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The 152nd General Assembly was busy in March, packed with 12 days of session in Legislative Hall. Sessions will take a two-week break after the Easter and will resume again on April 16th.
We are excited to bring back a physician presence in Legislative Hall. MSD has brought back this time-honored tradition for several reasons:
- Physician presence in the hall during a critical time in health care
- Access to legislators
- Ability to testify (support/ oppose) in person, guaranteeing MSD’s message is heard by the legislature
- Networking with other health care professionals
Thank you to Dr. Robert Varipapa, Dr. Richard Henderson, Dr. Laura Moylan, Dr. Selvam Mascarenhas, Dr. Michael Bradley, and Dr. Olubusola Ogunlade for representing MSD in Legislative Hall in the first quarter. MSD staff/ lobbyists will draft the testimony on the physician’s behalf. We also submit the testimony for official public record. If you are interested in learning more about representing MSD at Legislative Hall, contact Lisa Gruss at Lisa.Gruss@medsocdel.org.
For an overview of bills, please see the bill chart.
Updates on Priority Legislative Topics
Prior Authorization Reform
MSD, along with the Delaware Healthcare Association (DHA), authored a bill to significantly reform the prior authorization process. SB 10, the "Delaware Pre-Authorization Reform Act of 2023," was introduced on June 8. In the off session, MSD led a working meeting with Senator Townsend, the bill sponsor, and critical stakeholders to ensure language meets the needs of physicians and patients. Senator Townsend has requested MSD to collaborate with the payors to ensure the revised bill can be reintroduced this session. The Government Affairs Committee is meeting to determine an ideal path forward to introduce a strong bill that supports improvements in the process and does not need adjustments in the legislation over the years (in other words – gets it right the first time).
Primary Care Reform
Primary Care Reform remains a strategic priority for MSD. Our physicians have continued crucial conversations with Senator Townsend, the bill’s sponsor, in the off-season about concerns in the delays of implementation of SB 120. The Primary Care Reform Collaborative (PCRC) of the Delaware Health Care Commission (DHCC) have drafted a model based on a PM/PM amount with a Standard Quality Incentive (SQI) (E&M codes) and prospective Continuous Quality Incentive (CQI) (value-based care transformation) components, which was presented at a recent PCRC meeting this month. MSD has drafted new streamlined enhancements to SB 120, which sunsets in 2025. These proposed enhancements have been approved internally by the Primary Care Subcommittee, Government Affairs Committee, and the Executive Board. MSD will be collaborating with key stakeholders over the next several months to discuss possible enhancements to SB 120. Additionally, the PCRC leadership has also recognized that legislative action may be needed to address the upcoming sunset of SB 120.
Educational Transparency
MSD met with Representative Minor-Brown in January to discuss next steps regarding Educational Transparency (Title Misappropriation) and what they would like to achieve through legislation in 2024. In Delaware, legislation exists regarding the use of the word “doctor” in the clinical setting. However, with the growth of the digital age and advertising, additional clarity is needed within the legislation to ensure transparency to the patient, as well as their safety. The bill sponsor has agreed to work with MSD regarding legislation to ensure clarity in the introduction of non-physician doctors to patients, as well as truthful and transparent advertising. However, non-physician degreed doctors would be able to continue to use their earned title. Leveraging an expert in this area, a bill has been drafted.
Physician Workforce
Physician workforce remains a key priority for MSD. MSD is working to build a repository of resources available in Delaware to support workforce initiatives. Please see the “Did You Know?” Section for highlights on one of these initiatives.
MSD Related Resolutions
The MSD Council adopted resolutions at its Annual Meetings related to current advocacy activity.
Gun Violence is a Public Health Crisis (A-2023)
This resolution, adopted in November 2023, recognizes gun violence. This resolution, introduced by the MSD Gun Violence Workgroup, has 3 resolves:
RESOLVED, That the Medical Society of Delaware acknowledge and declare that gun-related violence is a public health crisis;
RESOLVED, That the Medical Society of Delaware support effective public health firearm injury reduction interventions such as community violence intervention programs, as well as clinically driven intervention, including counseling patients and families on safe firearm storage; and
RESOLVED, That the Medical Society of Delaware support legislation appropriately vetted by the Government Affairs Committee including, but not limited to, legislation that creates an application process to obtain a handgun-qualified purchaser permit to authorize the purchase of a handgun, prohibits selling or transferring a handgun to an individual unless the individual has a handgun-qualified purchaser permit, requires that an applicant complete a firearms training course within 5 years before date of application, and requires the Department of Safety and Homeland Security to develop and administer a firearms training voucher program for low-income residents.
Currently, there is a bill (SS 1 for SB 2 w/ HA 2, HA 6, HA 10, HA 11) in this session that updates the code related to deadly weapons. This act has multiple components including creating an application process, requiring an application to complete a firearms training course within five years of application, adding limits on transfers and sales, among other new requirements for records and training. The voucher program for low-income residents was removed due to the fiscal note. The bill has passed both the house and the senate, and the Governor has committed to signing this legislation.
Addressing Health Disparities in Food Allergy Prevention (A-2022)
At the Annul Meeting of the Council in November 2022, Sunjay Shah, MD; Randeep Kahlon, MD; and Sangita Modi, MD introduced this resolution that was adopted by the Council as submitted.
