The proposed bills physicians are keeping tabs on

Healthcare policy legislation has been in the spotlight for much of 2023, including issues related to reimbursement, advanced practice provider supervision requirements and payer policies. 

Here are five issues that have been tackled in 2023 for physicians to know:

1. Supervision requirements for certified registered nurse anesthetists. Government officials from Florida, Colorado, Delaware, Missouri and California are working to eliminate or loosen supervision requirements for certified registered nurse anesthetists. Florida lawmakers Rep. Mike Giallombardo and Sen. Blaise Ingoglia proposed legislation that would eliminate the current requirement for certified registered nurse anesthetists to have a written supervisory agreement with a physician. 

U.S. Reps. Sam Graves of Missouri and Jared Huffman of California reintroduced the Save America's Rural Hospitals Act, which aims to expand the scope of practice for CRNAs, allowing them to work without physician supervision.

2. Banning noncompete agreements. New York Gov. Kathy Hochul is debating whether to sign a bill that would prohibit noncompete agreements in the state.

As written, the bill would apply to all workers regardless of compensation. Ms. Hochul said she wants to see a compensation cap for the ban, floating $250,000 as a level above which noncompetes would be allowed.

She said she intends to act on most legislation by the end of 2023. However, it is possible that a decision on the bill may not come until early February.

3. Increasing transparency of Medicare Advantage plans. U.S. Sens. Bill Cassidy, MD, Catherine Cortez Masto, Elizabeth Warren and Marsha Blackburn introduced legislation designed to improve the transparency of Medicare Advantage plans. 

The Encounter Data Enhancement Act would require MA plans to report how much they are actually paying for patient services and how much patients are responsible for paying out of pocket.

While the government already requires Medicare Advantage to report encounter data on services provided, the data is often incomplete and lacking key information, the lawmakers said. The Encounter Data Enhancement Act would help lawmakers conduct oversight of federal dollars going to Medicare Advantage plans, assess quality of care and strengthen healthcare access. 

4. Burnout. Two pieces of legislation are in the pipeline in Congress that would attempt to reduce burnout among physicians and improve conditions to reduce provider shortages through annual payment updates to account for rising inflation, expanding prior authorization reforms that CMS finalized and allowing state legislatures to reform them to eliminate practice and administrative burdens.

5. Physician shortages. The Conrad State 30 and Physician Access Reauthorization Act, introduced in the Senate, aims to ease physician shortages by expanding residency training options, providing greater student loan support and creating smooth pathways for foreign-trained physicians.

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