What Has UMA Done for Me Lately?

LEGISLATIVE ADVOCACY – one voice speaking for ALL Utah physicians regardless of specialty

a)   Strong voice in Utah legislative process. We consistently push to support helpful legislation and stop harmful legislation. UMA has 2 full-time lobbyists providing effective representation before the state legislature, UDOH, the Governor’s office, DOPL, and other regulatory bodies. UMA tracks and responds to over 150+ bills each year in the legislature to protect physician interests and patient safety.


Some examples of direct UMA successes include:

    1. Peer Review Resolution– HUGE WIN! The Utah Supreme Court ruled that “peer review” can be “discovered” and admissible in court. The process had already begun when UMA heard about it and immediately jumped in and drafted legislation to amend Rule 26 of the Utah Rules of Civil Procedure. It passed and establishes additional privileges that protect matters connected to medical care and peer review against discovery and admission into evidence.
    2. Pharmacy Practice Act Revisions – Allows a prescriber to provide up to 30 days of sample Rx drugs excluding schedule II, opioids and benzo’s.
    3. Negligent Credentialing. The Utah Supreme Court created a “cause of action” in Utah for negligent credentialing. UMA got passed a bill so that Utah physicians will have full confidence that information disclosed in the credentialing process will continue to be protected from “discovery” in future medical malpractice cases.
    4. Amended Rule of Evidence. UMA & Lt. Gov. brought forward the “I’m sorry” resolution. The resolution fixes the previous ruling by the Utah Supreme Court that makes expressions of apology by medical providers possible without liability in court. Physicians can now make expressions of apology without concern that those statements will be used against them in a later mal practice case.
    5. UMA helped stop a planned 15.2% Medicare reimbursement cut to Utah physicians.
    6. UMA passed “prompt pay legislation” requiring insurance companies to pay within 30 days of receiving a claim.

These are just a few examples. There are many, many more.

b)   Push for increased reimbursement or fight to stop cuts to reimbursement.

c)   Represent physicians on many government or industry committees and task forces and much more.

d)   Constant input with both State and National elected representatives. They call us for input on where physicians stand on particular issues.

e)   Oppose inappropriate scope expansions by those who wish to practice medicine via legislation instead of getting the required education.

f)   Monitor regulatory changes and oppose inappropriate or overly restrictive regulation.


Medicare Reform Principles

UMA fully supports the AMA's "Characteristics of a Rational Medicare Payment System" principles listed below:

Simplicity, relevance, alignment, and predictability, for physician practices and the Centers for Medicare and Medicaid Services (CMS).

Ensuring financial stability and predictability

  • Provide financial stability through a baseline positive annual update reflecting inflation in practice costs, and eliminate, replace or revise budget neutrality requirements to allow for appropriate changes in spending growth.
  • Recognize fiscal responsibility. Payment models should invest in and recognize physicians’ contributions in providing high-value care and the associated savings and quality improvements across all parts of Medicare and the health care system (e.g., preventing hospitalizations).
  • Encourage collaboration, competition and patient choice rather than consolidation through innovation, stability, and reduced complexity by eliminating the need for physicians to choose between retirement, selling their practices or suffering continued burnout.

Promoting value-based care

  • Reward the value of care provided to patients, rather than administrative activities--such as data entry--that may not be relevant to the service being provided or the patient receiving care.
  • Encourage innovation, so practices and systems can be redesigned and continuously refined to provide high-value care and include historically non-covered services that improve care for all or a specific subset of patients (e.g., Chronic Obstructive Pulmonary Disease, Crohn’s Disease), as well as for higher risk and higher cost populations.
  • Offer a variety of payment models and incentives tailored to the distinct characteristics of different specialties and practice settings. Participation in new models must be voluntary and continue to be incentivized. A fee-for-service payment model must also remain a financially viable option.
  • Provide timely, actionable data. Physicians need timely access to analyses of their claims data, so they can identify and reduce avoidable costs. Though Congress took action to give physicians access to their data, they still do not receive timely, actionable feedback on their resource use and attributed costs in Medicare. Physicians should be held accountable only for the costs they control or direct.
  • Recognize the value of clinical data registries as a tool for improving quality of care, with their outcome measures and prompt feedback on performance.

Safeguarding access to high-quality care

  • Advance health equity and reduce disparities. Payment model innovations should be risk-adjusted and recognize physicians’ contributions to reducing health disparities, addressing social drivers of care, and tackling health inequities. Physicians need support as they care for historically marginalized, higher risk, hard to reach or sicker populations.
  • Support practices where they are by recognizing that the high-value care is provided by both small practices and large systems, and in both rural and urban settings.