Position Statement Manual

Transcription

1 Position Statement Manual Compiled February 2011

2 Table of Contents Expansion of Scope of Practice by Professional Licensing Boards.. Page 3 Health System Reform. Page 4 Marijuana. Page 5 Medicaid Expansion... Page 6 MMA s Representation of all Physicians.. Page 7 Patient Centered Medical Home.. Page 8 Physician Assisted Suicide.. Page 9 Sustainable Growth Rate (SGR).. Page 10

3 POSITION STATEMENT ON EXPANSION OF SCOPE OF PRACTICE BY PROFESSIONAL LICENSING BOARDS ADOPTED SEPTEMBER 7, 2012 Expansion of Scope of Practice by Professional Licensing Boards The Montana Medical Association recognizes that professional licensing boards authorized by Montana state statutes to license individuals in certain health care professions ( health care licensing boards ) have, at times, attempted to and actually have expanded the scope of health care licensees without having the statutory authority to do so. This practice is of concern to medical physicians and other licensed health care professionals. Licensed health care professionals are required to obtain specialized training and education in their respective areas of practice. The licensure and educational requirements set forth in statute and administrative rules promulgated by health care licensing boards are intended to ensure that the licensees treat patients in a manner that results in a positive relationship between the treatment and the health and safety of those patients. The Montana legislature adopts laws related to health care licensing in order to provide for the health and safety of Montana residents. If a health care licensing board expands the scope of practice beyond that which has been provided by statute, that board is bypassing the Legislature s domain related to such matters and avoiding necessary, and usually helpful, discussion related to the promulgation of laws associated with the scope of practice of health care professionals. For these reasons, the Montana Medical Association believes that health care licensing boards should not adopt rules that would expand the scope of practice of Montana s licensed health care professionals without first having clear statutory authorization to do so. ( , MMABoT, 134 TH AM)

4 POSITION STATEMENT OF ON HEALTH SYSTEM REFORM Adopted September 12, 2009 The members of the Montana Medical Association want to assure our patients that we share their concerns about many aspects of health system reform. For many people the system is now broken and is not sustainable. There should be health care for all citizens. The health care system should be quality-based and patient-centered. Montana Medical Association physicians believe that insurance should be affordable, accessible, and portable. The doctor-patient relationship should stay strong. We believe that insurance should provide a basic benefit package based on best medical evidence. Patients should not be denied coverage based on pre-existing conditions. Physicians of the Montana Medical Association are committed to excellent patient care. We agree with the need to reduce waste as well as to provide incentives for quality improvement, prevention, and wellness. Legislative reform must emphasize the recruitment, training, and support of primary care physicians. We recognize a critical need for tort reform to help reduce unnecessary costs and continue excellent patient care. We strongly encourage our patients to empower themselves. Significant incentives should be provided toward healthy behavior. Patients benefit from education and better health choices. More personal responsibility will increase the health of our country s citizens. Ultimately, patients have responsibility for deciding on and paying for their care. We urge our legislators to keep the following goals in mind: Physicians and patients should be the ones to make individual health care decisions; Americans deserve to choose their physicians; Emphasize recruitment, training, and support of primary care physicians; Enact insurance market reforms that expand choice and eliminate exclusions for preexisting conditions; Streamline insurance claim forms and procedures; Enact tort reform to reduce the cost of defensive medicine; Provide market-based incentives for quality improvement in the provision of care; Invest in Health Information Technology to improve quality and safety for patients; and, Provide universal coverage to all Americans. It is important that reforms provide affordable, high-quality care while reducing unnecessary costs. We recognize that the problems in our system are entrenched. It is going to require the combined efforts of physicians and patients to get meaningful change. Remember, we all have the power of the vote. ( , MMABoT, 131 ST AM)

5 POLICY UPON MARIJUANA Adopted September 11, 2010 Evidence suggests that the use of marijuana has beneficial effects in the treatment of certain intractable medical conditions. Further evidence has also shown significant risks and side effects related to such use. To the extent the law permits use of marijuana for medical indications, marijuana should be used only with proper indication in a safe and effective way. Like any other plant derivative used in medicine, marijuana, in whatever form, should be subject to the same regulatory scrutiny as any other psychoactive drug with the potential for abuse. More research regarding the safety, dosage, and effectiveness of this treatment is needed. Marijuana is an unregulated product of uncertain quality, quantity, and potency. Marijuana should be regulated in the same manner as other psychoactive medications. ( , MMABoT, 132 nd AM)

6 POSITION STATEMENT ON MEDICAID EXPANSION ADOPTED SEPTEMBER 7, 2012 Medicaid Expansion The MMA supports Medicaid expansion under the condition that patient access to physician care be maintained, recognizing that adequate payment for services with annual inflationary adjustments based on the CPI for medical care is crucial to ensuring such access. ( , MMABoT, 134 TH AM)

