POLICY FORUM PURPOSE

The Policy Forum process allows NDMA members to participate in the policy discussion process. It is designed to allow broad member input and feedback on critical health policy issues facing North Dakota physicians and care provided to their patients.

HOW IT WORKS

After policy issues have been presented and discussed, the Policy Forum adjourns. Next, the discussion summaries are brought forward to the NDMA Council where each topic will be carefully vetted. At this point, topics can be either adopted, amended and adopted, rejected, or referred for study.

2021 POLICY FORUM TOPICS

Medicaid Coverage 12 Months Post-Partum

North Dakota Medicaid currently covers pregnant women at a lower percentage of poverty level during pregnancy and 60 days post-partum. Studies have shown that extending Medicaid coverage for 12 months post-partum is beneficial to the mother’s health and her children’s health. The ND Department of Health has a taskforce working on a Medicaid state plan amendment to provide for coverage.

This policy proposal asks for NDMA’s support, as the ND Department of Health pursues a state plan amendment to allow Medicaid coverage to extend to one year postpartum. And if necessary, support legislation during the 2023 legislative session to establish coverage.

Proposal submitted by Erica Hofland, MD

Long Term Care Medical Director Directory and CME Requirement

By developing a state Certified Medical Director (CMD) program, North Dakota can lead in long-term care transformation and enable the most efficient and best possible communication regarding opportunities to improve care.

CME requirements can appropriately train physicians directing the medical care of vulnerable North Dakotan nursing home residents. Furthermore, when the pandemic crisis began last year both the ND Department of Health and the ND Long Term Care Association struggled with how to quickly reach all nursing home medical directors as there is currently no registry or database of these physicians.

This policy proposal asks for NDMA to champion the development of a North Dakota nursing home medical director registry and continuing medical education (CME) requirements and support legislation to accomplish this goal. If legislation is not required, NDMA should work together with state agencies to support this goal.

Proposal submitted by Jane Winston, MD, FAAFP, CMD

Patient Choice of Provider-Any Willing Provider

Narrow network plans continue to become more common. Patients are losing their choice to see the providers they want to see due to specific narrow network health plans. The 2021 legislature defeated a bill proposal that stated a health insurance company may not exclude a physician/healthcare provider from its insurance products if the physician/healthcare provider agrees with the insurance companies’ standard contract for that product. The bill was turned into a 2021/2022 interim study.

This policy proposal asks for NDMA to participate in the interim studies regarding narrow networks and continue to support patient choice and any willing provider legislation in the 2023 legislative session.

Proposal submitted by Duncan Ackerman, MD

Statewide Investment in Renewable Energy

North Dakota is vulnerable to the effects of climate change with a subsequent increased population exposure to particle pollution. With increased air pollution, there are significant adverse health effects such as increased likelihood of developing asthma, increased severity of asthma attacks, increased hospitalizations for asthma among children, and increased overall mortality in infants.

This policy proposal asks for NDMA to take a position that supports statewide investment in renewable energy to address greenhouse gas emissions in North Dakota, which will improve the health of North Dakotans, especially the pulmonary health of children.

Proposal submitted by Joshua Roback, MS-IV - UND SMHS Medical Student

Basic Care- Memory Care Facility Regulatory Reform

Basic Care facilities are held to a different regulatory standard than long term care facilities and are not intended to be regulated as a skilled nursing facility. Basic Care facilities are required to follow the requirements found in Chapter 33-03-24.1 of the North Dakota Administrative Code.

Even though CMS doesn't regulate our state basic care facilities we have a responsibility to provide the same level of protection to our vulnerable elders who live in these facilities as those who reside in federally regulated nursing homes.

The policy proposal asks NDMA to support legislation, if necessary, to accomplish reform of the basic care regulations to protect vulnerable North Dakotans who reside in basic care memory facilities.

Proposal submitted by Jane Winston, MD, FAAFP, CMD