Urgent Request: Protect the 80 Percent Rule for Fair Compensation

Thank You!

Emergency Medicine represented at the State hearing for the 80th percentile ruling Jan. 6! We had four Emergency Physicians testify in person, and at least 10 letters sent to the State regarding this important issue.  Many legislators and CEOs were present at the hearing, as well as the public and insurance agencies.  Please see the final statement from Alaska ACEP that was used as testimony to combat misinformation by the insurance companies.  Thank you to the amazing AK-ACEP board for your collaboration on the final statement!  Your time and stories matter. Healthcare is going through a major transformation both nationally and locally and your voice is important.  The large groups abusing the system got called to task. The data showed ED charges in this state are in-line nationally and we are fighting to protect the patient-physician relationship.  Continuing to make your voice heard is important.  Speak to your neighbors, legislators and friends.  Feel free to share our AK-ACEP statement.

Thank you for all you do!

Anne and the YOUR AK-ACEP Board

Overview: 

 

In 2004 Alaska required insurance agencies to pay at the  80th percentile of what is usual and customary in a geographic region as a consumer protection bill.  This was to require insurance copies to pay a fair price for services rendered.  As you can read in our statement, the 80th percentile for ED changes in Alaska  is in line, if not bellow many other geographical areas in the country including metro areas like Seattle and rural areas like TX.  This model is now being used as a best practice (often in combination with a ban on balance billing) around the nation as way to protect the patient from large “surprise bills” and keep EMTLA care reasonable covered.  Protecting the 80th percentile rule is more important now than ever with the rapid changes in health care as we stand as the remaining safety net in a very fast changing system.

Dear ACEP members,

We’ve just become aware of the importance of a meeting on Friday January 6th, when the Division of Insurance will hear testimony about reducing or eliminating the 80th percentile rule, a key provision in Alaska regulations that assures that health plans pay fair compensation to physicians.

We as your board have been struggling to learn as much as we can about this topic, prepare a response and work with other physicians in the State.

We believe that we could be profoundly negatively effected if the 80th percentile regulation is removed, as this would require insurance companies to pay less, resulting in us having to balance bill patients more, or if a ban in balance billing occurs, it would allow the insurance companies to set reimbursement at whatever they want with no ability to negotiate. We also worry that by removing this we will have less specialty coverage in this state.

I have linked a “semi-final” AK-ACEP position statement here on the issue and am open to any feedback.  I have also included JEMA group’s letter below; Providence is also writing its own letter but we NEED YOUR VOICE.

Interested persons can provide oral and/or written comments on the 80th percentile regulation and its effect on (1) consumers, (2) balance billing, and (3) healthcare costs (4) specialty coverage and access to care.   We have also included below the “Notice” from the State talking about what they are exactly looking for as well as a good summary for the Alaska Medical Association summarizing the 80% rule.

In other states, letter writing campaigns from emergency physicians have had a noticeable effect on legislation in process. We therefore ask for your help in writing a letter, asking that the current law be maintained.

We have included links to a template letter you can tailor for your own use or take some of your life experiences and use the template to draft your own response.  If you won’t mind coping annezink@mac.com on your response that would be great so when we testify if someone asks about what you said we at least have a heads up.

Letters and written testimony must be received by the Division of Insurance no later than 8:00 p.m. on January 6.   We will be testifying on AK ACEPs behalf in both Juneau and Anchorage that day but still need your letter and ideas!

Please submit your comments directly to the Division of Insurance:

By email: chip.wagoner@alaska.gov

By fax: (907) 465-3422

By mail: Chip Wagoner, PO Box 110805, Juneau Alaska 99811-0805

 

Links

Template Letter

Alaska 80th Percentile Whitepaper and Talking Points

Juneau Emergency Medical Associates Letter

AK-ACEP Statement

Notice of Public Scoping for Possible Changes 80th Percentile January 6 2017

 

Thank you for your help in preserving the safety net in Alaska.

 

Anne Zink, MD, FACEP
Emergency Medicine Medical Director Mat-Su Regional Hospital, Palmer Alaska
Alaska ACEP President
annezink@me.com
907-315-5991

Consider an Alaska ACEP Board Position

Your Chapter Needs You!

Volunteer your time and talents as a member of the Alaska ACEP Board of Directors. Provide your input to we determine the state’s emergency medicine priorities. All officer positions will be elected as well as 3 board seats at the next meeting. Want to learn more? Contact chapter leaders, Drs. Anne Zink and Benjamin Shelton. Interested individuals should submit a short bio and why they want to be part of the board to plp@wsma.org by Friday, Jan. 20, 2017. The election will be held Feb. 13, 2017 (location TBD) during a general membership meeting which includes a bylaw review and strategic planning session.

ACEP’s Leadership & Advocacy Conference (LAC) is March 12-15 in DC

AK-ACEP would like to invite all members to be the voice of emergency medicine at the Leadership and Advocacy Conference at the Grand Hyatt in Washington, DC, March 12-15. LAC is your chance to advocate for your specialty, engage and connect with EM leaders. The conference kicks off with an in depth look at EM legislative and regulatory priorities, followed by visits to your legislators on Capitol Hill. The meeting ends with special leadership-focused talks. Register today. Legislators need to hear from you!

Hale Borealis Forum – October 18-20, 2016

Alaska’s largest statewide health care conference is coming soon.
October 18-20, 2016 at the Anchorage Hilton

Register now to get the classes you want!

Learn how to conduct pain management in the field, respond to active shooter situations, provide trauma and rescue care in austere environments, address infectious diseases, support children in times of crisis, splint and cast upper and lower extremities, employ family assistance centers, and much more.

Take advantage of didactic and practical sessions on disaster response, emergency preparedness, medical practices, public health, and more.

Classes always fill up fast, so sign up now to access
•        Sessions for medical practitioners, law enforcement officers, nurses, disaster responders, fire fighters, and others in the emergency management and response field
•        Continuing education hours
•        Presentations by national leaders
•        Opportunities to engage with and learn from counterparts in your field

Register: http://haleborealis.com/