7 POSITION STATEMENT ON MMA S REPRESENTATION OF ALL PHYSICIANS ADOPTED SEPTEMBER 7, 2012 MMA s Representation of All Physicians The MMA, as an organization, is charged by its members to represent all Montana physicians. The MMA endeavors to understand and promote the interests of physicians in all medical specialties, in all venues. Issues involved in the provision of medical care are common to those physicians who are employed by entities such as clinics or hospitals as well as those who are in private practice. The MMA s priorities include the: 1. Preservation of the physician/patient relationship and patient choice of provider. 2. Promotion of ethical and professional behavior among physicians. 3. Promotion of the health and wellbeing of the populace of Montana. 4. Promotion of evidence-based health care practice and delivery. 5. Promotion of a legislative and regulatory environment that will enhance and not limit or impede priorities 1-4 above. 6. Collaborative effort with other health care entities and organizations to promote programs that support the priorities of the MMA While recognizing that increased economic pressures and complex issues of practice management have driven many physicians into employed relationships, this does not diminish and may even increase the importance of the MMA. The MMA will continue to represent all physicians in their professional needs, including employment based issues. ( , MMABoT, 134 TH AM)

8 POSITION STATEMENT ON PATIENT CENTERED MEDICAL HOME ADOPTED SEPTEMBER 7, 2012 Patient Centered Medical Home Our medical care system is increasingly complex. Combined with an aging population and an increased burden of chronic disease there is a clear need for effective care management. Primary care providers can and do provide this but have not been financially rewarded in ways that encourage both optimal management of disease and the provision of comprehensive preventive care. The concept of a MedicalHome was originally developed for children with chronic illness who needed a primary care physician to coordinate their management among multiple providers. This concept has evolved into the Patient Centered Medical Home (PCMH) which encompasses many aspects of coordinated care management directed by primary providers in a variety of settings. Experience has shown that medical care provided in a PCMH can improve medical outcomes, patient and provider satisfaction, and at the same time lower overall medical spending. The Montana Medical Association recognizes the importance of providing comprehensive primary medical care to Montanans. We believe that the Patient Centered Medical Home model has the potential to improve individual and population health while at the same time helping to control the growth of medical spending. We fully support the development and continued refinement of a uniform definition of the PCMH to apply to qualified primary care practices in our state. We strongly encourage a uniform approach to financial support and the participation of all payers in order to encourage the formation and maintenance of these Medical Homes. ( , MMABoT, 134 TH AM)

9 POSITION STATEMENT UPON PHYSICIAN ASSISTED SUICIDE Adopted February 21, 2009 The Montana Medical Association does not condone the deliberate act of precipitating the death of a patient. This does not imply, however, that a physician using his or her best judgment should not allow a patient to die with dignity. MMA supports and advocates for compassionate and competent palliative care at the end of life and, furthermore, acknowledges that medical efforts to eliminate irreversible and extreme pain and suffering at the end of life are an appropriate medical response that may result in hastening the patient s death. MMA acknowledges the patient s legitimate right to autonomy at the end of life, but does not accept the proposition that death with dignity may be achieved only through physician assisted suicide. ( , MMABoT, 54th IM)

10 2021 Eleventh Avenue Suite 1 Helena, Montana FAX Intrastate Toll Free mma@mmaoffice.org Montana physicians urge steps be taken to ensure Montana seniors have ongoing access to health care. The Montana Medical Association (MMA) believes it to be critically important that the recommendations of the Joint Select Committee on Deficit Reduction include a full repeal of the flawed payment formula, the Medicare Sustainable Growth Rate (SGR). Only with such a permanent fix can ongoing access to health care for our seniors be appropriately addressed and new payment models be adopted that align payment policies to improve efficiency, quality of care, and care coordination. Further, the MMA holds the position that the Frontier Amendment be maintained as it allows frontier states to address the unique challenges in serving patients in rural areas. The repeal of this adjusted Medicare reimbursement for Frontier states would weaken the Medicare program for Montana s senior citizens by reinstating an unfair reimbursement policy. The additional revenue has helped facilities to ensure continued access to affordable, quality medical treatment by affording them the chance to take steps to mitigate provider shortages and upgrade medical technology. MMA takes the above position due to concerns that the ongoing access to health care for our seniors is seriously threatened. Compared to the rest of the country, Montana, at 17 percent, has an above average proportion of Medicare patients. At just 14 practicing physicians per 1,000 Medicare beneficiaries, Montana is well below the national average. The current SGR formula calls for cuts of 29.5% on January 1, 2012 for physician services. Short-term interventions have prevented harmful cuts in the past, but can no longer be the answer. The temporary patches have not kept up with the growth in physician practice costs, have created instability in physician practices and places seniors access to care in jeopardy. Further, the cost of permanent payment reform escalates with the continued delays. It is estimated that additional short-term interventions will double the cost to approximately $600 billion by The MMA strongly urges the Joint Select Committee on Deficit Reduction to include a provision to permanently reform the Medicare physician payment system. In addition, the MMA is not in support of the repeal of the Frontier Amendment.