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State legislative update: Maternal mortality tops concerns
The American Congress of Obstetricians and Gynecologists held its State Legislative Roundtable in late October in Arlington, Va., with ob.gyns. and their lobbyists from 46 states. This is the largest number of states ever represented at the roundtable event, and it reflects the increased participation and engagement in policy making by women’s health care providers.
In the initial session, each state representative presented their top legislative issues for the year.
Attendees also discussed an increasing number of policies that focused on the exclusion of family planning providers from Medicaid. Some states have passed legislation that excludes Planned Parenthood and other qualified providers from participating in state-funded programs. These efforts raise serious concerns about access to care.
Susan Stone, DNSc, the president-elect of the American College of Nurse-Midwives (ACNM) – who was a guest at the meeting – discussed midwifery issues and shared the group’s top legislative priorities with a focus on issues and states in which there could be collaboration between ACOG and the ACNM. This discussion was continued in the breakout sessions, where a smaller group of attendees discussed a variety of issues including oversight, licensing requirements, and collaborative practices.
Another topic for the breakout sessions was the Maternal Mortality Review Committees. With an estimated 700 women dying of pregnancy-related causes in the United States every year and an additional 65,000 women experiencing serious health complications, the creation of a Maternal Mortality Review Committee in each state is a top priority. State representatives discussed this legislation and reviewed how to work with state medical societies, other medical organizations, and advocacy groups to enact this legislation. ACOG has written a proposal that will be presented to the American Medical Association in order to get their support for the passage of state legislation to create Maternal Mortality Review Committees.
Contraception and abortion access continued to be hot topics of discussion. Some states have passed laws that would protect or expand contraceptive coverage and access to abortion regardless of changes that may occur at the federal level. A few states have passed legislation that allows pharmacists to prescribe hormonal contraception. Over-the-counter access to long-term hormonal contraception has not been approved by the Food and Drug Administration and is not currently available.
Many ACOG advocates are lobbying to block state efforts to restrict abortion access, such as laws that ban abortion after 20 weeks, which have been passed in many states. A few states have passed bills that criminalize physicians who perform abortions after 20 weeks. Some states have passed or are considering legislation that defines life as beginning at conception, also referred to as “personhood” legislation. However, other states have blocked bills that would have forced physicians to tell women that a medication abortion can be “reversed.”
During a media workshop, attendees discussed interactions with the media and the use of digital media to advance legislative issues. Throughout the Roundtable, attendees tweeted using the hashtag #ACOGLegWork. The success of #ACOGLegWork resulted in the hashtag trending on Twitter. Ob.gyns. were urged to follow @ACOGAction, ACOG’s advocacy Twitter account, and to try Twitter on their own.
The next meeting of the ACOG State Legislative Roundtable will be Oct. 27-28, 2018, in Nashville, Tenn.
Dr. Bohon is an ob.gyn. in private practice in Washington. She is an ACOG state legislative chair from the District of Columbia and a member of the Ob.Gyn. News Editorial Advisory Board. She reported having no relevant financial disclosures.
The American Congress of Obstetricians and Gynecologists held its State Legislative Roundtable in late October in Arlington, Va., with ob.gyns. and their lobbyists from 46 states. This is the largest number of states ever represented at the roundtable event, and it reflects the increased participation and engagement in policy making by women’s health care providers.
In the initial session, each state representative presented their top legislative issues for the year.
Attendees also discussed an increasing number of policies that focused on the exclusion of family planning providers from Medicaid. Some states have passed legislation that excludes Planned Parenthood and other qualified providers from participating in state-funded programs. These efforts raise serious concerns about access to care.
Susan Stone, DNSc, the president-elect of the American College of Nurse-Midwives (ACNM) – who was a guest at the meeting – discussed midwifery issues and shared the group’s top legislative priorities with a focus on issues and states in which there could be collaboration between ACOG and the ACNM. This discussion was continued in the breakout sessions, where a smaller group of attendees discussed a variety of issues including oversight, licensing requirements, and collaborative practices.
Another topic for the breakout sessions was the Maternal Mortality Review Committees. With an estimated 700 women dying of pregnancy-related causes in the United States every year and an additional 65,000 women experiencing serious health complications, the creation of a Maternal Mortality Review Committee in each state is a top priority. State representatives discussed this legislation and reviewed how to work with state medical societies, other medical organizations, and advocacy groups to enact this legislation. ACOG has written a proposal that will be presented to the American Medical Association in order to get their support for the passage of state legislation to create Maternal Mortality Review Committees.
Contraception and abortion access continued to be hot topics of discussion. Some states have passed laws that would protect or expand contraceptive coverage and access to abortion regardless of changes that may occur at the federal level. A few states have passed legislation that allows pharmacists to prescribe hormonal contraception. Over-the-counter access to long-term hormonal contraception has not been approved by the Food and Drug Administration and is not currently available.
Many ACOG advocates are lobbying to block state efforts to restrict abortion access, such as laws that ban abortion after 20 weeks, which have been passed in many states. A few states have passed bills that criminalize physicians who perform abortions after 20 weeks. Some states have passed or are considering legislation that defines life as beginning at conception, also referred to as “personhood” legislation. However, other states have blocked bills that would have forced physicians to tell women that a medication abortion can be “reversed.”
During a media workshop, attendees discussed interactions with the media and the use of digital media to advance legislative issues. Throughout the Roundtable, attendees tweeted using the hashtag #ACOGLegWork. The success of #ACOGLegWork resulted in the hashtag trending on Twitter. Ob.gyns. were urged to follow @ACOGAction, ACOG’s advocacy Twitter account, and to try Twitter on their own.
The next meeting of the ACOG State Legislative Roundtable will be Oct. 27-28, 2018, in Nashville, Tenn.
