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  • Despite COVID-19 Restrictions, Your Legislative Team Advocated for You!

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    COVID-19 created significant challenges for our governmental affairs team during the 2021 spring legislative session. Legislators were allowed to return to the Capitol in Springfield – but lobbyists were not. 

    Despite these challenges, our governmental affairs team did end this session with significant wins. ISMS’ initiative to reform prior authorization processes passed the General Assembly unanimously! ISMS also supported other health insurance reform bills, including:

    • A comprehensive telehealth policy that brings coverage and payment parity with services delivered in person.

    • Legislation to ensure that all Medicaid MCOs’ and commercial insurers’ medical necessity determinations concerning mental health and substance use disorders are fully consistent with generally accepted standards of care.

    Other wins! 

    • Senate Bill 579, which passed the General Assembly, would require hospitals and facilities to offer a patient any unused portion of a facility-provided medication upon discharge when it is administered to a patient at the hospital or facility and is required for continuing treatment. This legislation started out as a resolution that a member submitted to ISMS!
    • Senate Bill 512, which also passed the General Assembly, creates the Preventing Youth Vaping Act that is designed to curb e-cigarette use by those under 21.

    For a comprehensive look, access our 2021 Legislative Report – Update on ISMS Legislative Activity in the Illinois General Assembly.

    If you have questions, please contact ISMS Senior Vice President of Legislative Affairs Erin O'Brien  by email.



  • Unpacking Prior Authorization Reform

    During the Spring Legislative Session in Springfield, the General Assembly unanimously approved the Prior Authorization Reform Act (House Bill 711)! This top ISMS initiative requires that substantive and important changes be made to insurer prior authorization (PA) practices.

    Physician Advocate is taking a deep dive into the various components of this important legislation. This week’s focus is timelines for urgent and nonurgent care.


    Part 2: How Does the Prior Authorization Reform Act Address Timelines?

    The current problem: Doctors may have to wait weeks before utilization review organizations respond to their PA requests, causing unnecessary delays in patient care.

    How House Bill 711 helps: It standardizes response times by requiring utilization review organizations to respond to PA requests within specific timeframes.

    • Nonurgent care: Utilization review organizations would be required to respond to prior authorization requests for nonurgent services within five calendar days of receiving all the necessary information. 

    • Urgent care: Utilization review organizations would be required to: 
    • Respond to prior authorization requests for urgent services within 48 hours of receiving all the necessary information. 

    • Establish a mechanism to ensure healthcare professionals have timely access to someone able to make prior authorization decisions related to urgent care services.

    If you missed Part 1 on transparency, you can read it here.

    Questions? Please contact ISMS Senior Vice President of Legislative Affairs Erin O'Brien  by email.

    Watch for next week’s topic related to the Prior Authorization Reform Act – adverse determinations.



  • What Happened to My AMA Resolution?

    Over the last 16 months, medical association meetings have looked different. Many of the resolutions adopted by ISMS include a request to take an issue to the national level via the AMA. Locally, we continue to make progress with our year-round resolution process. 

    Over 2020-21, ISMS has compiled 24 resolutions to the AMA for consideration. But due to the pandemic, the AMA policymaking pipeline has been operating under special rules, only considering “urgent” or “priority” business. In June, the AMA accepted and acted on three of our resolutions. The remaining 21 will be submitted at a future meeting when they are accepting regular business. All signs point to a regular, in-person AMA meeting in November, and we hope to see more of our resolutions considered then. 

    The following Illinois resolutions were acted upon at the AMA meeting earlier this month:

    Members can view resolutions and related actions any time by visiting our  Resolution Tracking web page.

    Questions? Contact ISMS staff  via email



  • Next Tuesday, June 29 at 2 p.m. – Session 1: Telehealth Equity Virtual Forum

    Starting next week, the Illinois Telehealth Network will be hosting a three-part series of virtual forums on telehealth equity. The sessions will feature interactive panel discussions on the current legal and regulatory environment for telehealth, reimbursement trends and opportunities, and telemedicine delivery and business models.

    The first forum, Telehealth Equity Virtual Forum (Session 1), will take place next Tuesday, June 29, running from 2 p.m. to 3:20 p.m. CDT and will cover current inequities, as well as projects that use telehealth to minimize these inequities. The forums are being offered at no cost. 

    ISMS is a supporting organization of this event.

    Register here.

    Don’t miss these important panel discussions!



  • Important Update: System Migration Takes Effect July 1 for MeridianHealth

    Join a webinar to learn more

    MeridianHealth's current web-based systems for managing its plans will be transitioned to Centene’s web-based platforms on July 1, 2021. Centene is the parent company of MeridianHealth. 

    To help with the transition, MeridianHealth is hosting one-hour webinars in June and July, which all begin at 1 p.m. CDT. Registration is required.

    These changes will not impact WellCare Medicare plans.

    MeridianHealth delivers government-based health plans (Medicare, Medicaid and the Health Insurance Marketplace) in several states, including Illinois.

    Questions? Please contact the ISMS Health Policy Research and Advocacy team by email



  • CONTRIBUTE TO IMPAC TODAY! Make Your Mark in Helping IMPAC Reach Our Goal

    The Illinois State Medical Society Political Action Committee (IMPAC) is kicking off its annual summer fundraising campaign to raise $50,000 in contributions by August 1. IMPAC intends to pursue every avenue to fight back against vicious attacks on your ability to practice, including having a major impact in the 2022 elections.

     

    IMPAC needs your help!  Your contribution can help make the difference needed to push back against the harmful polices brought forth by our opponents who out raise us and out spend us.

     

    Make your mark by acting today with a contribution to IMPAC!

    Read more …


  • ISMS Medical Students Making a Difference!

    Earlier this spring, two ISMS Medical Student Section (MSS) ad hoc committees – one focused on COVID-19 and the other on systemic racism – partnered with MasksNowIL to conduct a mask drive for minority communities. 

    MasksNowIL donated 6,000 masks to the students’ drive, and ISMS student leaders raised more than $500 to cover shipping costs.

    The students also collected more than 2,500 disposable masks and 100 cloth masks from generous donors in the Springfield area, including Memorial Medical Center, HSHS St. John's Hospital, and Springfield Clinic. These masks are currently being delivered to various organizations around Springfield.

    Kudos to the MSS ad hoc committees!

    If you have any questions, please send us an email.




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