Heart of Health Policy | State Advocacy Roundup: 2023 Legislative Session Highlights

State Advocacy Roundup: 2023 Legislative Session Highlights

ACC State Chapters, in concert with ACC Advocacy staff, have been hard at work pushing for state legislative solutions that protect and support both cardiovascular patients and clinicians. Here we roundup victories so far this year, as well as ongoing work to protect access to cardiovascular care and expand heart health education and awareness.

SCA Awareness and Preparedness

In response to Damar Hamlin's sudden cardiac arrest (SCA) on the football field earlier this year, AED-related bills have been trending across the U.S., with 100+ relevant bills being tracked by ACC's State Government Affairs Team. While the ACC has engaged state lawmakers on issues related to AEDs, CPR education and SCA awareness long before this legislative session, the recent uptick in SCA-related bills has presented a prime opportunity for action.

ACC Grassroots Action at Work

ACC State Chapters are the key to the College's state advocacy victories – hosting lobby days, meeting with lawmakers, testifying at committee hearings, sending hundreds of messages through action alerts and signing onto numerous letters in support of patients and policies to improve heart health in their communities.

Highlights from the past legislative session include:

  • The ACC California Chapter meeting in Sacramento, CA, where 18 members met with lawmakers to discuss pending health legislation on prior authorization, AED training for high school physical education credits, self-measured blood pressure coverage for Medicaid, health care worker compensation, and standards for compliance with the federal Clinical Laboratory Improvement Amendments.
  • The ACC Ohio Chapter hosting its annual legislative day with over 20 members, participating in conversations with lawmakers and staff around AEDs in schools, prior authorization gold carding and tobacco use prevention.
  • The ACC Tennessee Chapter organizing their first-ever lobby day, where meetings touched on hot topics such as reducing administrative burden, youth vaping and increased patient access to care.
  • ACC Arizona Chapter leaders joining ACC State Advocacy staff at the American Medical Association State Advocacy Summit in Marana, AZ. The Summit, which featured Arizona state legislators, insurance commissioners, health department officials and health policy experts, presented a unique opportunity to educate policymakers on issues like SCA prevention and cardiovascular workforce challenges, while engaging in discussions on prior authorization reform, clinician wellness, telehealth and health equity.

Numerous other chapters and members participated in lobby days or white coat days organized by state medical associations and key partners like the American Heart Association. Click here for ACC Action Alerts and more opportunities to contribute to ACC's grassroots action campaigns.

Joining with the National Football League's Smart Heart Sports Coalition in June, the College has been focused on pushing for the adoption of increased CPR education, access to AEDs and emergency action plan requirements across all 50 states, all targeted at protecting the lives of high school student athletes.

The College has built on this increased awareness to advocate for evidence-based policies proven to prevent death from SCA.

While much of the Coalition's work will continue during state legislative sessions in 2024, advocacy efforts are ongoing in several year-round legislatures, including Michigan, Ohio and Pennsylvania.

In Ohio, the ACC Advocacy Team, ACC Ohio Chapter, Coalition partners and other stakeholders have been working to bolster support for legislation, now before the Ohio Senate, that would require AEDs in schools and many municipal sports facilities in the state. Additionally, the bill would mandate the adoption of emergency action plans and training for staff.

Increasing AED access has also become a priority in the state of Maryland, where a state legislator's chief of staff lost their husband due to cardiac arrest outside a restaurant in Annapolis.

Sammy Zakaria, MD, FACC, testified on behalf of the ACC in support of H.B. 288/S.B. 299, a bill requiring food service facilities to have AEDs on site as well as implement a maintenance and training program that aligns with guidelines established by the Maryland Department of Health and Maryland Institute for Emergency Medical Services Systems.

In addition to providing expert testimony, ACC's Maryland Chapter sent multiple letters to chairs of committees and met with several lawmakers to help push the bill across the finish line. The legislation passed with bipartisan support on the last night of Maryland's legislative session.

The ACC Advocacy team will continue to make lifesaving SCA legislation a priority in future state legislative sessions. Keep an eye on ACC.org and in the ACC Advocate newsletter for updates.