Dr. Bohon is an ob.gyn. in private practice in Washington. She is an ACOG state legislative chair from the District of Columbia and a member of the Ob.Gyn. News Editorial Advisory Board. She reported having no relevant financial disclosures.
The American Congress of Obstetricians and Gynecologists held its State Legislative Roundtable in late October in Arlington, Va., with ob.gyns. and their lobbyists from 46 states. This is the largest number of states ever represented at the roundtable event, and it reflects the increased participation and engagement in policy making by women’s health care providers.
In the initial session, each state representative presented their top legislative issues for the year.
Attendees also discussed an increasing number of policies that focused on the exclusion of family planning providers from Medicaid. Some states have passed legislation that excludes Planned Parenthood and other qualified providers from participating in state-funded programs. These efforts raise serious concerns about access to care.
Susan Stone, DNSc, the president-elect of the American College of Nurse-Midwives (ACNM) – who was a guest at the meeting – discussed midwifery issues and shared the group’s top legislative priorities with a focus on issues and states in which there could be collaboration between ACOG and the ACNM. This discussion was continued in the breakout sessions, where a smaller group of attendees discussed a variety of issues including oversight, licensing requirements, and collaborative practices.
Another topic for the breakout sessions was the Maternal Mortality Review Committees. With an estimated 700 women dying of pregnancy-related causes in the United States every year and an additional 65,000 women experiencing serious health complications, the creation of a Maternal Mortality Review Committee in each state is a top priority. State representatives discussed this legislation and reviewed how to work with state medical societies, other medical organizations, and advocacy groups to enact this legislation. ACOG has written a proposal that will be presented to the American Medical Association in order to get their support for the passage of state legislation to create Maternal Mortality Review Committees.
Contraception and abortion access continued to be hot topics of discussion. Some states have passed laws that would protect or expand contraceptive coverage and access to abortion regardless of changes that may occur at the federal level. A few states have passed legislation that allows pharmacists to prescribe hormonal contraception. Over-the-counter access to long-term hormonal contraception has not been approved by the Food and Drug Administration and is not currently available.
Many ACOG advocates are lobbying to block state efforts to restrict abortion access, such as laws that ban abortion after 20 weeks, which have been passed in many states. A few states have passed bills that criminalize physicians who perform abortions after 20 weeks. Some states have passed or are considering legislation that defines life as beginning at conception, also referred to as “personhood” legislation. However, other states have blocked bills that would have forced physicians to tell women that a medication abortion can be “reversed.”
During a media workshop, attendees discussed interactions with the media and the use of digital media to advance legislative issues. Throughout the Roundtable, attendees tweeted using the hashtag #ACOGLegWork. The success of #ACOGLegWork resulted in the hashtag trending on Twitter. Ob.gyns. were urged to follow @ACOGAction, ACOG’s advocacy Twitter account, and to try Twitter on their own.
The next meeting of the ACOG State Legislative Roundtable will be Oct. 27-28, 2018, in Nashville, Tenn.
Dr. Bohon is an ob.gyn. in private practice in Washington. She is an ACOG state legislative chair from the District of Columbia and a member of the Ob.Gyn. News Editorial Advisory Board. She reported having no relevant financial disclosures.
Want to take action on health care legislation? Here’s how
The U.S. House of Representatives recently passed a revised version of the American Health Care Act (AHCA), which the nonpartisan Congressional Budget Office concluded would result in 14 million people losing coverage by 2018 and 23 million people losing coverage by 2026.
The American Congress of Obstetricians and Gynecologists is opposed to this bill and has stated that it will leave Americans “worse off than they are today” by cutting Medicaid, eliminating Medicaid expansion, allowing states to opt out of covering essential benefits like maternity care, and weakening protections for people with preexisting conditions.
[polldaddy:9770191]
If you are concerned about the AHCA or other national or state legislation and want to take action, there are a variety of options. If you are an ACOG member, the staff can make advocacy relatively easy by providing background and talking points for your letters and phone calls. But even without that support, advocacy doesn’t need to be hard or time consuming.
State level
At the state level, the best person to contact is your ACOG section chairman, who can then direct you to your state’s legislative chairman. The legislative chairman will provide you with information on legislative actions that have been taken by the section. If you are interested in women’s health legislation, there may be an advocacy list to join that will provide legislative alerts. You may even choose to tweet about the alerts.
Often the state legislative chairman will send out information about an upcoming bill and ask for ACOG members to provide testimony. If there is a bill of particular interest, you can offer to testify either in person or submit written testimony. Often talking points are made available to help in the preparation of testimony.
Many states also have a Lobby Day, a day when members of the ob.gyn. community meet at the state house to advocate for or oppose legislation. This action can be easier than providing testimony because the time and date are predictable, while legislative hearings may not be.
There is a great deal that can be done at the state level in support of women’s health. Perhaps your state does not have a maternal mortality committee, perhaps there needs to be funding for vaccinations, or perhaps you want to support legislation that continues to provide health care for women even if the AHCA becomes law.
National action
Legislative action at the national level mirrors that at the state level, but it is coordinated by the ACOG Government Affairs Department. Contact this department via acog.org. One option is to become an advocate and receive legislative alerts. This alert system informs ACOG members about congressional actions and gives you the option to directly contact your members of Congress through email with a specific message. Some physicians may prefer to send an email different than the one provided by ACOG, while others may tweet using hashtags like #obgynaction or #docs4coverage.
You may prefer to contact your member of Congress by phone. The U.S. Capitol Switchboard number is 202-224-3121. Phone calls typically are taken by staff members. It is reasonable to ask for a staff member who handles the issue you wish to discuss. This person may be referred to as the L.A. (legislative assistant). Inform the staff member that you are a constituent and you would like to leave a brief message for the Senator or Representative. Your comments may be as brief as stating that you support or oppose a particular piece of legislation. As with the letter, you should state the reasons for your opinion and may include a short personal story. If you do not already know it, you should ask for the lawmaker’s position on the bill.