RESOLVED, that the Medical Society of Delaware supports efforts by the Delaware State Legislature to provide education to families on food allergy prevention and create access to infant-safe peanut and well-cooked egg protein for all infants.
HB 274 amends the Delaware code relating to insurance coverage of allergen introduction in dietary supplements for infants. This act would require all health insurance plans subject to requirements under Delaware law, including Medicaid, to provide coverage to infants under the age of 1, of at least 1 early peanut allergen introduction dietary supplement and at least 1 early egg allergen introduction dietary supplement. The cost would be no charge to the insured patients. The bill is out of committee.
Other Updates
Please refer to the March 20, 2024, Legislative Alert regarding HB 350 and the proposed "Protect Medicaid Act of 2024."
Alzheimer's Disease, Dementia Education
MSD met with Senator Mantzavinos, the bill sponsor for SB 283 (151st) and its sister bill, SB 185, related to continuing education for the “diagnosis, treatment, and care of patients with Alzheimer’s disease or other dementias” in late October and again on February 26th. As a result of the latter meeting, it was agreed that the new proposed legislation will include a one-time, two-hour CME, due upon re-licensure. MSD is working with the American Medical Association (AMA) on suggested language for the bill sponsor. MSD is also working on a few areas of compromise including excluded specialties, attestation language, and education modules for physicians to select from.
HIV Pre-Exposure and Post-Exposure Prophylaxis Treatments
SB 194 proposes to increase the scope of practice for pharmacists, allowing them to initiate, dispense and administer HIV PrEP and PEP. PrEP is a medically complex process and MSD/GAC provided verbal and written testimony against this portion of the bill for several reasons. MSD met with the bill sponsor, pharmacists, and additional stakeholders regarding concerns with pharmacists increasing scope in this area. Several states allow for pharmacists to administer PrEP and MSD has engaged the AMA in this discussion, receiving feedback from other state medical societies on their experience. MSD is providing additional suggestions to the Senator McBride, the bill sponsor, based on feedback from the other state medical societies. The AMA does not support increased scope legislation. If you are interested in AMA resources regarding defending scope bills or supporting the increased education of physicians, contact Lisa Gruss at Lisa.Gruss@medsocdel.org or visit AMA’s Scope of Practice Campaign.
Coverage of Annual Ovarian Cancer Screening Tests
Speaker Longhurst introduced a bill to increase coverage of screening for ovarian cancer with HB 15 w/ HA 1. MSD is following the lead of ACOG on this bill. Both ACOG and MSD have raised concerns with this bill including the cons with codifying risk factors, not only in this bill, but all legislation. MSD and ACOG have also discussed the evidence-based pros and cons of screening and counseling with the bill sponsor. This bill has passed both houses. It was immediately signed by the Governor after passage in the Senate.
Coverage of Prostate Screening for Men at High Risk
Similarly, HB 302 (Rep. Bolden) requires all group, blanket, and individual health insurance plans to cover prostate screening for men at high risk. The proposed bill identifies certain high-risk groups. MSD supports the bill but has suggested different language that would refer to screening guidelines and does not codify specific populations. This bill is reported out of committee.
Coverage for Doula Services
In an effort to support maternal and infant health care in the state of Delaware, Representative Minor-Brown introduced HB 345. This act requires Medicaid coverage for additional postpartum visits with a doula upon recommendation of a licensed clinician. Both ACOG and MSD support this important bill. The bill is reported out of committee.
Increased Access to Mammograms
HB 253 is a bill that would update the Delaware Code relating to mammograms. This Act’s goal is to increase access to mammograms for women 40 years of age and older. Although MSD applauds the bill sponsor, Representative Williams, for the initiative to make preventive care more accessible to all, the bill lacks detail regarding follow-up to abnormal results and liability. MSD is collaborating with other stakeholders on this bill, including the American College of Radiology (ACR), to ensure that both the federal and local health care landscape is understood regarding access to mammograms and self-referrals. MSD and stakeholders are exploring the benefit of including language in the bill that would 1) limit the bill to large health care systems; and 2) utilize nurse navigators to support patients that do not have a physician of care as part of their self-referral.
Did you know?
Delaware is now home to six (6) residency programs, offering numerous opportunities to bring physicians to our state. To learn more – check out the Residency program webpage for these programs:
The Medical Society of Delaware currently boasts 212 resident members. Nicole Kushner, DO is the MSD Resident Representative on the MSD Executive Board and Council.
Here are some other interesting pearls from Dr. Kushner regarding the Residency Programs in Delaware:
- Delaware is home to 6 accredited residency programs with over 15 specialties represented.
- Delaware residency programs have strong connections with medical schools, including PCOM and Jefferson, to help educate our students and show them the benefits of Delaware.
- ChristianaCare has a multitude of fellowships, including cardiology, interventional cardiology/radiology, surgical oncology, ultrasound, and many others.
- The newest residency program in our state is Beebe Health Family Medicine and welcomed four wonderful residents in July 2023
- Residents in Delaware participate in many initiatives in our state, including holding leadership positions in MSD, DAFP, ACP, and many others.
Contact Us
For more details on specific legislation, or if you have other questions, please contact:
MSD actively monitors all health-related legislation and maintains an active and visible presence in the Legislative Hall on your behalf.
The Medical Society of Delaware Legislative e-Updates are a benefit to our members, providing information on legislative activity of interest in the 152nd General Assembly in Dover.
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