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Informed Consent, Prior Authorization, and More: Updates from PAMED’s Board of Trustees Meeting

Pennsylvania Medical Society (PAMED) and medical specialty leaders met in Harrisburg on Aug. 15-16, 2017, to address some of the health care hot topics affecting physicians and patients in the state. Issues on the agenda included the recent Pa. Supreme Court decision on informed consent and PAMED's advocacy campaign to reform the current prior authorization process.

Here are highlights of the issues addressed by Pennsylvania physician leaders:

  • Informed Consent—A recent Pa. Supreme Court ruling, which states that the duty to obtain a patient's informed consent is a non-delegable duty owed by the physician conducting the surgery or treatment, is having a significant impact on the practice of medicine in Pennsylvania. PAMED physician leaders voted to explore possible legislative solutions that would clarify the informed consent process in Pennsylvania.

    Additionally, PAMED recently conducted a member survey on informed consent and found that some physicians are reporting negative impacts such as delays in patient care. Survey results will be shared with members soon. Get details on the Court's decision, as well as a member-exclusive video and Quick Consult fact sheet with guidance, at www.pamedsoc.org/informedconsent.
  • Prior Authorization Reform—The current prior authorization process with insurance companies lacks transparency, and long wait times jeopardize timely patient care. PAMED supports HB 1293, state legislation that would address these issues. Find out about PAMED's prior authorization advocacy initiative—including how you can encourage patients to share their stories with lawmakers and how to spread the word via a new social media campaign—at www.pamedsoc.org/priorauth.

  • Independence Blue Cross Modifier 25 Policy Change—PAMED will continue to advocate on behalf of physicians in strong opposition to a new Independence Blue Cross (IBC) payment policy, which, effective Aug. 1, is reducing physician reimbursement by 50 percent when Modifier 25 is used. Learn more at www.pamedsoc.org/modifier25.

  • Out-of-Network Physician Payment—PAMED will stand behind the specialty societies in their legislative efforts to support physicians' ability to continue to bill patients for their services, and at the same time, to support patient access to care, patient choice, patient billing transparency, and patient protections from financial hardship caused by business decisions of insurers narrowing their networks of providers and shifting more of the cost-sharing burden for in-and-out-of-network care to patients without their knowledge. PAMED will also support the AMA's Principles of Out of Network Care.

  • PAMED's Care Centered Collaborative—The Care Centered Collaborative (CCC) is PAMED's strategic partner helping physicians and practices succeed in value-based care. CEO Jaan Sidorov, MD, shared updates, including the CCC's development of business plans for a management services organization (MSO) and a population health service offering. Access the CCC's resources, including a MACRA/MIPS reporting tool, at www.patientccc.com.

To learn more about PAMED's advocacy efforts on behalf of physicians and patients, visit www.pamedsoc.org/advocacy

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