An ideal method of interacting with members of Congress is through town hall meetings. These meetings typically are posted on the member’s website and hearing from constituents in person can have a tremendous impact on legislators. Letters to the Editor, interviews with journalists, and advocating for candidates are also options to consider. In such cases, consider contacting the ACOG Government Affairs Department. They can provide helpful dos and don’ts before an interview is scheduled or an article is written.
Health care policymaking that is not based on scientific or medical evidence is dangerous for our patients. We, as their physicians, need to advocate on their behalf. Stay or get involved to help ensure that our patients can get the health care they need when they need it.
Dr. Bohon is an ob.gyn. in private practice in Washington, and an ACOG state legislative chair from the District of Columbia. She is a member of the Ob.Gyn. News Editorial Advisory Board. Dr. Bohon reported having no relevant financial disclosures.
The U.S. House of Representatives recently passed a revised version of the American Health Care Act (AHCA), which the nonpartisan Congressional Budget Office concluded would result in 14 million people losing coverage by 2018 and 23 million people losing coverage by 2026.
The American Congress of Obstetricians and Gynecologists is opposed to this bill and has stated that it will leave Americans “worse off than they are today” by cutting Medicaid, eliminating Medicaid expansion, allowing states to opt out of covering essential benefits like maternity care, and weakening protections for people with preexisting conditions.
[polldaddy:9770191]
If you are concerned about the AHCA or other national or state legislation and want to take action, there are a variety of options. If you are an ACOG member, the staff can make advocacy relatively easy by providing background and talking points for your letters and phone calls. But even without that support, advocacy doesn’t need to be hard or time consuming.
State level
At the state level, the best person to contact is your ACOG section chairman, who can then direct you to your state’s legislative chairman. The legislative chairman will provide you with information on legislative actions that have been taken by the section. If you are interested in women’s health legislation, there may be an advocacy list to join that will provide legislative alerts. You may even choose to tweet about the alerts.
Often the state legislative chairman will send out information about an upcoming bill and ask for ACOG members to provide testimony. If there is a bill of particular interest, you can offer to testify either in person or submit written testimony. Often talking points are made available to help in the preparation of testimony.
Many states also have a Lobby Day, a day when members of the ob.gyn. community meet at the state house to advocate for or oppose legislation. This action can be easier than providing testimony because the time and date are predictable, while legislative hearings may not be.
There is a great deal that can be done at the state level in support of women’s health. Perhaps your state does not have a maternal mortality committee, perhaps there needs to be funding for vaccinations, or perhaps you want to support legislation that continues to provide health care for women even if the AHCA becomes law.
National action
Legislative action at the national level mirrors that at the state level, but it is coordinated by the ACOG Government Affairs Department. Contact this department via acog.org. One option is to become an advocate and receive legislative alerts. This alert system informs ACOG members about congressional actions and gives you the option to directly contact your members of Congress through email with a specific message. Some physicians may prefer to send an email different than the one provided by ACOG, while others may tweet using hashtags like #obgynaction or #docs4coverage.
You may prefer to contact your member of Congress by phone. The U.S. Capitol Switchboard number is 202-224-3121. Phone calls typically are taken by staff members. It is reasonable to ask for a staff member who handles the issue you wish to discuss. This person may be referred to as the L.A. (legislative assistant). Inform the staff member that you are a constituent and you would like to leave a brief message for the Senator or Representative. Your comments may be as brief as stating that you support or oppose a particular piece of legislation. As with the letter, you should state the reasons for your opinion and may include a short personal story. If you do not already know it, you should ask for the lawmaker’s position on the bill.
An ideal method of interacting with members of Congress is through town hall meetings. These meetings typically are posted on the member’s website and hearing from constituents in person can have a tremendous impact on legislators. Letters to the Editor, interviews with journalists, and advocating for candidates are also options to consider. In such cases, consider contacting the ACOG Government Affairs Department. They can provide helpful dos and don’ts before an interview is scheduled or an article is written.
Health care policymaking that is not based on scientific or medical evidence is dangerous for our patients. We, as their physicians, need to advocate on their behalf. Stay or get involved to help ensure that our patients can get the health care they need when they need it.
Dr. Bohon is an ob.gyn. in private practice in Washington, and an ACOG state legislative chair from the District of Columbia. She is a member of the Ob.Gyn. News Editorial Advisory Board. Dr. Bohon reported having no relevant financial disclosures.
The U.S. House of Representatives recently passed a revised version of the American Health Care Act (AHCA), which the nonpartisan Congressional Budget Office concluded would result in 14 million people losing coverage by 2018 and 23 million people losing coverage by 2026.
The American Congress of Obstetricians and Gynecologists is opposed to this bill and has stated that it will leave Americans “worse off than they are today” by cutting Medicaid, eliminating Medicaid expansion, allowing states to opt out of covering essential benefits like maternity care, and weakening protections for people with preexisting conditions.
[polldaddy:9770191]
If you are concerned about the AHCA or other national or state legislation and want to take action, there are a variety of options. If you are an ACOG member, the staff can make advocacy relatively easy by providing background and talking points for your letters and phone calls. But even without that support, advocacy doesn’t need to be hard or time consuming.
State level
At the state level, the best person to contact is your ACOG section chairman, who can then direct you to your state’s legislative chairman. The legislative chairman will provide you with information on legislative actions that have been taken by the section. If you are interested in women’s health legislation, there may be an advocacy list to join that will provide legislative alerts. You may even choose to tweet about the alerts.
Often the state legislative chairman will send out information about an upcoming bill and ask for ACOG members to provide testimony. If there is a bill of particular interest, you can offer to testify either in person or submit written testimony. Often talking points are made available to help in the preparation of testimony.
