Legislative Update 2021

105 DAYS

mary eversole

This year’s “long” legislative session was like no other. Virtual (for the most part), demonstrations, and a strong focus on pandemic response. The regular session adjourned on April 25, 2021 as scheduled. WSMA’s phenomenal government affairs and policy team drove the policy priorities to benefit PCMS member providers and their patients. Additionally, the final adopted budget did not increase taxes on physicians and provides appropriations that benefits the medical community. It also aims to foster economic recovery over the next two years.

Audio-only telemedicine, HB 1196: SIGNED

Would allow patients to receive covered health care services over the telephone, advancing the goal of ensuring they get the right care, in the right place, at the right time. Due to existing emergency orders, insurers are currently required to cover and pay for audio-only services, but action is needed to ensure that patients can continue to receive appropriate care over the phone on an ongoing basis. HB 1196 generally requires that insurers provide the same coverage and reimbursement for audio-only telemedicine services as they would for care delivered in person or via audio/visual telemedicine.

PPE Reimbursement, SB5169: SIGNED

Requires commercial insurance carriers to begin reimbursing for PPE costs during the pandemic. The bill is scheduled to be signed by Gov. Jay Inslee today, April 16. Once signed by the governor, the bill will take effect immediately and Washington will become the first state in the country to require reimbursement for PPE in this way. The WSMA and other supporters of this important legislation believe it is a necessary step to help spread the increased costs of delivering care during the pandemic and ensure everyone is paying their fair share. For the duration of the federal public health emergency, any provider treating patients in state-regulated commercial health plans who has incurred costs for PPE can bill the newly created CPT code 99072 and be reimbursed $6.57 per patient encounter.

Health equity CME, SB5229:

Would direct the boards and commissions of licensed health professions to adopt rules establishing a health equity CME requirement at least once every four years to provide health care professionals with tools to care for patients of diverse identities and backgrounds and to be knowledgeable about cultural sensitivities, patterns of disparities, and implicit bias, all of which can impact patient care and health outcomes.

Medicaid reimbursement, SB5246:

Would restore the primary care and pediatric service Medicaid reimbursement rate adjustments vetoed by Gov. Jay Inslee in 2020 due to state budget concerns arising from the pandemic. Restoring the rate adjustments will improve access to care for Washingtonians by expanding physician participation in Medicaid networks at a time when it is desperately needed and long overdue.

COVID-19 liability protections, SB5271:

Would establish a clear method for determining the standard of care for health care providers and facilities caring for COVID-19 patients and reflects the realities of this challenging time. Physicians have faced numerous challenges in delivering care during the pandemic, including shortages of supplies and shifting government directives on when and how services can be delivered.

*bills have been passed by the legislature and on the Governor’s Desk for signature at time of publication

BUDGET HIGHLIGHTS

• $59.2 billion state operating budget for two years starting July 1, 2021.

~ $140 million for Medicaid rate increases effective October 1, including 15% increases for primary care and behavioral health services, and 21% for pediatric services.

~ $147 million for Foundational Public Health Services in the 2021-23 budget, and $296 million in the 2023-25 budget.

~ $1.1 billion to respond to the COVID-19 pandemic, including funds for vaccines, testing and public health workforce.

~ $34 million for medical education supports, including $16 million for family medicine residencies and more than $10 million for behavioral health professional loan repayment.