Punching Above Our Weight
Click to Enlarge
Colleagues:
This has been a big week for our lobbying efforts. Kudos to all who came to DC for the AMA National Advocacy Conference or visited Albany the same days for the Budget Hearings. I would like to share a personal vignette with you. We were in Senator Schumer’s office reiterating the urgent need for reversing the recent Medicare cuts and preventing future Medicaid cuts, to which the aides were offering the usual “The Senator shares your concerns…” To amplify my concerns, I referenced an alarming situation reported to me from a physician’s office regarding a managed care plan that was planning to drop their payments well below even Medicaid rates.
The rationale for the cuts was the uncertainty in Congress about future Medicaid funding. Never mind that such cuts have not yet happened, this company was acting now. That got the aide’s attention.
We made additional points that this was a concrete real-time example of how insurance companies are now acting. We said consolidation has resulted in the survival of only a few companies that now wield monopolistic power and present “take-it-or-leave-it” contracts with terms that are economically unsustainable. In addition, cumulative cuts and failure of payments to keep up with inflation have devastated practices. We also urged that any pending Medicaid cuts be done “surgically” so as to cut out the real fat and otherwise preserve physician payments.
Thankfully the company retreated from its plan to slash their payments to this physician office. Quite frankly, I must say that the result was perhaps more due to Heather Lopez’s efforts as our MSSNY insurance ombudswoman who was working behind the scenes to help this Clinic, and maybe less related to our lobbying earlier that day. Either way, whether it was from MSSNY staff advocacy with the insurer, or MSSNY lobbying that put this ball over the top, the bottom line is that MSSNY is in your corner fighting for you.
In DC, the big issues are Medicare payment reform and good prospects this year for a retrospective 2% increase and preserving physician practice payments despite looming Medicaid cuts. In Albany, we are lobbying hard for preservation of the dispute resolution process for resolving Medicaid managed care plan underpayments, workers comp issues, restoration of cuts to the Excess Medical Malpractice insurance layer, prior authorization, and scope of practice issues, among others.
All of this also takes money, both in terms of additional dues dollars to fund our advocacy efforts and in political activity. Both MSSNYPAC and AMPAC need your donations now. Our funds are low, and we are being vastly outspent by the insurance companies, drug companies, and PBM groups. Your leadership is doing all we can with our physical presence, but we need your help from back home with donations to the PACs. We are seeing results that surpass what should otherwise be expected with our limited resources. In that sense, we are punching above our weight. Imagine what we could accomplish if more physicians became members, and if more donated to the PAC. By the way, one does not have to be a member of MSSNY to donate to MSSNYPAC. So, if you are from outside NY and you are reading this message, yes, we would welcome your donations too. Click here to donate to MSSNYPAC.
Also, our Lobbying Day in Albany is scheduled for Tuesday March 11. Do come. For more information and to register today, click here.
All the best,
Jerome C. Cohen, MD
MSSNY President