Many states also have a Lobby Day, a day when members of the ob.gyn. community meet at the state house to advocate for or oppose legislation. This action can be easier than providing testimony because the time and date are predictable, while legislative hearings may not be.
There is a great deal that can be done at the state level in support of women’s health. Perhaps your state does not have a maternal mortality committee, perhaps there needs to be funding for vaccinations, or perhaps you want to support legislation that continues to provide health care for women even if the AHCA becomes law.
National action
Legislative action at the national level mirrors that at the state level, but it is coordinated by the ACOG Government Affairs Department. Contact this department via acog.org. One option is to become an advocate and receive legislative alerts. This alert system informs ACOG members about congressional actions and gives you the option to directly contact your members of Congress through email with a specific message. Some physicians may prefer to send an email different than the one provided by ACOG, while others may tweet using hashtags like #obgynaction or #docs4coverage.
You may prefer to contact your member of Congress by phone. The U.S. Capitol Switchboard number is 202-224-3121. Phone calls typically are taken by staff members. It is reasonable to ask for a staff member who handles the issue you wish to discuss. This person may be referred to as the L.A. (legislative assistant). Inform the staff member that you are a constituent and you would like to leave a brief message for the Senator or Representative. Your comments may be as brief as stating that you support or oppose a particular piece of legislation. As with the letter, you should state the reasons for your opinion and may include a short personal story. If you do not already know it, you should ask for the lawmaker’s position on the bill.
An ideal method of interacting with members of Congress is through town hall meetings. These meetings typically are posted on the member’s website and hearing from constituents in person can have a tremendous impact on legislators. Letters to the Editor, interviews with journalists, and advocating for candidates are also options to consider. In such cases, consider contacting the ACOG Government Affairs Department. They can provide helpful dos and don’ts before an interview is scheduled or an article is written.
Health care policymaking that is not based on scientific or medical evidence is dangerous for our patients. We, as their physicians, need to advocate on their behalf. Stay or get involved to help ensure that our patients can get the health care they need when they need it.
Dr. Bohon is an ob.gyn. in private practice in Washington, and an ACOG state legislative chair from the District of Columbia. She is a member of the Ob.Gyn. News Editorial Advisory Board. Dr. Bohon reported having no relevant financial disclosures.
Advisor’s Viewpoint: State legislative update
In mid-September, the American Congress of Obstetricians and Gynecologists’ state legislative chairs and lobbyists from 41 states met to discuss top state legislative issues. This group meets annually in the early fall in order to share legislative issues from the previous legislative session and discuss goals for the upcoming session. The attendees sit state by state around a large, rectangular table, where they can share challenges experienced and challenges expected with current legislation and emerging issues.
The discussion included recent legal decisions and new issues. One hot topic was the June 2016 Supreme Court ruling related to TRAP (Targeted Regulation of Abortion Providers) laws. Some states are still encumbered by TRAP laws, despite the recent ruling against the Texas abortion regulations. There are actions underway in some states to get these regulations reversed to be in compliance with the Supreme Court decision.
The Zika virus was a very popular topic. The states with reported cases discussed their efforts to inform patients about the virus and contain its spread. Funding and legislation in support of these efforts was discussed. A relatively new legislative action is exempting feminine hygiene products from state tax, the so-called tampon tax. This tax exemption was recently endorsed by the ACOG Committee on Government Affairs.
Another topic discussed was the push to create a Maternal Mortality Committee in each state. Some states have had this committee for many years and shared pearls for how to get the legislation passed. Collaboration with advocates in the medical community and with the state departments of health was considered to be critical in the passage of legislation to support the creation of these committees.
There was prolonged discussion in the general session, as well as in breakout sessions, about the different types of midwives and the goal to establish a collaborative working relationship with them. Questions discussed included the educational goals for each group, as well as their level of responsibility. The licensing of midwives varies between states, ranging from the State Board of Midwifery to the State Board of Nursing to the State Board of Medicine. Maine was recognized as a state that has successfully created a collaborative relationship with the midwives who practice there. ACOG continues to work with the American College of Nurse-Midwives to create collaborative practice relationships.
Another breakout session focused on reproductive health. This group discussed legislation that interferes with the patient-physician relationship, including mandating an outdated protocol for administering medication abortion and even threatening physicians who provide abortion services with jail time. State legislation to allow pharmacists to prescribe hormonal contraception was also reviewed.
There was consensus among the meeting participants that communication with legislators about evidence-based medicine and sound science, along with ob.gyns.’ advocacy in state legislatures, is critical to counterbalancing inappropriate political interference in the patient-physician relationship. The discussion also touched on the importance of continued collaboration with partners across the medical community, since attempts to legislate the practice of medicine can negatively impact a wide range of clinical practices.
Dr. Bohon is an ob.gyn. in private practice in Washington, D.C. She is an ACOG state legislative chair from the District of Columbia and a member of the Ob.Gyn. News Editorial Advisory Board. She reported having no relevant financial disclosures.
In mid-September, the American Congress of Obstetricians and Gynecologists’ state legislative chairs and lobbyists from 41 states met to discuss top state legislative issues. This group meets annually in the early fall in order to share legislative issues from the previous legislative session and discuss goals for the upcoming session. The attendees sit state by state around a large, rectangular table, where they can share challenges experienced and challenges expected with current legislation and emerging issues.
The discussion included recent legal decisions and new issues. One hot topic was the June 2016 Supreme Court ruling related to TRAP (Targeted Regulation of Abortion Providers) laws. Some states are still encumbered by TRAP laws, despite the recent ruling against the Texas abortion regulations. There are actions underway in some states to get these regulations reversed to be in compliance with the Supreme Court decision.
The Zika virus was a very popular topic. The states with reported cases discussed their efforts to inform patients about the virus and contain its spread. Funding and legislation in support of these efforts was discussed. A relatively new legislative action is exempting feminine hygiene products from state tax, the so-called tampon tax. This tax exemption was recently endorsed by the ACOG Committee on Government Affairs.
