurance company and government bureaucrats” from getting interfering with the patient physician relationship its top priority.

In addition to insurance and Medicaid-related proposals, the physicians have included a four-pronged telemedicine initiative (which includes reimbursement parity), increases in Medicaid funding for physician reimbursement and graduate medical education, and opposing any new cause of action against physicians in the legislative agenda.

The priorities not only improve the overall health of Floridians they are good for the health care sector of the economy. Physicians have a positive impact on the economy, FMA president Alan B. Pillersdorf writes in the introduction to the 20-page document. He notes that the 43,000 physicians support more than 528,700 jobs, directly or indirectly and support $40.2 billion in wages.

A bevy of insurance reforms are the FMA’s top priority. Similar to last year, the FMA will push legislation that requires one standardized electronic  process for all insurance companies for submitting prior authorization requests. If insurers don’t respond within 72 hours the request for PA is approved.

The FMA also wants to alter fail first protocols. The proposal would require insurance companies to approve an override within the first 24 hours if during the fail first period a physician believes the treatment would cause an adverse reaction or cause physical harm.

The Senate Banking and Insurance Committee this week discussed some of the same issues.

Many of the changes made under the Affordable Care Act already have taken place and some of the wrinkles with Obamacare are becoming apparent. Doctors and insurance companies are both caught up in a provision of the Affordable Care Act that gives people a 90 day grace period before losing coverage for not paying premiums. Insurance companies are required to cover any care the patients sees for the first 30 days, only.

That means there are 60 days where claims could accrue but payment is not required. Physicians want the Legislature to sign off on a proposal that would give physicians the ability to make “appropriate payment arrangements” for patients with Obamacare plans after Day 60.