Opioid Policies

(You can see a video summary of this article as part of Advocacy Committee Chair Dr. Klint Peebles' webinar, seen here).

To say 2021 in policy was unprecedented is not an exaggeration. At a minimum, we saw a budget process delayed until almost the fall, which never happens in DC politics. That alone is a good analogy for how unusual this year was in politics and policy. Despite the unusual nature of the year, MSDC and the physician community have a lot to celebrate about this calendar year.

To recap, 2021 is the first year of the 24th DC Council session. Each session is two years, so bills not passed or withdrawn by December 31 are still able to be considered in 2022. Usually that means the volume of regular order legislation considered is less than even-numbered years. Further complicating the legislative process is the continued COVID pandemic. The Council continues to conduct business virtually - with staff and members finally going back to the Wilson Building a little late this year - and this has impacted the legislative and regulatory processes.

The MSDC advocacy agenda saw some early wins from the Council. Three bills with MSDC support were enacted this year:

• B24-0020/L24-0025, the Flavored Tobacco Product Prohibition Amendment Act of 2021. The law prohibits the sale of tobacco to minors under the age of 16 and prohibits the sale of flavored tobacco products without an exemption.
• B24-0143/A 24-0202, Certified Midwife Credential Amendment Act of 2021. The act regulates the licensure and registration of certified midwives by the Board of Nursing.
•  B24-0399, Preserve Our Healthcare Workforce Emergency Amendment Act. The legislation extended the temporary license to practice medicine established by the public health emergency declaration.

In addition, B24-0557, the Copay Accumulator Amendment Act, was introduced by Councilmember Mary Cheh and four co-introducers this month. The bill, a top MSDC priority and one crafted by MSDC members, requires insurers to apply discounts, financial assistant, and other reductions of out-of-pocket expenses when calculating prescription coinsurance or copayments. This bill is important as some insurers are applying prescription discounts to copayments, meaning patients are now paying more for prescriptions especially for specialty drugs.

During the Council budget process this year, MSDC saw two priorities receive funding that will improve the health of the District for years. The first is a one-time increase in federal funds for the Health Professionals Loan Repayment Program (HPLRP). The program, a strategic priority for MSDC, allows the District government to fund loan reimbursement for more health professionals working in underserved areas in the District. The second item funded was legislation funding postpartum care in Medicaid for 12 months after birth, a major priority for MSDC, ACOG, and the pediatric community.

The pandemic has shown that the borders between Maryland, Virginia, and DC are irrelevant when it comes to public health and the physician community's constant push for regional licensure took a big step forward this year. As we shared last week, the DC Board of Medicine voted to deem Maryland and Virginia's physician licensure requirements "substantially equivalent" to DC's, opening to door to more license reciprocity. This action could allow Maryland and Virginia physicians in the near future to have an expedited license approval process, something much needed in DC.

On the legal front, MSDC's partnership with the AMA Litigation Center continues to be a source of medical victories. MSDC joined the Litigation Center in a successful amicus brief for the federal case on the Biden Administration's eviction moratorium this summer. The amicus laid out public health reasons for extending the moratorium, and the language was involved in the decision. MSDC is equally optimistic for a positive outcome on two other amicus briefs filed on behalf of the District's minor consent for vaccinations law. This amicus, filed with the AMA and other health groups, defends the legislation in two cases filed by parents arguing the law is unconstitutional.

These successes are built on the hard work and advocacy of physicians throughout the year. Despite being busier than ever, physicians took time out of their schedules to testify at Council hearings and meet with members of the Council and Bowser Administration. These first-hand stories impacted the way bills were discussed and pushed forward the physician advocacy agenda. For example, Dr. Alice Fuisz gave important, practical testimony on a bill that would put onerous record-keeping requirements on physician practices. Her stories of how her office followed best practice but would be overwhelmed by the bill's requirements made an impact on the Committee on Health.

Finally, MSDC launched its new Advocacy Curriculum to help physicians learn how to better advocate for their patients and keep up to date on advocacy information. The curriculum included live events and written articles (like this one) to help physicians and medical students feel confident participating in advocacy activities. The live events including townhalls on major policy topics and meetings with three Councilmembers.

Next year promises to be a very busy one for the physician advocacy agenda, but 2021 helped build a foundation for success in 2022.