CMA fights federal bill that would allow VA to preempt state telemedicine laws The California Medical Association (CMA) and the American Medical Association (AMA) are fighting a provision in the National Defense Authorization Act (NDAA) for fiscal year 2017 that would preempt state telemedicine laws and dismantle accountability mechanisms needed to ensure patient protection. The NDAA is an annual piece of legislation that primarily authorizes the federal government to spend money for war operations and military base operations. The two houses of Congress passed their own versions of this annual legislation over the summer. The version passed by the U.S. Senate includes language that CMA believes would allow the Veteran's Administration (VA) to preempt state laws governing medical licensure, medical practice, professional liability and reimbursement by altering the applicable state law from where the patient receives the medical services to the location of the physician providing the services. Because of a multitude of differences between the two bills, a formal conference committee will be convened in September to reconcile the differences. CMA and AMA are working to get this language removed from the final bill. “Changing the applicable state laws from the location where the patient is located to the state where the health care provider is located for purposes of state licensure, medical liability and reimbursement does not achieve the intended outcome,” CMA and AMA wrote in the letter. “Namely, it would create confusion by altering well-established legal principles and open new conflicts of law questions, degrade important patient protections, and create confusion with regard to payment and coverage. If enacted, section 705(d) would dismantle accountability mechanisms needed to ensure patient protection because (1) state licensing boards where the patient is located would lack authority over practitioners licensed in another state and (2) state boards where the practitioner is licensed would have no authority to conduct investigations in a different state where the patient is located.“ Currently, patients and others may file complaints with the state medical board where medical care is rendered. Altering the applicable law to the state where the provider is located would place the burden solely on the patient to navigate through the complaint filing and investigatory process (once they have identified the state of licensure of the physician and applicable state medical practice laws) across one or more state lines. CMA and AMA strongly believe that enhancing access to care through telemedicine must be done so in a manner that ensures patient safety and accountability. New innovations to expand access must be designed to ensure the delivery of safe, quality care where clear lines of accountability are maintained. To read the letter, click here. September 22, 2016 CMA, General Telemedicine, Veterans, Regulatory Advocacy 0 0 Comment Read More »
CMA joins 97 specialty and state medical societies in letter to VA about plan to allow advanced practice registered nurses to practice independently The California Medical Association (CMA) joined 97 specialty and medical societies to send a letter to the Department of Veteran Affairs (VA) expressing concerns with a proposed rule that would allow advanced practice registered nurses (APRN) to practice independently in the VA health system. CMA also submitted an additional letter opposing the proposed regulations. The agency announced at the end of May that it wants to expand the scope of practice for APRNs to allow them to order and read diagnostic tests, administer anesthesia, prescribe medications and manage acute and chronic diseases—without physician oversight. The proposal is intended to address long wait times for veterans seeking health care. CMA and the other medical societies are extremely concerned that the VA rule would lower the standards of care and put the health of veterans at risk. “Nurses are an integral part of physician-led health care teams that deliver high-quality care to patients,” the letter said. “In the case of APRNs, they are well equipped to play advanced roles in the health care team. However, APRNs are not substitutes for physicians in diagnosing complex medical conditions, developing treatment plans that take into account patients’ wishes and limited health care resources, and ensuring that the treatment plan is followed by all members of the health care team.” The letter urges the VA to consider policy alternatives that prioritize team-based care rather than independent nursing practice. Under the proposed rule, APRNs working for the VA would be able to practice independently even in states like California where it is outside of their legally defined scope of practice. “The proposal supersedes state law, centralizes health care decision-making, and eliminates local control of licensing and regulation of physicians and health care providers,” the letter said. “This actually results in a lower-standard of care for our veterans than for other patients.” Click here to read the letter. August 8, 2016 General Registered Nurses, Regulatory Advocacy, Scope of Practice, Veterans, Nurses 0 0 Comment Read More »
Gov. Brown appoints CMA physician to California Department of Veterans Affairs Vito Imbasciani, M.D., a member of the California Medical Association (CMA) Board of Trustees, has been appointed secretary at the California Department of Veterans Affairs (CalVet), Gov. Jerry Brown announced Friday. Dr. Imbasciani, a Los Angeles democrat, previously served as surgeon in the U.S. Army Medical Corps from 1986 to 2014 and as state surgeon for the California National Guard from 2006 to 2014. He is currently the director of government relations at the Southern California Kaiser Permanente Medical Group, where he has also worked as a urologic surgeon for the past 18 years. Dr. Imbasciani received his medical degree from the University of Vermont College of Medicine and has Doctor of Philosophy and Master of Arts degrees in musicology from Cornell University. He has been a CMA Trustee since 2005 and is now president-elect of the Los Angeles County Medical Association. While Gov. Brown has announced Dr. Imbasciani’s appointment to CalVet, the position still requires confirmation from the Senate. September 23, 2015 General Veterans, Physician Leadership 0 0 Comment Read More »
Congress allows veterans to seek care outside VA system Congress yesterday sent a $17 billion landmark bill to President Obama that will help U.S. veterans avoid long waits for health care within the U.S. Department of Veterans Affairs (VA). There was overwhelming support in both the Senate (91-3) and House (unanimous) for the bill, which will provide $10 billion in emergency spending over the next three years to allow veterans to seek care from private doctors and other health professionals due to delays in the VA system. Veterans would have access to private doctors if they could not get an appointment with the VA within 30 days or if they live more than 40 miles from a VA clinic. The bill also includes $5 billion for hiring more VA doctors, nurses and other medical staff; and another $1.3 billion to open 27 new VA clinics across the country. The legislation also makes it easier to fire hospital administrators and senior VA executives for negligence or poor performance. The American Medical Association (AMA) applauded the move. “The AMA believes that all Americans should have timely access to health care, especially those who bravely serve our country,” said AMA President Robert M. Wah, M.D. “Our nation’s physicians can and should be a part of the solution to ensure America’s veterans can access the care they need and deserve.” August 4, 2014 General Hospitals/Health Care Facilities, Quality of Care, Veterans, Federal Legislation 0 0 Comment Read More »
