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STATE | ASPS Engages Mass. on Out of Network & Surgical Scope

Attempts to curb out-of-network billing and eliminate the conditions that precipitate its occurrence have become increasingly common at the state level, and Massachusetts is no exception. A recently-introduced, 130-page healthcare omnibus includes – among other items – provisions to address out-of-network billing, a requirement that referring physicians identify another physician's network status, a commission directed to set the noncontracted commercial rates for emergency and nonemergency services, and an expansion of the surgical scope of practice for optometrists.

ASPS submitted comments urging the Massachusetts Senate to amend certain provisions before voting on the measure. The bill was expedited by the chamber's leadership and unfortunately passed the Senate by a vote of 33-6 without many of the Society's recommended changes. The measure is now under consideration by the House of Representatives, where ASPS is engaged in discussions with other stakeholders, including the Massachusetts Medical Society and Physicians for Fair Coverage, to craft amendments and develop a strategy to influence the omnibus in the House.

Several other pieces of legislation were heard by the Joint Committee on Public Health. Among those were two nearly-identical bills that would establish a loophole for optometrists to perform surgery. The bills are worded to restrict optometrists from performing loosely-defined 'invasive' procedures, which would still allow them to perform procedures that are still in fact surgical. ASPS submitted comments to the committee highlighting this loophole and its ramifications. The Society worked closely with the American Academy of Ophthalmology in crafting a united message to state legislators.

ASPS also submitted comments in opposition to a bill that would allow physicians to let their board certification lapse, yet still participate in insurance plans, be employed by or secure hospital privileges, and obtain licensure in Massachusetts. ASPS believes – and stated to the committee – that the certification provided by the American Board of Plastic Surgery is the best validation of physician knowledge for the specialty.

While ASPS will continue to oppose the above measures, the Society voiced its support of a measure that would define surgery in a manner consistent with the definition drafted by the American College of Surgeons and the American Medical Association. Strengthening the statutory definition of surgery is one of ASPS's core legislative issues and will be supported at every turn.

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