Legislative Agenda

Scope of Practice Issues

A number of non-physicians will be attempting to pass legislation to increase their scope of practice into the realm of the practice of medicine without the requisite training and clinical experience.

 

The SCMA's Position:

The SCMA supports an approach to health care that encourages better teamwork, less fragmentation, and higher quality, all of which hinge on continuing the proven practice of physician-led delivery of care. Further, the SCMA believes that the only proper way to provide care is through proper education and training, rather than through legislation. The SCMA remains committed to protecting the patients of South Carolina from those who seek clinical privileges through legislation instead of education.

 

Why This Matters To Physicians:

Due to having the highest level of education and medical training, physicians have always been regarded as the leader of the medical team in South Carolina. However, with this leadership also comes the responsibility of patient safety. Due to their level of training and education, a physician's skill for providing the appropriate care while ensuring patient safety is unmatched when compared to other providers.

 

Why This Matters To Patients:

Patients expect and deserve the quality of care that can only be found in the physician-led care team. Patient safety is key, and having the trust of a physician who can provide the appropriate level of care while ensuring patient safety, is what ultimately provides patients with the best quality of care.

Telemedicine

Telemedicine is the use of electronic means to communicate health information from one site to another. In recent years, legislation has been introduced to allow physicians to provide care via telemedicine to their patient.

 

The SCMA's Position:

Access to health care is critical to patients and their providers alike and telemedicine is a means to provide increased access. However, insurance companies should compensate physicians accordingly for their time spent treating patients and consulting colleagues via telemedicine.

 

Why This Matters To Physicians:

Many physicians are already using telemedicine as a means to practice medicine and reimbursement for these services are at the discretion of the insurance carrier. By uniformly addressing payment guidelines through legislation, physicians could more widely use this tool which will ultimately result in increased access for South Carolina patients.

 

Why This Matters To Patients:

Increased financial incentives for physicians to use telemedicine as another tool for treatment and diagnosis will strengthen access to quality health care for patients, particularly those in rural areas.

Medical Marijuana

Although a potentially beneficial medical treatment, the potential medical use of cannabinoid oil needs to continue to be studied, clarified, and confirmed before legislation should be considered. The SCMA supports clinical trials and research for these substances but not legislation for prescription medical marijuana.

 

The SCMA's Position:

The SCMA is very sympathetic to those that have testified to the benefit of medical marijuana in their lives but these results remain anecdotal and are not supported by research. Additionally, the SCMA does support FDA approved controlled studies of marijuana and cannabinoids in clinical trials of these substances at academic research centers in South Carolina and elsewhere.

 

Why This Matters To Physicians:

All drugs being considered for approval and medical use undergo significant testing so the prescribing physician can understand the effects of the drug, the chances it will work and the potential for complications.

 

Why This Matters To Patients:

There is not enough documented medical evidence of the long-term effects of the use of cannabinoids or marijuana in patients.

False Claims Act

The False Claims Act imposes liability on persons and companies who defraud governmental programs. It is the Government’s primary tool in combating fraud against those that receive government dollars. The provision would allow people who are not affiliated with the government to file actions on behalf of the government (informally called "whistleblowing"). Persons filing under the act stand to receive a portion (usually about 15–25 percent) of any recovered damages. Claims under the law have typically involved health care, military, or other government spending programs, and dominate the list of largest pharmaceutical settlements.

 

The SCMA's Position:

The SCMA has consistently fought against false claims legislation.

 

Why This Matters To Physicians:

What is not generally mentioned is that it causes thousands of unjust lawsuits. Any physician who sees a Medicaid patient would be deemed as receiving state dollars and could be sued at any point under the act. It causes costly litigation and can be used as a tool to get doctors or others that have had a suit brought against them to settle instead of fight to an adjudicated result. Physicians are in the practice of providing care for their patients. Each day they are in court fighting an unjust lawsuit is a day that patients are not being properly treated. The cost of doing business goes up which leads to increased costs to patients.

 

Why This Matters To Patients:

Access to quality affordable health care is always paramount for patients. Having a physician in the office caring for their patients, rather than in court fighting a lawsuit is crucial. In addition, having affordable care is important. The more dollars that a physician has to settle for in an unjust lawsuit are dollars that may be passed on to the patient.

Insurance Reform

There is an opportunity to reduce health care costs while improving care, simply by reforming outdated and inefficient insurance company policies that restrict access to necessary care and treatments.

 

The SCMA's Position:

Insurance companies too often use their size and influence to insert themselves directly into the practice of medicine, consistently interfering with the physician-patient relationship.

 

Why This Matters To Physicians:

Protecting a physician's right to treat his/her patient based solely on the principals of medicine is critical to maintaining the sanctity of the physician-patient relationship.

 

Why This Matters To Patients:

Patients should be able to be confident that their physician's recommended course of treatment is based solely on sound medical judgment, not insurance carrier obstacles and reimbursement procedures.

Uninsured In South Carolina

At the 2015 SCMA House of Delegates, the SCMA Board of Trustees was tasked through a resolution to review our current stance on Medicaid expansion. The SCMA Board of Trustees has met several times to discuss this resolution and take a second look at our position. After careful thought and consideration, the Board has reviewed and updates its position.

 

The SCMA's Position:

The South Carolina Medical Association will actively work to collaborate with other interested parties to seek solutions for coverage of the uninsured. While this could include variations of Medicaid Expansion as an option, we remain concerned that full Medicaid Expansion under the terms of the Affordable Care Act is a temporary and unsustainable fix that is not the best solution for the long-term health issues facing South Carolina.

 

What Is The SCMA Doing?

Further, the SCMA Board of Trustees has established the SCMA Uninsured Patient Care Committee. This committee, chaired by Dr. John Ropp, consists of physicians who have been tasked with developing an action plan for the uninsured in South Carolina and reaching out to appropriate parties for collaboration. A plan for the uninsured will be presented at the 2017 House of Delegates.

 

Why This Matters To Physicians:

The expansion of Medicaid could potentially put thousands of more patients on the rolls in an already crowded medical field, and physicians may become inundated with those that do not currently have a provider.

 

Why This Matters To Patients:

Access to care is vital for South Carolina's patients. The flood of patients that will be seen due to the proposed Medicaid expansion could mean that one's ability to see their physician in a timely manner will be greatly diminished.