Non-Compete Clauses and Restrictive Covenants

Non-compete agreements, and their negative impact on cardiovascular clinicians across the country, have been a priority for several ACC State Chapters this legislative session. The ACC Minnesota Chapter, led by Stephen J. Smalley, MD, FACC, worked with the Minnesota Medical Association to pass S.F. 3025, which stipulates that employers in the state are prohibited from using non-compete clauses in all newly signed employment contracts starting July 1.

The chapter plans to advocate for the inclusion of contracts signed before the implementation of the new law. In Indiana, a bill was signed into law in April banning non-compete agreements for primary care physicians. Although the original bill included all physicians, the legislature ultimately decided to move forward incrementally.

ACC's Indiana Chapter played a vital role in educating lawmakers on how non-competes negatively impact physicians and patients. These discussions helped move the legislation forward, and the chapter will continue advocating to expand the scope of this new law in future legislative sessions.

Non-compete bans have also seen major progress in the state of New York, where S.B. 3100-A passed in the state legislature and now awaits the governor's signature. ACC's New York Chapter strongly supports the bill, launching a grassroots campaign to encourage the governor to sign.

State Advocacy Roundup: 2023 Legislative Session Highlights

Restrictive covenants and their effect on the field of cardiology remain a significant topic of discussion for ACC's Board of Governors (BOG) and ACC leadership at large. ACC President B. Hadley Wilson, MD, FACC, recently held a Heart-to-Heart conversation on restrictive covenants with several subject matter experts. Click here to access the Heart-to-Heart recording and links to an ACC BOG White Paper on the topic.

Prior Authorization Reform

The popularity of legislation aimed at reducing administrative burden through the reform of health plans' step therapy protocols and praior authorization policies continues to increase. In the state of Washington, the governor signed H.B. 1357, prior authorization legislation that expedites response times for provider requests and determinations and requires payers to integrate prior authorization information into electronic health records.

ACC Washington Chapter Advocacy Chair Ruchi Kapoor, MD, PhD, testified before the Washington State House Appropriations Committee, explaining why reducing administrative burdens by modernizing prior authorization would benefit patients and clinicians. This win came following a years' long grassroots effort from physicians, PAs and patient advocacy organizations as well as negotiations with payers.

Additional State Victories

Register Today For ACC Legislative Conference 2023

Registration is now open for ACC Legislative Conference 2023! Join your ACC Advocacy team Oct. 15-17 in Washington, DC, to hear from ACC leaders, staff and other experts on health policy, network with your fellow ACC advocates and speak directly to your lawmakers on issues impacting the field of cardiology. This year's conference will focus on policies that would stabilize the Medicare payment system, address health care workforce shortages, decrease health care inequities across the nation and more. Click here to learn more and register.

In South Carolina, the governor signed S.B. 164 into law, a bill that repeals the state's Certificate of Need (CON) law. This bill was a priority for ACC's South Carolina Chapter, working closely with key stakeholders over the past two legislative sessions to pass the best possible bill for all ACC members in the state.

Currently, 35 states and the District of Columbia have CON programs, which according to numerous studies have failed to achieve their intended goal of containing costs. The repeal of CON in South Carolina goes into effect immediately for most health care facilities, including ambulatory surgical centers.

Expanding Medicaid coverage for postpartum care has garnered bipartisan support in many states across the country. This year, both Alaska and Missouri passed legislation to expand coverage from 60 days to 12 months. ACC's Alaska Chapter prioritized this legislation and participated in a grassroots campaign to urge lawmaker support. To date, 36 states have implemented expanded coverage, with Alaska and Missouri both awaiting federal approval.

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Prevention, SCD/Ventricular Arrhythmias, Smoking

Keywords: ACC Publications, Cardiology Magazine, Medicaid, Workers' Compensation, Prior Authorization, Expert Testimony, Vaping, Laboratories, Telemedicine, Policy, Health Policy, Workforce, Health Services Accessibility, Postpartum Period, Cardiopulmonary Resuscitation

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