A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Just Do It: The End-of-Session Legislative Agenda

Just Do It: The End-of-Session Legislative Agenda

July 28, 2008

The legislature turns into a pumpkin at midnight, Thursday, with the end of formal sessions. Legislation can still pass during the informal sessions which will continue through the end of the year, but anything controversial has to get through both branches by July 31. HCFA is working on a number of bills that have passed one or both houses, waiting final approval. With just a few days left, we urge the House and Senate to prioritize the following bills: Oral Health Initiative: S. 2819 is the historic oral health omnibus bill, which unifies dentists, dental hygienists, dental assistants and advocates to enhance the oral health workforce and strengthen the state’s oral health infrastructure. The bill would strengthen both the DPH Office of Oral Health and the MassHealth dental program, along with supporting public health dental hygienist and dental assistants. Oral health is a critical component of overall health. Dental disease has been linked to a multitude of complex health problems such as heart disease, stroke, diabetes, and low-birth weight and premature infant births. As with all disease, prevention efforts are critical and are most effective when started early and with frequent reinforcement. It is clear that dental disease is almost entirely preventable when people have access to community and individual oral health prevention methods. Click here for more information. Children's Mental Health: S. 2804, the Children's Mental Health bill sponsored by Rep. Ruth Balser and Senator Steven Tolman will improve the systems of care for children living with mental illness by: screening children early to identify developmental, mental health and substance abuse needs; giving schools the tools to identify and manage children with mental health needs; implementing policies for fixing the "stuck kids" problem by ensuring that children are in the most appropriate and least restrictive setting; and, improving communication among state agencies to ensure coordination of care. An article in yesterday's Metrowest Daily News highlighted the critical need for the bill. Visit www.childrensmentalhealthcampaign.org for more information. Health Care Cost Control: The House and Senate have each passed comprehensive legislation (S. 2660 and H. 4974). HCFA is awaiting the outcome of negotiations to produce the final bill. Among our key concerns:

Quality Improvement - Our Consumer Health Quality Council is hoping that the final bill includes public reporting (by healthcare facility) of healthcare-associated infections and serious reportable events (aka never events). We also strongly support prohibiting reimbursement to hospitals for costs associated with the occurrence of never events. Both bills include innovative provisions for which we have been advocating all session: establishing patient and family councils and rapid response methods at hospitals. We believe these will both decrease costs and increase quality by encouraging patient and family involvement in their care and partnership with their medical providers.

Ban on Data-Mining – Pharmaceutical companies purchase information from the prescriptions consumers fill and use it for direct-to-provider marketing. Banning this practice (known as “data-mining”) will ensure that pharmaceutical companies cannot use consumers’ private health information to magnify the influence of their marketing on prescribing decisions.

Pharmaceutical Gift Ban -A wealth of research shows that pharmaceutical gifts of all sizes influence prescribing decisions, leading to increased prescribing of the highest-cost and least proven drugs. A legislative gift ban is the most effective way to prevent this threat to affordability and patient safety. See the Mass Prescription Reform Coalition for more info.

Payment Reform - Fundamental payment reform is crucial to effective cost control, and we believe such a process should aim to propose an “all-payer” system that aligns Medicare, Medicaid, and private coverage along the same rules, simplifying provider billing and rewarding healthy outcomes, rather than costly procedures. To increase political acceptance, the process should include key administration and legislative representatives. While the group should be kept as small as possible, we think a consumer representative is crucial to insure broad public acceptability of the recommendations.

Health Reform Funding - The Governor has proposed a balanced solution to the shortfall in funding for MassHealth and Commonwealth Care. The proposal is consistent with the shared responsibility model. Back in April, premiums and copays were raised for lower-income people in CommCare, and they must not be the only to ones to pay. The proposed broadening of the fair share assessment would only collect what employers originally were expected to pay when health reform was enacted. The proposed assessment on excess insurer reserves would recapture unneeded funds being held by insurers.