What Wins The Physician Community Got in the HORA Revision Bill May 8, 2024

MSDC, the Physician Voices for Patient Safety Coalition, and the DC "house of medicine" have been working tirelessly since November to remove concerning provisions from B25-545. The bill updates the Health Occupations and Regulations Act, better known as the DC law overseeing health licensing and regulation. The bill contained numerous scope of practice expansions for numerous allied health professionals, plus made worrying changes to the make-up of the Board of Medicine. Yesterday, the Council passed the bill on its final reading.

MSDC and the coalition met with Councilmembers, sent letters, rallied our memberships, and spoke up about many of the changes and why removing physicians from the center of the care team would be dangerous to DC healthcare. While we did not win every request, below are some of the major wins you, your medical society, and the physician coalition had in the bill:

• Originally, the Board of Medicine would be composed of many fewer physicians and add up to four allied health providers as voting members, essentially equating physicians with other allied health professions on the oversight Board. The bill as passed changed to only add 2 physician assistants as voting members while only reducing the physician seats by one, maintaining a physician majority on the Board.
• Podiatrists in the original bill would have seen major scope expansion, including the ability to treat wrists and soft tissue in the hand, soft tissue from the ankle to the knee, and oversee the administration of anesthesia. The bill as passed removes this and only allows podiatrists to administer local anesthesia.
• Optometrists would have seen major scope expansion, including prescribing authority, treatment of medical conditions, and more. All optometrist scope expansions were removed.
•  The bill originally required laboratory technicians to be licensed for the first time. That requirement - opposed by MSDC, the Hospital Association, and Pathologists - was removed.
• Athletic trainers and physical therapists would have been classified as medical providers and had certain tests and treatments permitted unsupervised. These were reduced in the final bill and DC Health given more regulatory oversight over the professions.

This legislation was a major effort by the physician community, and this plus the new prior auth law shows the power of the physician voice in DC.

Yet the work is never done. Join us June 17 for Council Visit Day to meet Councilmembers and their staff, and speak to the Council on important medical issues before the Council (like the gun violence mandatory CME legislation).