Another topic discussed was the push to create a Maternal Mortality Committee in each state. Some states have had this committee for many years and shared pearls for how to get the legislation passed. Collaboration with advocates in the medical community and with the state departments of health was considered to be critical in the passage of legislation to support the creation of these committees.
There was prolonged discussion in the general session, as well as in breakout sessions, about the different types of midwives and the goal to establish a collaborative working relationship with them. Questions discussed included the educational goals for each group, as well as their level of responsibility. The licensing of midwives varies between states, ranging from the State Board of Midwifery to the State Board of Nursing to the State Board of Medicine. Maine was recognized as a state that has successfully created a collaborative relationship with the midwives who practice there. ACOG continues to work with the American College of Nurse-Midwives to create collaborative practice relationships.
Another breakout session focused on reproductive health. This group discussed legislation that interferes with the patient-physician relationship, including mandating an outdated protocol for administering medication abortion and even threatening physicians who provide abortion services with jail time. State legislation to allow pharmacists to prescribe hormonal contraception was also reviewed.
There was consensus among the meeting participants that communication with legislators about evidence-based medicine and sound science, along with ob.gyns.’ advocacy in state legislatures, is critical to counterbalancing inappropriate political interference in the patient-physician relationship. The discussion also touched on the importance of continued collaboration with partners across the medical community, since attempts to legislate the practice of medicine can negatively impact a wide range of clinical practices.
Dr. Bohon is an ob.gyn. in private practice in Washington, D.C. She is an ACOG state legislative chair from the District of Columbia and a member of the Ob.Gyn. News Editorial Advisory Board. She reported having no relevant financial disclosures.
In mid-September, the American Congress of Obstetricians and Gynecologists’ state legislative chairs and lobbyists from 41 states met to discuss top state legislative issues. This group meets annually in the early fall in order to share legislative issues from the previous legislative session and discuss goals for the upcoming session. The attendees sit state by state around a large, rectangular table, where they can share challenges experienced and challenges expected with current legislation and emerging issues.
The discussion included recent legal decisions and new issues. One hot topic was the June 2016 Supreme Court ruling related to TRAP (Targeted Regulation of Abortion Providers) laws. Some states are still encumbered by TRAP laws, despite the recent ruling against the Texas abortion regulations. There are actions underway in some states to get these regulations reversed to be in compliance with the Supreme Court decision.
The Zika virus was a very popular topic. The states with reported cases discussed their efforts to inform patients about the virus and contain its spread. Funding and legislation in support of these efforts was discussed. A relatively new legislative action is exempting feminine hygiene products from state tax, the so-called tampon tax. This tax exemption was recently endorsed by the ACOG Committee on Government Affairs.
Another topic discussed was the push to create a Maternal Mortality Committee in each state. Some states have had this committee for many years and shared pearls for how to get the legislation passed. Collaboration with advocates in the medical community and with the state departments of health was considered to be critical in the passage of legislation to support the creation of these committees.
There was prolonged discussion in the general session, as well as in breakout sessions, about the different types of midwives and the goal to establish a collaborative working relationship with them. Questions discussed included the educational goals for each group, as well as their level of responsibility. The licensing of midwives varies between states, ranging from the State Board of Midwifery to the State Board of Nursing to the State Board of Medicine. Maine was recognized as a state that has successfully created a collaborative relationship with the midwives who practice there. ACOG continues to work with the American College of Nurse-Midwives to create collaborative practice relationships.
Another breakout session focused on reproductive health. This group discussed legislation that interferes with the patient-physician relationship, including mandating an outdated protocol for administering medication abortion and even threatening physicians who provide abortion services with jail time. State legislation to allow pharmacists to prescribe hormonal contraception was also reviewed.
There was consensus among the meeting participants that communication with legislators about evidence-based medicine and sound science, along with ob.gyns.’ advocacy in state legislatures, is critical to counterbalancing inappropriate political interference in the patient-physician relationship. The discussion also touched on the importance of continued collaboration with partners across the medical community, since attempts to legislate the practice of medicine can negatively impact a wide range of clinical practices.
Dr. Bohon is an ob.gyn. in private practice in Washington, D.C. She is an ACOG state legislative chair from the District of Columbia and a member of the Ob.Gyn. News Editorial Advisory Board. She reported having no relevant financial disclosures.
Congressional Leadership Conference
Repealing the Sustainable Growth Rate, gestational diabetes, more residency positions for ob.gyns., and reducing liability were on the minds of ob.gyns. at the Congressional Leadership Conference this year.
Approximately 400 ob.gyns. attended the 32nd annual American College of Obstetricians and Gynecologists Congressional Leadership Conference (CLC) in Washington, D.C., during March 2-4. Forty-nine states plus Puerto Rico; Washington, D.C.; and Ontario were represented. The attendees learned about pending legislation and subsequently lobbied their legislators in Congress for their cosponsorship of four bills.
While Congress met the April 1 deadline to avoid the 24% Medicare pay cut called for by the Sustainable Growth Rate (SGR) formula, it did so via a 1-year patch and not by passing the comprehensive reform favored by many physicians. The SGR has created financial instability in health care. More than $150 billion has been spent to avoid physician payment cuts and the temporary patch will increase that cost. CLC attendees had asked their representatives and senators to cosponsor the Sustainable Growth Rate Repeal and Medicare Provider Modernization Act of 2014 (H.R. 4015). This bill would repeal the SGR and guarantee physicians 5 years of payment increases at 0.5% per year. The House passed H.R. 4015, but a modification was introduced and passed by a voice vote. That is the bill that ultimately went to the Senate and was passed, and that President Obama signed.
