Stop the presses!
Author: Schmidt, John H., III
Pub Date: 01/01/2011
Publication: Name: West Virginia Medical Journal Publisher: West Virginia State Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 West Virginia State Medical Association ISSN: 0043-3284
Issue: Date: Jan-Feb, 2011 Source Volume: 107 Source Issue: 1
Accession Number: 248734345
Full Text: Just as Angie was finalizing this issue of the Journal, a federal district judge in Virginia issued a ruling finding the individual mandate requirement under federal health care reform unconstitutional. This decision comes on the heels of two prior federal court rulings that upheld key provisions of the reform package, including the individual mandate. Court watchers and legal experts now say it is all but certain the United States Supreme Court will be forced, sooner rather than later, to resolve the constitutionality question of this and possibly other key provisions of the new federal health care law. 'Sooner' under even the most expeditious scenario, however, will likely be one to two years before our nation's highest court issues its final ruling.

I cannot recall a time in all my years as a practicing physician of the level of uncertainty we physicians have faced on so many fronts. Thanks to a ninth.. .and tenth reprieve in the last eight years by congress, the specter of a twenty five percent cut in Medicare reimbursement under the seriously flawed SGR formula was put off for another year. There has not been a December in the last eight years that physicians, faced with the possibility of a looming reimbursement cut, were forced to consider whether or not they would be able to continue to care for Medicare patients.

Possibly the most immediate concern for every West Virginia physician is the challenge to West Virginia's cap on non-economic damages, the cornerstone provision of our hard fought medical liability reform. Despite the fact that the state supreme court has upheld previously (1991 and 2001) that the state legislature was within its constitutional authority to place a cap on non-economic damages, the Court has again accepted a case (MacDonald v. City Hospital) that puts our cap squarely in jeopardy.

Physicians remember all too well the access to care crisis our West Virginia patients faced a decade ago when many physicians were forced out of practice or out of state because of our broken medical liability system. The improved practice environment the medical liability reforms have brought are now at risk. National actuarial experts calculated that the anticipated increase in medical liability insurance premiums will be eighteen percent--thanks to a ruling in Illinois striking down that state's non-economic damages cap. Higher insurance premiums, lower reimbursement, just more uncertainty for West Virginia physicians.

West Virginia physicians can have confidence in the advocacy efforts the West Virginia State Medical Association is making on their behalf. In my first few months as your president, I have visited a number of component societies around the state, participated in medical society meetings in our neighboring states and attended the Interim AMA meeting where the groundwork was laid for a strong push in 2011 for congressional action on legislation to allow physicians to directly contract with Medicare patients and not be hamstrung by the onerous 'take it or leave it' CMS provider participation requirements.

We have also been outspoken in the press and on public affairs programs about the importance of preserving our medical liability reform. We worked with a broad coalition of advocacy groups from the medical, business and insurance communities to submit Amicus briefs outlining our most persuasive legal and policy arguments to the state supreme court on why preserving the cap on non-economic damages is critical.

We pushed, prodded (and candidly, demanded) our congressional delegation for a permanent repeal to the SGR and coordinated a media outreach with AARP calling on congress to preserve access to care for the over 371,000 West Virginia seniors and our service men and women and their families who receive their health coverage under Tri-Care.

Our government relations committee is finalizing a pro-active agenda for the upcoming legislative session that begins January 12. The committee is making recommendations on several new items that will help improve the practice environment for all West Virginia physicians, including a measure to prohibit health insurance companies from creating silent PPO's. Notably absent from this year's agenda is our need to fight for the further phase out of the onerous provider tax. Every West Virginia physician has shared in our successful lobbying effort to repeal the provider tax. In case you missed it, as of July 1, 2010, the provider tax on physicians exists no longer thanks

to the efforts of your WVSMA.

Yes, physicians are faced with many uncertainties but rest assured your professional society is fighting every day on your behalf. Now is not the time to be discouraged--rather let us unite in our efforts to preserve and protect the practice of medicine for the future of our beloved profession and our patients.

John H. Schmidt III, MD

WVSMA President
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