Sept. 6, 2018: State Advocacy Update


The AMA and the Utah Medical Association submitted a statement (PDF) to the Utah insurance commissioner during an Aug. 17 public hearing concerning the proposed CVS-Aetna merger in Utah. The statement urged the commissioner to block the proposed merger in Utah on grounds that it is anti-competitive under Utah laws in the Medicare Part D stand-alone prescription drug plan (PDP) market.

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The statement was based on an analysis (PDF) given by Richard M. Scheffler PhD, a health economics professor at the University of California, Berkeley. The statement and Dr. Scheffler's expert report found that the merger's claimed efficiencies, such as expanded use of retail clinics, would not be sufficient to offset the anticompetitive effects. The AMA will continue to oppose the proposed CVS-Aetna merger before state and federal regulators.

The Illinois State Medical Society (ISMS) and Illinois Psychiatric Society led the way for a new law that strengthens protections and transparency for mental health and substance-use disorder parity as well as prohibits all prior authorization and step-therapy requirements for treatment of substance-use disorders. The bill, Illinois Senate Bill 1707 (PDF), was signed last month by Gov. Bruce Rauner.

"If a patient needs care but is forced to delay treatment, or have treatment denied, because of prior authorization or step therapy, the consequences can be fatal," the AMA emphasized in a letter to Rauner urging him to sign the bill.

The ISMS also reported that the bill:

  • Increases transparency by requiring health plans to submit parity compliance analyses to the Illinois Department of Insurance (DOI) and the Illinois Department of Healthcare and Family Services (HFS) for review, and share online.
  • Requires the DOI and HFS to conduct market examinations/parity compliance audits and to report their enforcement activities annually.
  • Requires the Illinois Auditor General to review implementation of the state parity law and to report back to the General Assembly.

For information about the new law, contact ISMS's Erin O'Brien at [email protected].

Effective Oct. 2, California physicians must consult California's prescription drug monitoring database (the Controlled Substance Utilization Review and Evaluation System, or CURES) prior to prescribing Schedule II, III or IV controlled substances. All individuals practicing in California who possess both a state regulatory board license authorized to prescribe, dispense, furnish or order controlled substances and a Drug Enforcement Administration Controlled Substance Registration Certificate must be registered to use CURES.

The California Medical Association (CMA) recently co-hosted a live CURES webinar with the California Department of Justice (DOJ) and the Medical Board of California regarding this new duty-to-consult requirement. The webinar provides an overview of the new mandate and the requirements imposed by the law when checking CURES. It also includes an overview of the registration process and key features of the CURES database.

The webinar is now available for on-demand viewing—free to all interested parties. Additional California opioid-related educational resources are available on the AMA opioid microsite.

AMA President Barbara L. McAneny, MD, made the most of a recent trip to Mississippi. Her activities included attending the Mississippi State Medical Association (MSMA) Annual Meeting in Jackson, being featured as a keynote speaker and guest of honor at the Governor's Health Care Summit, and making a guest appearance on a statewide talk radio program, "SuperTalk Mississippi."

Dr. McAneny's speech at the Health Care Summit highlighted the positive economic impact that physicians have in the country at large and in Mississippi specifically. She stressed the benefits of a strong medical education system, encouraged the allocation of state funds for new residency slots and emphasized the importance of keeping physicians that train in Mississippi in the state.

The following morning, Dr. McAneny addressed the 150th MSMA House of Delegates Annual Meeting, where she highlighted efforts to address gun violence, health care reform and easing the burden of prior authorization.