Weekly Legislative Update: May 7, 2018
THE LEGISLATURE HAS ADJOURNED SINE DIE!
On the evening of Thursday, May 3, the Oklahoma Legislature officially adjourned SINE DIE…the 2018 Session is OVER! The Oklahoma State Medical Association (OSMA) was actively involved in many pieces of legislation and had an extremely successful session, but we still have work ahead. The following recaps several of the measures in which OSMA played an active role:
APN “SCOPE OF PRACTICE” EFFORT FALLS SHORT
During the last two weeks of session, the nurse practitioners attempted to use the legislative process to again press for "independent scope of practice" authority in Oklahoma. SB 570 (Griffin/Cockroft), a carry-over bill from 2017 dealing with “Cosmetology and Barbering”, was stripped and replaced with Advanced Practice Nurse Independent Licensure language similar to last year’s HB 1013.
Although the process was within the rules, many legislators considered this a tactic which avoids the transparency required for the process of open government. OSMA sent a “Call For Action” to our members which generated nearly 700 emails to legislators assuring they understood this issue is about Patient Safety. Many thanks for those members who participated in the effort! The Conference Committee Report for SB 570 did not receive enough signatures to be “signed out of committee”. OSMA OPPOSED – Measure FAILED.
Revenue raising measures passed this session (mainly designed to increase common education funding) combined with general revenue increases due to economic growth provided the legislature with some budget flexibility for the first time in nearly a decade. A $7.6 billion budget has been signed by the Governor whereby most agencies received a flat budget with no cuts while some were provided an increase in funding.
SB 1605 (David/Wallace), directs the Oklahoma Health Care Authority (OHCA) to increase SoonerCare provider reimbursement rates by 2%. OSMA SUPPORTED – Sent to the Governor
Tobacco Settlement Endowment Trust (TSET): SJR 45 (Fields/Echols) created a State Question allowing TSET dollars to be utilized to fund Oklahoma’s Graduate Medical Education (GME) programs housed within the OU and OSU medical schools. TSET funds are utilized for tobacco prevention and cessation programs as well as medical research grants. OSMA opposes the diversion of TSET dollars and continues to support ongoing negotiations between the Oklahoma Health Care Authority (OHCA) and the Centers for Medicare and Medicaid Services (CMS) to assure full funding to these vital GME programs. OSMA sent a “Call For Action” to our members generating nearly 200 emails to legislators assuring they understood this issue is about keeping their promise to maintain TSET dollars for their intended purpose. OSMA OPPOSED – Measure FAILED
Pharmaceutical Related Legislation
The Oklahoma Commission on Opioid Abuse, Chaired by Attorney General Mike Hunter and included Kevin Taubman, MD, OSMA President as an active participant, provided legislative recommendations to combat this national public health issue. The medical community was made well aware that substantial reform was at hand. In an effort to address some of the Commission recommendations and retain significant influence on legislation content, OSMA was pro-active and requested the filing of several pharmaceutical related bills specific to the opioid overdose epidemic.
E-Prescribing: HB 2931 (Mulready/David) Requires the implementation of a statewide e-prescribing system effective January 1, 2020. The measure allows for physicians who do not have the technical capability to accommodate such a system to request an exemption through their respective licensure board. OSMA SUPPORTS – Sent to the Governor
Pill Limits: SB 1446 (Sykes/Derby) Some members on the Commission requested to completely eliminate access to opioids while others desired a maximum prescription of 3-days. Due to negotiations spearheaded by OSMA, this measure allows for an initial 7-day prescription of opioids or Class II narcotics for acute pain associated with post-surgery, post-injury, or disease. A second 7-day prescription may be written but could not be filled until after the first prescription expires. Subsequently, if deemed necessary by the physician, 30-day prescriptions associated with a pain management plan and three-month “course of treatment” reviews must be established. SB 1128 (Yen/Derby) was utilized as a “trailer bill” to revise the initial prescription for a post major surgical procedure (as defined by their licensure board) to be 14 days. OSMA SUPPORTS – SB 1446 Signed by the Governor; SB 1128 sent to the Governor
Good Samaritan Law: SB 1367 (Yen/Derby) When a person is attempting to help another in the case of a suspected overdose of a Schedule I or Schedule II controlled dangerous substance and that person cooperates with emergency responders and peace officers at the scene, they would be immune from prosecution based solely on an offense of drug possession or use. This measure was a Medical Student Advocacy Bill. OSMA SUPPORTS – Sent to the Governor
