Gov. Hochul’s Budget Presents Big Challenges for Physician Community
Click to Enlarge
Colleagues:
On Tuesday, Governor Hochul released one of the most challenging budgets for the physician community in many years. This budget seeks to legislate through the power of the purse items such as physician assistant independence, workers compensation reform, and out of network physician payment. These items must be removed from the budget and be properly legislated by the Senate and Assembly.
While the physician community applauds such actions as prior authorization reforms, continued funding for the Doctors Across New York medical student loan forgiveness program and the Committee for Physician’s Health, the overall budget misses key opportunities to improve affordability for New Yorkers by meaningfully reforming the state’s broken liability system. Like every New Yorker who pays more every year in car or homeowners’ insurance, we doctors pay more in liability insurance than any other state because NY medical liability payouts in 2024 were more than California and Florida combined, with only a third of their population. This broken system needs to be fixed. All New Yorkers deserve to have more affordable insurance coverage.
The physicians of NY are committed to making care affordable and available, but this is not the cure. Expanding independence to Physician Assistants that feel that one day they can practice one specialty and then the next day practice another specialty without additional training will not balance the budget—and may break it. Giving more power to the insurance industry to arbitrarily set rates for emergent care through gutting the IDR will improve CEO pay and stock prices, will not help the budget, and will worsen emergent care accessibility and quality—especially for our most vulnerable New Yorkers.
Here is a summary of the budget from MSSNY’s Senior Vice-President & Chief Legislative Counsel, Moe Auster:
Adverse Provisions
- Require Physicians to pay 50% cost share for Excess
- Eliminate ability to appeal out of network Medicaid Managed Care disputes to IDR
- Change IDR process to re-include State Empire Plan enrollee disputes; however, make the arbitration consideration criteria more insurer-friendly by tying it to a “50% of allowed payments” benchmark
- Permitting many PAs to practice without any defined physician supervision after 8,000 hours of practice
- Eliminating the role of the county medical society in approving physicians to participate in the Workers’ Compensation program.
- Expand reporting requirements for completed material transactions of healthcare acquisitions
- Passing from SED to DOH oversight of physician private practice incorporation
Positive Provisions
- Prior Authorization reforms, including ensuring a prior authorization for a chronic condition shall not be less than one year
- Permitting Medical Assistants to administer immunizations
- Extends telehealth health insurance payment parity for 2 more years
- Linking immunization coverage standards to those recommended by AAP, AAFP, ACP or ACOG
- Expanding and clarifying coverage for Biomarker testing
- A new $75 million investment in the Medical Indemnity Fund
- Reducing Interest rates on court judgments
- Increased investment in the Early Intervention program
- CPH funded at historical level of $990,000
- Doctors Across New York medical student loan relief program funded at historical level of $15.86M
Advocacy matters, and as The Voice of New York Physicians, our collective voice must speak clearly on the needs of our patients and our profession.
Renew your MSSNY membership if you have not yet done so, or join if you are not a member. Please generously give to the PAC to support our profession in its advocacy.
Please review the MSSNY Grassroots Action Center for action items.
Most importantly, please plan to come to Albany on March 10 for MSSNY’s Annual Physician Advocacy Day.
Your voice matters. MSSNY amplifies that voice.
Thank you.
All the best,
David Jakubowicz, MD, FACS
MSSNY President
