I appreciate having the opportunity to update CPMA members on a number of initiatives that the legislative team is currently pursuing and working on for the Connecticut Podiatric Medical Association.

This August six different Scope of Practice requests were submitted to the Connecticut Department of Public Health.  These include proposals submitted by the Nurse Anesthetists, Dental Hygienists, Nurse-Midwives, Occupational Therapists, Physician Assistants and Podiatry.  The DPH commissioner will decide by mid-October which proposals move forward to a full scope of practice committee review.  Regardless of the decision, the negotiation process will begin on a separate provision passed this past legislative session that sets up a working group to review Podiatry’s surgical laws.

As you may recall, a six-member committee of Doctors of Podiatric Medicine and Orthopedic Surgeons was created in Section 18 of Public Act 23-97.  This committee will discuss the proposed changes to surgery in the podiatric practice act.  We are seeking to permit qualified Podiatrists to perform a total ankle replacement, to set and treat a pilon fracture and to expand the areas covered in a foot amputation.

We have also been working following up on our discussions with DSS Commissioner Andrea Barton Reeves, on Medicaid fee reimbursements.  As we have reported previously, there is funding in next year’s budget (fiscal year ’25) to increase Medicaid fees for specialist physicians. The DSS commissioner dedicated $3 million in ARPA dollars for consultants to review all rates with an expectation that recommendations could be made by the commissioner in the 2024 legislative session.   We are continuing to make the case that higher fees are needed to cover physician costs.

Meanwhile, we continue to monitor the development and implementation of the Health Information Technology system called Connie.  Many professions have been asking specific questions about the process.   The Office of Health Strategy (OHS) plans to issue Policies and Procedures that will address many of them.  Our coalition of medical professionals wrote to the Governor’s office this past session about issues with Connie, and we are reserving the right to have a corrective bill introduced next legislative session. Finally, we are facilitating a briefing by OHS staff on Connie for CPMA members.

We are also monitoring the work of the Healthcare Benchmark Initiative Steering Committee of OHS.  This panel is working to develop guidelines where health care costs are analyzed by component, and then compared to several different inflation factors.  Those that exceed inflation, such as pharmacy, are then given additional review to pressure manufacturers to reduce the end costs. This has implications across-the-board, but has not yet touched Podiatric medical care services.  Ultimately, a number of observers believe that this initiative could result in financial penalties against component areas that are deemed to have unjustified price increases.  A new report updating the 2022 healthcare benchmarking should be available this Fall.

Over the next month state agencies will be developing their fiscal year 2025 budgets and legislative packages for submittal to the Office of Policy and Management.  We will be monitoring this closely for agencies such as DSS, DPH and OHS.   Although the two-year budget was enacted last legislative session, the second year is adjusted, and those changes will start with agency requests.  We will keep you informed on this as the fiscal year 2025 budget process proceeds.

UPDATE BELOW: October 27, 2023

This August, six different Scope of Practice requests were submitted to the Connecticut Department of Public Health.  These included proposals submitted by the Nurse Anesthetists, Dental Hygienists, Nurse-Midwives, Occupational Therapists, Physician Assistants, and Podiatry.  The DPH commissioner decided to advance several of these to a full committee review, and Podiatry’s submission is one of them!  This is a significant success for our profession.  The review committee will meet three times this fall with representation from CPMA.  Our proposal is to update and expand the Podiatric scope of practice so that it includes the ability to perform a total ankle replacement, setting a tibial pilon fracture, and expanding the area involved in a foot amputation.  Once the committee completes its work, DPH will send a report of the committee’s discussions to the Public Health committee in January, and that will clear the way for us to request that the committee raise our scope expansions in a drafted bill.  This will be a top priority of your legislative team in 2023.