Pain Management Clinic Regulation: SB 1124 (Yen/Derby) Similar to the qualification that attorneys are required to own law firms and engineers are required to own engineering firms, pain management clinics should be owned by MD’s or DO’s and should be licensed and regulated. Currently, they can be owned by non-physicians and provide limited oversight. OSMA SUPPORTS (Not heard on the House Floor) Measure FAILED
Other Legislation of Importance to the Medical Community
Scope of Practice: SB 1329 (Scott/Teague) Would have expanded the “scope of practice” for radiologist assistants and technicians by allowing for independent licenses and certifications. OSMA OPPOSED (Not heard in House Rules Committee) Measure FAILED
Sunscreen for Students: SB 950 (Stanislawski/Rogers) Requires public schools to allow a student to possess and self-apply sunscreen regulated by the Food and Drug Administration (FDA) without previous written authorization. This measure was another Medical Student Advocacy Bill. OSMA SUPPORTS – Signed by the Governor
Appointment Authority: HB 3036 (Lepak/Treat) Provides that the State Board of Health shall become an advisory board only. The bill provides that the State Commissioner of Health, appointed by the Governor with the advice and consent of the Senate, shall have complete authority over the Department of Health and may be removed or replaced by the Governor without cause. OSMA OPPOSED – Sent to the Governor
Occupational Licensing: SB 1475 (Pugh/Osburn) Creates an Occupational Licensing Advisory Commission designed to review each occupational or professional licensing act every four years and make recommendations to the legislature on whether a license should be maintained, modified or repealed. At the request of OSMA and others, the bill was amended to require a representative of the medical community serve on the Commission. Sent to the Governor
SB 2932 (Mulready/Pugh) Requires the Oklahoma Health Care Authority (OHCA) to seek a waiver to require work and/or educational qualifications to receive Medicaid benefits. Governor Fallin has already issued an Executive Order requiring OHCA to do so. OSMA OPPOSED – Sent to the Governor
HB 2933 (Mulready/David) Provides for a first-year license fee waiver for low-income individuals. At the medical community’s request, the measure exempts those holding a license to practice health care. OSMA NO POSITION – Sent to the Governor
Managed Care for Medicaid – Early in the session, three Medicaid Managed Care measures (SB 1331; SB 1285 & SB 1310) were placed on the Senate Appropriations Committee Agenda. After SB 1331 failed, SB 1285 & SB 1310 were not heard. OSMA OPPOSED – Measures FAILED
Legal Reform: SJR 68 (Sykes) This would have created a State Question placing “Certificate of Merit” to a vote of the people. This concept maintains that a plaintiff declaring negligence in a civil action must present expert witness testimony showing there was a “breach of duty” by the defendant which resulted in harm to the plaintiff. Despite legislative efforts to do so, the Oklahoma Supreme Court has consistently overturned the law as unconstitutional as either “special law” or “denying access to the court system”. Unfortunately, this legislation got caught up in a political battle unrelated to the bill. OSMA SUPPORTS – Measure FAILED
OSMA and OMPAC is preparing for the upcoming Elections. The medical community MUST participate in the election process in order to support “PRO-MEDICINE” members of the legislature.
INVEST IN YOUR PROFESSION…INVEST IN OMPAC TODAY!
Please mark these important election dates on your calendar:
Primary Election: June 26** (Voter Registration Deadline: June 1)
Run-Off Primary Election: August 28 (Voter Registration Deadline: August 3)
General Election: November 6 (Voter Registration Deadline: October 12)
**State Question 788, the so-called “Medical” Marijuana ballot question, will be considered by a vote of the people on June 26. OSMA OPPOSES the passage of this State Question which does NOT represent “medical marijuana”.
If SQ 788 passes, obtaining a state-issued medical marijuana “license” would require a board-certified physician’s signature. However, in Oklahoma, the broad utilization of the term “physician” includes not only MD’s and DO’s, but also includes dentists; chiropractors; podiatrists; optometrists; and, veterinarians. There would be no specific qualifying conditions to receive a “medical” marijuana license. The physician would not offer a traditional prescription but would provide a patient with an authorization license to purchase marijuana at a state certified dispensary operating under a license provided by the Oklahoma Department of Health.
Individuals with licenses would be permitted to possess up to three ounces of marijuana on their person and eight ounces of marijuana in their residence. A seven percent (7%) tax would be levied on marijuana sales, with revenue being allocated to administrative costs, education, and drug and alcohol rehabilitation. Licenses would be required to operate dispensaries, commercial growing operations, and processing operations.
OSMA does not have policy opposing the use of medical marijuana; however, due to the fact that the ballot language does NOT require any qualifying medical conditions and allows non-MD’s and DO’s authority to provide licenses to purchase, grow and possess the Class I narcotic, OSMA OPPOSES the passage of SQ 788.