Page 36 - OCMS1Q21

MSMS 2021 LEGISLATIVE PRIORITIES
The following are the legislative issues we are prioritizing in 2021. The majority of our resources and efforts will be dedicated to action on these issues.
Prior Authorization and Step Therapy Reform
The prior authorization process diverts valuable resources away from direct patient care, can delay the start or con- tinuation of necessary treatment, and can negatively impact patient health outcomes. Step therapy, also known as fail first, is another practice that dis- rupts patient care by requiring patients to try other therapies before being approved for the treatment that their doctor originally prescribed. MSMS will work closely with the Legislature, regulators and stakeholders on ways to streamline, standardize and make the prior authorization and step therapy process more transparent, clinically appropriate, and evidence based.
POLICY OBJECTIVE: Reform prior autho- rization and step therapy with a focus on clinical validity, continuity of care, transparency and fairness, and timely access and administrative efficiency.
ACTION: Advocate for legislation to reform prior authorization and step therapy, including efforts that promote transparency, appropriate clinical deci- sion-making, and timely processing of requests.
Patients are best served by a team- based approach that provides the maximum amount of choice for their care while ensuring that they benefit from the additional training and exper- tise having a physician on the team.
A highly functioning health care team is the best way to serve patients while addressing the other access issues, not legislation that creates silos. MSMS will continue to promote the role of the physician as the leader of the health care team and oppose any efforts to expand allied health professionals scope of practice that may put patients at risk.
POLICY OBJECTIVE: Protect the health and safety of patients by opposing efforts of health care practitioners
to seek licensure or recognition to perform tasks or procedures for which they lack the education, training or experience.
ACTION: Proactively promote phy- sician-led, team-based care efforts, including holistic approaches to scope of practice and licensure that meaning- fully address care.
Telemedicine
While telemedicine provided an avenue for health care providers
to safely treat patients during the COVID-19 pandemic, it has proven to be an effective care delivery method that ensures convenient and timely access to patients. Further, regard-
less of whether a patient receives care in-person or virtually, the standard for medical care does not change. Before the outbreak of COVID-19 insurers previously covered telemedicine visits to varying extents, however, there were often obstacles such as low reimburse- ment, restrictions on where the patient can be located, and types of services covered. While payers did respond by removing some of the regulatory and administrative burdens during the pan- demic, these policies are now reverting to pre-pandemic times.
POLICY OBJECTIVE: Achieve telemedi- cine parity for payment and services.
ACTION: Advocate for legislation that ensures payment and service parity for the use of telemedicine services in clinically-appropriate scenarios.
Team-Based Care/ Scope of Practice
36
MARCH/APRIL 2021 | WWW.OCMS-MI.ORG
14 miicchiigganMEEDDIICCIINEE®® || JJANUARY// FFEEBRUARY2021