Shaping Debate at State

CMS works at the grassroots to set legislative agendas in Springfield and Washington

CHICAGO MEDICAL Society resolutions led the way, shaping new policies and directives at the Illinois State Medical Society’s Annual House of Delegates. As a wellspring of these measures, CMS creates a powerful ally for local physicians and opportunities for those who want an active and personal role in shaping legislative agendas. The ISMS House met April 20-22 in Oak Brook. Meeting highlights include the installation of CMS Past President Kathy M. Tynus, MD, as ISMS president for 2018-2019 (see “Chicago Physician Installed as ISMS President”) and election of officers and trustees.
When it came to new policy, most CMS resolutions won approval by the House or were referred for study. Part of the Annual Meeting was also devoted to progress reports on efforts of years past such as CMS proposals for the elimination of restrictive covenants and anti-compete agreements and a physician bill of rights. In today’s evolving practice environment, CMS keeps its promise to fight vigorously for the interests of Chicago-area physicians. This representation comes with topnotch medical education and opportunities for physicians who want to influence legislation and public health advocacy.
Here’s a recap of CMS resolutions that won adoption or referral for study:

Use of HSAs for Direct Primary Care (Referred for Study)
Original Sponsor: Howard Axe, MD
This measure from CMS would expand access to primary care through state and national policy supporting patients’ use of health savings accounts to pay for direct primary care (DPC) services. CMS’ resolution seeks federal legislation that addresses and clarifies Internal Revenue Code (IRC) Section 223(c) so that DPC medical homes do not constitute a health plan; the measure also seeks to establish the legality of treating periodic payments to DPC practices as qualified medical expenses under IRC Section 213(d). Allowing periodic-fee agreements without IRS interference or penalty would improve access to all primary care providers, including those who practice in a DPC model.

Physician Compensation Reporting by Drug and Device Companies (Adopted)
Original Sponsor: Amy Derick, MD
Under this CMS measure, any compensation reported under the Physician Payments Sunshine Act must be accompanied by a verifiable receipt signed by the physician acknowledging receipt of that compensation. The resolution also seeks the immediate removal of contested reported compensation from the OpenPaymentsData.CMS.gov website until the reporting company validates the compensation with a signed receipt. Finally, the measure calls for fines when companies reporting physician payments do so without proper documentation. Such companies would be fined $1,000 per occurrence.
ISMS will transmit the resolution to the AMA for implementation with the federal Centers for Medicare and Medicaid Services.

Reform of Pharmaceutical Pricing: Negotiated Payment Schedules (Adopted)
Original Sponsor: Robert Sobel, MD
CMS’ resolution targets the process by which pharmaceutical companies create perverse price discrepancies between the newest agents and popular generics; incentivize “me-too” drug development and patent-extending alterations; and create a generic market with uneven competition under the Hatch-Waxman Act. The measure supports federal legislation to modify the Hatch-Waxman Act and the Biologics Price Competition and Innovation
Act (Biosimilars Act) so that time-specific patent protections are replaced with negotiated payment schedules and indefinite exclusivity for FDAapproved drugs in the Medicare Part D Program.
ISMS adopted the resolution and will transmit it to the AMA.

Mandatory Influenza Vaccination for Healthcare Workers (Substitute Adopted)
Original Sponsor: Jerrold B. Leikin, MD
Although healthcare workers are urged to protect patient safety by being immunized against vaccine-preventable illnesses, new policy advanced by CMS says that healthcare workers should not be terminated from employment due solely to their refusal to get the influenza vaccine. The resolution requests similar policy adoption by the AMA while still recommending that healthcare workers get immunized.

Prescription Drug Importation (Adopted as Amended)
Original Sponsor: A. Jay Chauhan, DO
This CMS measure supports the FDA allowing patients to purchase prescription medications from Canada. As such, ISMS will urge the AMA to work with the U.S. Congress and the FDA to establish oversight of any imported Canadian prescription medications to protect consumers from counterfeit, contaminated, and harmful drugs.

Trauma-Informed Care and Services for Victims of Human Trafficking (Adopted as Amended)
Original Sponsor: Traci A. Kurtzer, MD
CMS’ resolution to ISMS encourages physicians to take the lead in their institutions to ensure hospitals and clinics have policies and procedures in place to provide affordable, trauma-informed medical care to victim-survivors of human trafficking. Therefore, as per the CMS measure, ISMS will educate clinics, hospitals and physicians about the new Illinois State Law PA 99-870: Illinois Department of Healthcare and Family Services Medical Benefits for Non-citizen Victims of Trafficking, Torture or Other Serious Crimes, which became effective Jan. 1, 2018, and which amends the Public Aid Code to cover healthcare services for eligible non-citizens.

The Illinois Cranial Anticoagulation Reversal ICARE Initiative (Adopted)
Original Sponsors: Darian Esfahani, MD; Scott Leikin, DO; Joseph Lee, MD; Nikesh Bajaj, DO
CMS’ resolution to ISMS urges support for initiatives that reduce barriers to the use of anticoagulation reversal agents that are up to date with contemporary guidelines in emergency settings for hemorrhagic stroke and other life-threatening
clinical indications, including the Illinois Cranial Anticoagulation Reversal (ICARE) Initiative or subsequent iterations for the benefit of Illinois stroke patients.

Engage and Collaborate with the Joint Commission (Referred for Decision)
Original Sponsor: Jerrold B. Leikin, MD
This resolution calls upon ISMS and AMA to engage and collaborate with the Joint Commission’s Board and Leadership to provide and survey appropriate medical standards, as per its mission statement.

Abused and Neglected Child Reporting Act (Adopted)
Original Sponsor: Linda F. Gruenberg, DO
Per this resolution, ISMS will research the process for reporting cases of alleged child abuse as provided under the Abused and Neglected Child Reporting Act (325 ILCS 5/). It further calls for an amendment to the Illinois State Statute so that the Department of Children and Family Services (DCFS) and other agencies investigate any and all reported and alleged cases of abuse to a minor regardless of the alleged perpetrator’s relation to the child, lack of responsibility for the child, or the alleged perpetrator’s residence. Currently, those investigations do not extend to distant family members who have only occasional contact with the child or who live outside Illinois, or to adult friends and acquaintances of the family who do not reside in Illinois. Such individuals fall outside the definition of persons whom the DCFS will investigate for reported alleged child abuse.