Health Equity

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Being a physician in the District in the 21st century means being on the front line of the most pressing public health issues in the world. In our small geographic boundaries, physicians help address issue found in every state all in one area. The issues are too lengthy to list on one webpage but physicians are on the front lines of addressing health issues for all District residents.

News, Statements, and Testimony on Health Equity Issues

25th Council session information coming soon.

 

Fed's Prior Auth Reforms Mirror DC Law

Jan 18, 2024, 09:19 AM by MSDC staff
New rules bring Medicare Advantage and Medicaid plans nationwide to similar standards to what DC private insurers need to comply with beginning this year.

 

CMS's announcement yesterday of new reforms to the Medicare Advantage, Medicaid, and Affordable Care Act plans' prior authorization rules are a huge step in reducing physician paperwork burden. They also mirror legislation passed by DC and supported by MSDC last year.

Among other changes, the new rules would require coverage for urgent treatments within 72 hours and seven day for non-urgent treatments. Insurers will also need to publicize prior authorization denial rates and justifications for denials. Changes will mostly be in place by 2026. However, the changes do not apply to all drug prescriptions.

These reforms were similar to those included in then-B25-124, the Prior Authorization Reform Amendment Act. That legislation applied to the private insurance market and (as of February) implements shorter turnaround times, more insurer disclosures and reporting, and more protections for patients' treatments from process abuse. The DC law did require funding in the District budget to apply to Medicaid and Alliance programs, although it is unclear how the new CMS requirements change this calculus.

American Medical Association analysis of CMS regulation

Sample of Health Equity Legislation MSDC Tracked 

 

Student Access to Treatment Amendment Act (B23-467)

What does it say? The bill allows for the administration of medicinal marijuana in schools as well as allows students to bring sunscreen to schools and apply it without a prescription.

MSDC position: MSDC supports the language permitting sunscreen application in schools

Current status: A win for DC physicians and public health! The legislation passed the Council in February and was signed by the Mayor. Previous temporary and emergency legislation permitted students to use sunscreen at schools this school year already.

Electronic Medical Order for Scope of Treatment Registry Amendment Act (B23-261)

What does it say? The bill requires DC Health to establish an electronic Medical Order for Scope of Treatment registry (eMOST).

MSDC position: MSDC supports this legislation to more easily allow patients to make their treatment orders known.

Current status: A win for the physician community and our patients! The Council passed the bill in December and the Mayor signed it into law on January 16, 2020.

Healthy Beverage Choices Amendment Act (B23-495)

What does it say? The bill would implement a 1.5 cent per ounce tax on the distribution of "sugary" beverages. The money collected from the tax would establish a Healthy People, Healthy Places Open Spaces Grant Program.

MSDC position: MSDC sent a letter to Council Chair Mendelson asking for a hearing to discuss all of the issues around a beverage tax.

Current status: The bill was introduced October 8, 2019 and referred to the Committee on Business and Economic Development and the Committee of the Whole.