The Gestational Diabetes Act of 2013 (H.R. 1915/S. 907) provides funding for research and surveillance to improve screening for gestational diabetes and track women who have this diagnosis. This disease is estimated to affect 18% of all pregnancies and is increasing in frequency, according to the American Diabetes Association. Currently, there is minimal research being conducted on gestational diabetes.
The Training Tomorrow’s Doctors Today Act of 2013 (H.R. 1201) provides for 15,000 additional residency positions over the next 5 years. Currently, Medicare pays $3 billion for resident salaries (direct graduate medical education) and $6.4 billion for the higher cost of patient care in teaching hospitals (indirect GME). The number of federally funded residency slots has not increased since 1997. It is anticipated that there will be an 18% shortage of ob.gyns. by 2030 and 25% by 2050 if there is no increase in residency positions, according to ACOG. This bill requires hospitals receiving federal funding to allocate 25% of residency slots to primary care and general surgery. In this bill, ob.gyn. is considered primary care. The Senate does not have a companion bill.
The Saving Lives, Saving Cost Act of 2014 (H.R. 4106) was introduced in the House by a Republican lawyer and a Democratic physician. This bill provides for the option of a review by an independent medical review panel in a medical malpractice case where adherence to approved clinical guidelines can be used as a defense. This bill strives to cut medical costs by reducing the incidence of defensive medicine and frivolous lawsuits through the establishment of quality-promoting guidelines. At the time of the CLC, this bill had recently been introduced. There is no companion bill in the Senate.
The next CLC will be March 8-10, 2015.
Dr. Bohon is the American College of Obstetricians and Gynecologists’ D.C. Section Fellow Chair and a private practice ob.gyn. in Washington. She said she had no relevant financial disclosures. E-mail her at obnews@frontlinemedcom.com.
*This story was updated 4/3/2014
Repealing the Sustainable Growth Rate, gestational diabetes, more residency positions for ob.gyns., and reducing liability were on the minds of ob.gyns. at the Congressional Leadership Conference this year.
Approximately 400 ob.gyns. attended the 32nd annual American College of Obstetricians and Gynecologists Congressional Leadership Conference (CLC) in Washington, D.C., during March 2-4. Forty-nine states plus Puerto Rico; Washington, D.C.; and Ontario were represented. The attendees learned about pending legislation and subsequently lobbied their legislators in Congress for their cosponsorship of four bills.
While Congress met the April 1 deadline to avoid the 24% Medicare pay cut called for by the Sustainable Growth Rate (SGR) formula, it did so via a 1-year patch and not by passing the comprehensive reform favored by many physicians. The SGR has created financial instability in health care. More than $150 billion has been spent to avoid physician payment cuts and the temporary patch will increase that cost. CLC attendees had asked their representatives and senators to cosponsor the Sustainable Growth Rate Repeal and Medicare Provider Modernization Act of 2014 (H.R. 4015). This bill would repeal the SGR and guarantee physicians 5 years of payment increases at 0.5% per year. The House passed H.R. 4015, but a modification was introduced and passed by a voice vote. That is the bill that ultimately went to the Senate and was passed, and that President Obama signed.
The Gestational Diabetes Act of 2013 (H.R. 1915/S. 907) provides funding for research and surveillance to improve screening for gestational diabetes and track women who have this diagnosis. This disease is estimated to affect 18% of all pregnancies and is increasing in frequency, according to the American Diabetes Association. Currently, there is minimal research being conducted on gestational diabetes.
The Training Tomorrow’s Doctors Today Act of 2013 (H.R. 1201) provides for 15,000 additional residency positions over the next 5 years. Currently, Medicare pays $3 billion for resident salaries (direct graduate medical education) and $6.4 billion for the higher cost of patient care in teaching hospitals (indirect GME). The number of federally funded residency slots has not increased since 1997. It is anticipated that there will be an 18% shortage of ob.gyns. by 2030 and 25% by 2050 if there is no increase in residency positions, according to ACOG. This bill requires hospitals receiving federal funding to allocate 25% of residency slots to primary care and general surgery. In this bill, ob.gyn. is considered primary care. The Senate does not have a companion bill.
The Saving Lives, Saving Cost Act of 2014 (H.R. 4106) was introduced in the House by a Republican lawyer and a Democratic physician. This bill provides for the option of a review by an independent medical review panel in a medical malpractice case where adherence to approved clinical guidelines can be used as a defense. This bill strives to cut medical costs by reducing the incidence of defensive medicine and frivolous lawsuits through the establishment of quality-promoting guidelines. At the time of the CLC, this bill had recently been introduced. There is no companion bill in the Senate.
The next CLC will be March 8-10, 2015.
Dr. Bohon is the American College of Obstetricians and Gynecologists’ D.C. Section Fellow Chair and a private practice ob.gyn. in Washington. She said she had no relevant financial disclosures. E-mail her at obnews@frontlinemedcom.com.
*This story was updated 4/3/2014
Repealing the Sustainable Growth Rate, gestational diabetes, more residency positions for ob.gyns., and reducing liability were on the minds of ob.gyns. at the Congressional Leadership Conference this year.
Approximately 400 ob.gyns. attended the 32nd annual American College of Obstetricians and Gynecologists Congressional Leadership Conference (CLC) in Washington, D.C., during March 2-4. Forty-nine states plus Puerto Rico; Washington, D.C.; and Ontario were represented. The attendees learned about pending legislation and subsequently lobbied their legislators in Congress for their cosponsorship of four bills.
While Congress met the April 1 deadline to avoid the 24% Medicare pay cut called for by the Sustainable Growth Rate (SGR) formula, it did so via a 1-year patch and not by passing the comprehensive reform favored by many physicians. The SGR has created financial instability in health care. More than $150 billion has been spent to avoid physician payment cuts and the temporary patch will increase that cost. CLC attendees had asked their representatives and senators to cosponsor the Sustainable Growth Rate Repeal and Medicare Provider Modernization Act of 2014 (H.R. 4015). This bill would repeal the SGR and guarantee physicians 5 years of payment increases at 0.5% per year. The House passed H.R. 4015, but a modification was introduced and passed by a voice vote. That is the bill that ultimately went to the Senate and was passed, and that President Obama signed.
