Several issues have high priority, doctors' advocate says

By LARRY HANNAN
http://www.jacksonville.com

Doctors look out for their patients while Jay Millson looks out for the doctors.

Millson, the executive vice president of the Duval County Medical Society, advocates for the interests of doctors in Duval County.

The medical society, which is part of the Florida Medical Association, also creates a local directory of health care providers and publishes Northeast Florida Medicine, a biannual journal focused on issues facing area health care providers.

With the Legislature now in session, Millson finds himself monitoring proposed legislation.

There is nothing as high profile this year as there was a few years ago when the Legislature took up medical malpractice reform, eventually capping the amount insurance companies had to pay at $500,000.

But Millson warns there are several issues that need to be addressed soon, or they could reach a crisis point similar to the medical malpractice crisis of a few years ago that threatened to have doctors leave the state.

What is the biggest legislative priority of the Duval County Medical Society and the Florida Medical Association during the 2008 legislative session?

The top priority is a managed care bill that contains three different components.

Right now if you file a claim you have six months do that. But the managed care organizations have 30 months to review a claim. They can go back and say a payment must be made back to them. We’ve asked for it to be reduced to 12 months, it looks like it’ll be reduced to 18 months. That creates a more level playing field.

We also have an issue with third-party payments made directly to a doctor. (Managed care networks) will refuse to make payments to doctors who don’t participate in their network.

This pressures the doctors to join their network. We want to require the companies to honor third-party payments. Right now the insurers usually pay the patient, who then pays the doctor.

Finally, preferred provider organizations are purchasing lists of physicians participating in different networks and then paying the doctors the lowest rates that the doctors have agreed to accept. We’re pushing legislation to stop this unless the doctor and the insurer have agreed to a specific contract.

Obviously insurance companies don’t like this legislation, and the two sides are butting heads over this in Tallahassee right now.

Are their other priorities being pushed in Tallahassee?

We’re pushing for sovereign immunity for emergency room calls. In emergency rooms you’re not choosing your patients, they’re choosing you. It’s unfair to subject emergency room personnel to lawsuits.

We also want expert witnesses who come into Florida to testify in trials to register with the state as expert witnesses. Right now you come in, testify, and you’re gone. We’d like to have some accountability for people who do this. If you provide false testimony, you should lose your credentials as an expert witness.

There’s also a goal of getting a handle on Medicaid rates. Medicaid has expanded to the point where it’s a quarter of our (state) budget. We need to stop the bleeding. But I don’t think there’s an easy answer.

The state is in a billion-dollar budget crunch. How is that affecting your expectations from Tallahassee?

It’s changed everything. Things are really slowing down this year because of the shortfall. They just don’t have the money. We still hope to accomplish our goals, but the game is being played in a completely different way.

larry.hannan@jacksonville.com (904) 359-4470

see original

About