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February 2007
Note: Questions relating to state legislative activity or any of the items noted in ACS Cross Country may be directed to Mindy Baker, State Affairs Associate, at mbaker@facs.org.
New Jersey Governor Vetoes Cosmetic Surgery Tax Repeal
Weeks after the New Jersey legislature unanimously passed legislation to repeal the state’s tax on cosmetic surgery, Governor Corzine vetoed A-2282 on January 26. Supporters of the legislation are considering their options. In his veto message the Governor noted:
“...as was the case in 2004 when the cosmetic medical procedure tax was first enacted, the State continues to require reliable, recurring sources of revenue to support charity care and other worthy programs that improve the lives of people in New Jersey. The revenues generated by the cosmetic medical procedure tax, while somewhat less than the original revenue forecast in 2004, are nevertheless recurring and dependable.”
New Jersey was the first (and only) state to pass a 6 percent tax on cosmetic medical and dental procedures in 2004. By 2005, the tax generated only about a quarter of its projected revenue, prompting a reevaluation of the efficacy of this tax. In March of 2006, State Assemblyman Joseph Cryan, the original sponsor of the tax, introduced a repeal bill (A-2282/S-1783) saying that the tax was "an untested revenue stream that ultimately hasn’t delivered."
The American College of Surgeons is part of a coalition dedicated to stopping the passage of physician taxes and will continue to work with the New Jersey Chapter and its coalition partners.
To read the Governor’s full veto message, visit: http://www.njleg.state.nj.us/2006/Bills/A2500/2282_V2.PDF
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UPPL Repealed in District of Columbia, Introduced in Several Other States
In 2007, the College will continue to support legislation to repeal the UPPL (Uniform Accident and Sickness Policy Provision). These laws currently allow insurance companies to deny payment of medical claims for injuries sustained while the injured party was intoxicated or under the influence of a controlled substance.
In late December, the Washington, DC, City Council passed legislation to repeal the UPPL. The bill was signed by the newly elected Mayor Adian Fenty and completed its mandatory 30-day review by the US Congress to become effective immediately.
According to Ensuring Solutions to Alcohol Problems at George Washington University Medical Center, “Although Virginia still has AELs [UPPL], a recent review of policies by Ensuring Solutions found that insurers operating in the state do not include exclusions in their policies.
It's likely that there is a regional effect on insurers," according to Rick Mauery, the GWU researcher who conducted the review. "When the majority of states in a metropolitan area prohibit AELs [UPPL], it may be easier and less costly for insurers to standardize policies and avoid the use of exclusions.” (http://www.ensuringsolutions.org/resources/resources_show.htm?doc_id=360971&cat_id=986 as of Jan 31)
Also in 2007:
- Indiana and Texas introduced legislation in January to repeal their states UPPL. (IN HB 1378 & TX HB 634)
- Tennessee is planning on introducing a resolution calling on its Comptroller to study the state’s existing drug and alcohol laws, including the potential adverse effects of UPPL.
- Ohio introduced a bill in December of 2006, which died upon adjournment; however supporters of the bill are hoping to reintroduce the bill in 2007.
- New York’s legislature has passed UPPL legislation, only to have the then-Governor Pataki (R) veto the legislation. New York’s new Governor, Eliot Spitzer (D), has indicated his willingness to sign the legislation should it make it to his desk.
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History: In 1947, the National Association of Insurance commissioners (NAIC) adopted the UPPL (Uniform Accident and Sickness Policy Provision) as a model law. The law states that health insurers would not have to reimburse patients for costs incurred when an accident is a result of "the insured's being intoxicated or under the influence of any narcotic." Most states adopted this language, and it is still on the books in many states. In 2001, NAIC formally changed its position to support the repeal of this legislation. Other groups that support the repeal of this language include: the National Conference of Insurance Legislators (2001); American Medical Association (2003); Mothers Against Drunk Driving; National Commission Against Drunk Driving (2001); American College of Emergency Physicians; and American Public Health Association (2004).
Recent Successes: Colorado, Connecticut, Iowa, Maryland, Nevada, North Carolina, Rhode Island, Vermont*, Washington D.C., and Washington State
*Vermont repealed its UPPL, but did not add legislation to specifically prohibit these types of exclusions.
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January a Busy Month for Bill Introductions
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Click here to view an excel file
of the pie chart. |
According to State Net, a legislative tracking company, 27,422 bills have been introduced in state legislatures across the country as of January 18th. (Source: http://www.statenet.com/ as of January 31, 2007)
In an effort to focus state advocacy resources, the College’s Health Policy Steering Committee has established five broad priority issues—Medical Liability Reforms, Scope-of-Practice Issues, Provider Taxes, Trauma-Related Legislation, and legislation pertaining to Office-Based Surgery/Ambulatory Surgical Centers. More information about these issues can be found by clicking here: State Legislative Priorities.
College staff are currently tracking more than 125 bills in 25 states. If you have questions about legislation in your state, or if there is a bill in your state you would like to notify the College about, contact Mindy Baker, State Affairs Associate, at mbaker@facs.org.
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Health Care System Reform on the State Legislative Agenda
Due to years of inaction by the federal government, and the realization that something really needs to be done about the 47 million uninsured in the United States, many state legislatures are taking up the issue of health system reform during their 2007 legislative sessions. A number of governors have suggested proposals or simply raised the issue in their state-of-the-state addresses, and California's governor offered a sweeping proposal in his state. In addition, the American College of Surgeons joined with the American Medical Association and eight other national specialty societies to support principles for reforming the national health care system. Surgeons are encouraged to share these principles with their state legislators and to participate in advocacy efforts on this important health care issue.
Other States Considering Proposal's
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ISMIE Mutual Insurance Company Lifting Moratorium on New Policies
In 2005, Illinois passed significant medical liability reforms, including a $500,000 cap on noneconomic damages for physicians. Citing the effects of SB 475, ISMIE Mutual Insurance Company (Illinois’s largest medical liability insurer) announced in January that it would begin to partially lift a moratorium on new policies and would implement “an annual dividend plan [which] will distribute to ISMIE policyholders the cost-savings reaped to date from the recent medical litigation reforms.”
In a press release dated January 15, ISMIE Chair, Harold L. Jensen, MD, noted that, “We see very positive signs that things are improving here, that litigation reforms are really beginning to work.”
Details of the two programs were announced in a letter sent to all ISMIE policyholders. To view a copy of the letter, visit: http://www.ismie.com/news/2007_0115_phletter.pdf. ISMIE has also posted a list of FAQs, which may be found at: http://www.ismie.com/news/2007_0131_dividends_faq.pdf.
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Other Provisions of Illinois’s SB 475 (2005)
- $1 million cap for hospitals
- an "I'm Sorry" provision
- expansion of the Good Samaritan law to include retired physicians providing free care and for free care provided in the home
- stronger standards for expert witnesses
- improvements to the affidavit of merit
- enhanced medical disciplinary standards for physicians
- internet profiling of physician's professional credentials, disciplinary and medical litigation histories
- additional regulation of the Illinois insurance industry.
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Past Issues of ACS Cross Country:
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ACS State Affairs
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Division of Advocacy and Health Policy
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Jon H. Sutton
Manager, State Affairs
Chicago Headquarters
312-202-5358
jsutton@facs.org |
Mindy Baker
State Affairs Associate
Chicago Headquarters
312-202-5363
mbaker@facs.org |
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Revised February 9, 2007
Advocacy and Health Policy
This page and all contents are Copyright © 2003-2007
by the American College of Surgeons, Chicago, IL 60611-3211
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