The Gestational Diabetes Act of 2013 (H.R. 1915/S. 907) provides funding for research and surveillance to improve screening for gestational diabetes and track women who have this diagnosis. This disease is estimated to affect 18% of all pregnancies and is increasing in frequency, according to the American Diabetes Association. Currently, there is minimal research being conducted on gestational diabetes.
The Training Tomorrow’s Doctors Today Act of 2013 (H.R. 1201) provides for 15,000 additional residency positions over the next 5 years. Currently, Medicare pays $3 billion for resident salaries (direct graduate medical education) and $6.4 billion for the higher cost of patient care in teaching hospitals (indirect GME). The number of federally funded residency slots has not increased since 1997. It is anticipated that there will be an 18% shortage of ob.gyns. by 2030 and 25% by 2050 if there is no increase in residency positions, according to ACOG. This bill requires hospitals receiving federal funding to allocate 25% of residency slots to primary care and general surgery. In this bill, ob.gyn. is considered primary care. The Senate does not have a companion bill.
The Saving Lives, Saving Cost Act of 2014 (H.R. 4106) was introduced in the House by a Republican lawyer and a Democratic physician. This bill provides for the option of a review by an independent medical review panel in a medical malpractice case where adherence to approved clinical guidelines can be used as a defense. This bill strives to cut medical costs by reducing the incidence of defensive medicine and frivolous lawsuits through the establishment of quality-promoting guidelines. At the time of the CLC, this bill had recently been introduced. There is no companion bill in the Senate.
The next CLC will be March 8-10, 2015.
Dr. Bohon is the American College of Obstetricians and Gynecologists’ D.C. Section Fellow Chair and a private practice ob.gyn. in Washington. She said she had no relevant financial disclosures. E-mail her at obnews@frontlinemedcom.com.
*This story was updated 4/3/2014
ACOG Congressional Leadership Conference Legislative Actions
The American College of Obstetricians and Gynecologists 31st annual Congressional Leadership Conference (CLC) involved discussion of bills affecting women’s health care, graduate medical education, repeal of the Independent Payment Advisory Board, (IPAB) and repeal of the Sustainable Growth Rate (SGR).
Twelve Representatives and one Senator who came from Capitol Hill discussed these bills with the 330 ob.gyns. who attended the CLC (including 122 junior fellows).
Also included in the first 2 days of the conference was expert advice on how to advocate, provided by specialists and our own ACOG president James T. Breeden, who role-played as a senator being lobbied by ob.gyns.
Held March 3-5, 2013, in Washington, the CLC also gave the attendees the opportunity to visit their Representatives and Senators with requests for action on specific legislation.
The first "ask" was for cosponsorship of the Women’s Health Resolution SR 60 sponsored by senators Barbara Boxer (D-CA), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Frank Lautenberg (D-NJ) and Jeanne Shaheen (D-NH) and HR 94, sponsored by Rep. Jan Schakowsky (D-IL). Each of these resolutions endorses supportive efforts to ensure that women’s health is a priority in Congress and will be addressed positively. Specifically included is access to affordable insurance coverage for pregnancy care and access to contraception and other preventive services. It also opposes legislation that is harmful to women’s health and interferes with the patient-provider relationship.
The second "ask" was for support of HR 574, the Medicare Physician Payment Innovation Act of 2013, introduced by Rep. Allyson Schwartz (D-PA) and Rep. Joe Heck, D.O. (R-NV). Sponsorship for a companion bill in the Senate was the "ask" for senators because there is no comparable bill in the Senate. HR 574 repeals the SGR, which is a formula that establishes the annual goal for the cost of physician services in Medicare. If the costs are greater than budgeted, an occurrence every year since 2002, the reimbursement for physicians is cut. Every year this has happened, Congress has blocked the payment cut. The outcome of this action is an increasing cost overrun that is currently $138 billion. One year ago, it was $316 billion, so now is the time to act. This bill encourages the development of new payment and delivery models with a focus on quality, efficiency, and patient outcomes. Current best-practice models would be evaluated to determine the best system for high quality and high value care. With the SGR in place, increasing numbers of physicians are planning to opt out of Medicare, thus decreasing access to care for many patients.
The final "ask" was for cosponsorship of the Quality Care for Moms and Babies Act of 2013, HR 896, sponsored by Rep. Eliot Engel (D-NY) and Act S 425 cosponsored by Sen. Debbie Stabenow (D-MI) and Sen. Charles Grassley (R-IA). These bills allocate $15 million for the development and growth of collaboratives that help improve the health of mothers and babies and reduce health care costs. The collaboratives would encourage projects such as those that have been designed to increase breast feeding and decrease the number of cesarean sections performed. The bill also authorizes $16 million to facilitate a quality measurement program that includes collection of data through electronic health records.
Forty-nine states as well as Puerto Rico and Canada were represented at the conference.
The next CLC is scheduled for March 2-4, 2014.
Dr. Bohon is an ob.gyn in private practice in Washington. She is a member of the Ob.Gyn. News Editorial Advisory Board. She said that she had no relevant financial disclosures.
The American College of Obstetricians and Gynecologists 31st annual Congressional Leadership Conference (CLC) involved discussion of bills affecting women’s health care, graduate medical education, repeal of the Independent Payment Advisory Board, (IPAB) and repeal of the Sustainable Growth Rate (SGR).
Twelve Representatives and one Senator who came from Capitol Hill discussed these bills with the 330 ob.gyns. who attended the CLC (including 122 junior fellows).
Also included in the first 2 days of the conference was expert advice on how to advocate, provided by specialists and our own ACOG president James T. Breeden, who role-played as a senator being lobbied by ob.gyns.
