| Your Duval County Medical Society is working very
diligently with the Florida Medical Association and the American Medical Association to
fight for your right to practice your chosen profession in a climate that is best suited
for you and your patients. Countless hours are spent each year -- locally, in Tallahassee
and in Washington -- educating legislators and policy makers on medical and patient
issues. For the most part, this effort has been effective.
We are engaged in an ongoing battle that best succeeds when you familiarize yourself
with the issues, discuss the issues with your family, staff, patients, friends and
legislators. Dealing in the legislative arena and the arena of public opinion building is
a job that needs everyone's assistance. Because of the nature of many of our issues,
instant gratification is not always possible. Some members have claimed that organized
medicine is not doing anything for you. If you feel this way, please take a closer look at
what is being done, and commit some time to take an active part in this process. You can
serve on the Legislative Committee or as a key contact physician for a legislator you may
know or want to get to know. Do not sit there and complain without having been involved.
Talk to those physicians you know who are not members of the DCMS about how unfair it
is for those who are members and fighting the battle to be footing the cost and
sacrificing the time while they reap the benefits. It is time they did their fair share.
Please review the following list of major legislative issues the FMA plans to have
addressed during the next legislative session. Our website - www.dcmsonline.org -
includes position papers on many of these issues with direct e-mail links to your
legislators. If you still feel that the DCMS is not doing anything for you please do
something about it. Please call one of the DCMS officers, board members or staff and share
your concerns and what you feel we should do to better serve your needs. This is very
important not only to you but also to the very purpose of our DCMS. If we are not serving
the members we are not performing our role.
1999 FMA Legislative Priorities
Managed Care Issues
Due Process
- Require managed care company to inform a physician of the reason for termination from
the plan.
- Allow physician to appeal the termination through an internal process established by the
managed care company, with the company maintaining the final decision authority (similar
to process within the hospital setting).
Patient Choice
- Allow patients to see a physician outside of the managed care panel, if they are willing
to pay a higher co-payment. The additional charge to the patient should be a reasonable
amount. This approach will not increase costs for the managed care company.
Enforcement Language for Late Payment by Managed Care Companies
- Add stronger enforcement language to the 1998 managed care late pay statutes,
encouraging managed care companies to comply with the timely payment statute.
Medical Directors Sign Care Denials
- Require the medical director, a Florida licensed physician, to sign any patient care
denials in writing. This will provide patients improved accountability from the managed
care companies' medical decision-makers.
HMO Accountability
- Hold managed care companies legally accountable for medical decisions they make. Allow
patients to bring lawsuits against managed care companies when their medical
determinations lead to patient injury or death.
Elimination of Exclusive Contracts Clauses
- Prohibit managed care companies from requiring physicians to contract "only"
with that company.
Continuity of Patient Care in Emergency Settings
- Require timely response to an emergency physician request to have a surgeon respond to
emergency. Allow the emergency physician to utilize the on call physician when a timely
response is not given by the managed care company. These physicians should be reimbursed
under provisions in current law, and they should be permitted to provide appropriate
follow up care to the patient for the emergency episode. Today, managed care companies
will at times transfer the care of the patient to one their physicians when the surgery
has been done, not allowing the surgeon to provide important follow up care.
Create Physician Review Panels
- Create physician review panels to review managed care company practices regarding
patient care issues. These panels would be within the Department of Insurance and be given
the authority to levy appropriate penalties for violations of state managed care laws and
regulations.
Managed Care Companies Honor Patient Contracts
- Require managed care companies to honor their contracts with patient for the terms of
the contract. When managed care companies market their contracts, they "sell"
various provisions, such as physicians on the panel, drug formularies, authorization
procedures, etc. The company should require honoring that contract for the entire period,
and not making changes that could limit a patient's access to services they had previously
purchased.
Tort Reform Issues
- Expert witnesses must be actively practicing in the same specialty as the defendant
physician.
- Allow the defense attorney to talk informally with the subsequent treating physician.
- Extend sovereign immunity to physicians providing care to indigent patients under
contracts with the state or federal government (i.e., Medicaid).
- Tighten the definition of frivolous lawsuits to reduce the number of such suits.
Scope Of Practice Issues
- Oppose any expansion of allied health professionals' scope of practice (i.e., ARNPs,
Optometrists, Pharmacists, Psychologists, etc.).
- Oppose Optometrists' hospital staff privileges.
- Oppose prescription authority for psychologists.
- Oppose controlled substance prescriptive authority for ARNP's.
- Oppose the creation of a "Pharmacist Practitioner".
- Authorize the Boards of Medicine and Osteopathic Medicine to take action against all
persons who inappropriately practice and/or advertise medical or surgery services. (Res.
98-57)
Additional Support Issues
- Repeal requirement that currently licensed physicians must be fingerprinted by the year
2000 relicensure cycle (Passed during the 1997 Session)
- Transfer of the Division of Alcohol, Drug Abuse and Mental Health to the Department of
Health.
- Increased funding for graduate medical education and research.
- Telemedicine - Licensure requirement for physicians providing "primary"
diagnosis.
- Repeal of the 1.5% tax on select physician-owned outpatient facilities (i.e., diagnostic
centers).
February, 1999/ Jacksonville Medicine
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