NV MGMA Membership - Legislative update

01 Jun 2017 5:44 AM | Anonymous

05/31/2017

NV MGMA Membership - Legislative update

Call to action

This session has included a myriad of healthcare issues, but as the final days come into focus, there are several issues around the payment for emergency services to providers and hospitals that remain unresolved and threaten the viability of those services within the state.

Two bills were introduced to address Out-of-Network payments for providers who care for emergent patients.  The Senate Bill promulgated by NSMA and MGMA, sponsored by Senator (and Doctor) Joe Hardy has died in Committee.  That bill would have used market-rate charges to identify the payments required by insurance companies.

AB382 is still alive and gets worse for physicians on every amendment.  In its current form, physicians would be required to accept as payment the 1) “average amount negotiated by the third party for in-network care” (no word on how this would be determined or verified), 2) 125% of Medicare or 3) arbitration.  We had worked hard to make arbitration something we could live with but in this version, the expense is split between both parties which is untenable for the vast majority of ER bills, which average a charge of $770 for an ER provider bill, the timeframes and steps are onerous and the guiding principles for the arbitrator to consider don’t include protective guidance about what should be considered.

Additionally, in late May, Maggie Carlson introduced AJR14 (first hearing was yesterday) which would rate-set the hospitals to 115% of Medicare for their emergency care. 

  • Providers aren’t included, but we de facto are because this influences the hospitals ability to pay for ER Call and the like.
  • Joint Resolutions (this is an Assembly JR) do not cross the Governor’s desk, so there is no opportunity for a veto.  They must pass two sessions in a row then go to a vote then become a constitutional amendment.  We would have rate-setting for emergency care in the Nevada Constitution. 

What are we doing?

Highly disturbing?  Correct!  The Nevada Medical Association (Catherine O’Mara) and their lobbyists have taken the lead on this fight.  NV MGMA has engaged through their association and has been present for negotiations, document reviews, drafting of compromises and the like.  Jeff Snyder, Donna Juell and I have offered suggestions, crafted responses, given testimony (I have testified 3 times on these issues), met with the Governor’s office (multiple times including yesterday).  We were met by an absolute unwillingness to negotiate on our bill.  Although they engaged us on AB382, it appears that none of that was taken to heart since the most recent amendment is worse than the original bill.  One can only assume it was a tactic to run out the clock.

What can you do?

Until the last amendment broke late Friday afternoon, we had been hopeful to have a reasonable compromise.  Sadly, the language put out was worse.  It is probably by design to allow us no time to rally the troops.  What you can do includes

  • Call your legislators, particularly those in the Senate and let them know you OPPOSE AB382 and AJR 14.  Click here to find your State Senator and State Assemblyman.
  • Review and distribute the attached flier (Click here for flyer)
  • Watch your email and plan to attend, sign-in in opposition at the next hearing for either/or both bills. 

 

Karen Massey, MHA, FACMPE, CPMSM