Held March 3-5, 2013, in Washington, the CLC also gave the attendees the opportunity to visit their Representatives and Senators with requests for action on specific legislation.
The first "ask" was for cosponsorship of the Women’s Health Resolution SR 60 sponsored by senators Barbara Boxer (D-CA), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Frank Lautenberg (D-NJ) and Jeanne Shaheen (D-NH) and HR 94, sponsored by Rep. Jan Schakowsky (D-IL). Each of these resolutions endorses supportive efforts to ensure that women’s health is a priority in Congress and will be addressed positively. Specifically included is access to affordable insurance coverage for pregnancy care and access to contraception and other preventive services. It also opposes legislation that is harmful to women’s health and interferes with the patient-provider relationship.
The second "ask" was for support of HR 574, the Medicare Physician Payment Innovation Act of 2013, introduced by Rep. Allyson Schwartz (D-PA) and Rep. Joe Heck, D.O. (R-NV). Sponsorship for a companion bill in the Senate was the "ask" for senators because there is no comparable bill in the Senate. HR 574 repeals the SGR, which is a formula that establishes the annual goal for the cost of physician services in Medicare. If the costs are greater than budgeted, an occurrence every year since 2002, the reimbursement for physicians is cut. Every year this has happened, Congress has blocked the payment cut. The outcome of this action is an increasing cost overrun that is currently $138 billion. One year ago, it was $316 billion, so now is the time to act. This bill encourages the development of new payment and delivery models with a focus on quality, efficiency, and patient outcomes. Current best-practice models would be evaluated to determine the best system for high quality and high value care. With the SGR in place, increasing numbers of physicians are planning to opt out of Medicare, thus decreasing access to care for many patients.
The final "ask" was for cosponsorship of the Quality Care for Moms and Babies Act of 2013, HR 896, sponsored by Rep. Eliot Engel (D-NY) and Act S 425 cosponsored by Sen. Debbie Stabenow (D-MI) and Sen. Charles Grassley (R-IA). These bills allocate $15 million for the development and growth of collaboratives that help improve the health of mothers and babies and reduce health care costs. The collaboratives would encourage projects such as those that have been designed to increase breast feeding and decrease the number of cesarean sections performed. The bill also authorizes $16 million to facilitate a quality measurement program that includes collection of data through electronic health records.
Forty-nine states as well as Puerto Rico and Canada were represented at the conference.
The next CLC is scheduled for March 2-4, 2014.
Dr. Bohon is an ob.gyn in private practice in Washington. She is a member of the Ob.Gyn. News Editorial Advisory Board. She said that she had no relevant financial disclosures.
The American College of Obstetricians and Gynecologists 31st annual Congressional Leadership Conference (CLC) involved discussion of bills affecting women’s health care, graduate medical education, repeal of the Independent Payment Advisory Board, (IPAB) and repeal of the Sustainable Growth Rate (SGR).
Twelve Representatives and one Senator who came from Capitol Hill discussed these bills with the 330 ob.gyns. who attended the CLC (including 122 junior fellows).
Also included in the first 2 days of the conference was expert advice on how to advocate, provided by specialists and our own ACOG president James T. Breeden, who role-played as a senator being lobbied by ob.gyns.
Held March 3-5, 2013, in Washington, the CLC also gave the attendees the opportunity to visit their Representatives and Senators with requests for action on specific legislation.
The first "ask" was for cosponsorship of the Women’s Health Resolution SR 60 sponsored by senators Barbara Boxer (D-CA), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Frank Lautenberg (D-NJ) and Jeanne Shaheen (D-NH) and HR 94, sponsored by Rep. Jan Schakowsky (D-IL). Each of these resolutions endorses supportive efforts to ensure that women’s health is a priority in Congress and will be addressed positively. Specifically included is access to affordable insurance coverage for pregnancy care and access to contraception and other preventive services. It also opposes legislation that is harmful to women’s health and interferes with the patient-provider relationship.
The second "ask" was for support of HR 574, the Medicare Physician Payment Innovation Act of 2013, introduced by Rep. Allyson Schwartz (D-PA) and Rep. Joe Heck, D.O. (R-NV). Sponsorship for a companion bill in the Senate was the "ask" for senators because there is no comparable bill in the Senate. HR 574 repeals the SGR, which is a formula that establishes the annual goal for the cost of physician services in Medicare. If the costs are greater than budgeted, an occurrence every year since 2002, the reimbursement for physicians is cut. Every year this has happened, Congress has blocked the payment cut. The outcome of this action is an increasing cost overrun that is currently $138 billion. One year ago, it was $316 billion, so now is the time to act. This bill encourages the development of new payment and delivery models with a focus on quality, efficiency, and patient outcomes. Current best-practice models would be evaluated to determine the best system for high quality and high value care. With the SGR in place, increasing numbers of physicians are planning to opt out of Medicare, thus decreasing access to care for many patients.
The final "ask" was for cosponsorship of the Quality Care for Moms and Babies Act of 2013, HR 896, sponsored by Rep. Eliot Engel (D-NY) and Act S 425 cosponsored by Sen. Debbie Stabenow (D-MI) and Sen. Charles Grassley (R-IA). These bills allocate $15 million for the development and growth of collaboratives that help improve the health of mothers and babies and reduce health care costs. The collaboratives would encourage projects such as those that have been designed to increase breast feeding and decrease the number of cesarean sections performed. The bill also authorizes $16 million to facilitate a quality measurement program that includes collection of data through electronic health records.
Forty-nine states as well as Puerto Rico and Canada were represented at the conference.
The next CLC is scheduled for March 2-4, 2014.
Dr. Bohon is an ob.gyn in private practice in Washington. She is a member of the Ob.Gyn. News Editorial Advisory Board. She said that she had no relevant financial disclosures.