WEEKLY LEGISLATIVE UPDATE: February 9, 2018

OSMA is tracking nearly 300 new pieces of state legislation for 2018. This week, the Legislature hit the ground running! The budget debate is providing the foundation for this year’s session and the OSMA lobby team is working hard to capture enough votes to pass the cigarette tax housed within the “Step Up Oklahoma” proposal.

HB 1033X (Wallace/David) Revenue Raising:  The “Step-Up Oklahoma” revenue proposal passed the House Appropriation and Budget Committee this week by a vote of 21-5. A floor vote is scheduled for Monday, February 12. As an OSMA member, you received a “Call For Action” encouraging you to contact your House and Senate member encouraging support for the $1.50 per pack cigarette tax housed within the measure. OSMA SUPPORTS

Many Other Important Issues to the OSMA

The Oklahoma Commission on Opioid Abuse, chaired by Attorney General Mike Hunter, recently provided recommendations addressing the nationally-recognized public health issue of opioid misuse. Many of the recommendations will be considered by the Senate Health & Human Services Committee. The OSMA remains proactive on addressing this serious problem and has requested several measures in order to remain engaged in negotiations.

SB 1128 (Yen) E-Prescribing: Requiring electronic prescriptions is a trend across the nation…and Oklahoma is not immune. The OSMA understands the difficulty of accessibility, expense and time management associated with the implementation of such a structure. While deliberating, the Legislature should also consider an alternative method for compliance. (Senate Health & Human Services) OSMA Active in Negotiations

SB 1446 (Sykes) Pill Limits: Restricting the availability of opioids is a commission recommendation. In order to assure a physician’s ability to address each case independently, any limitation should also allow an M.D. or D.O. to consider prescriptive authority on a case-by-case basis. The OSMA is exploring the recommendations of the Centers for Disease Control and Prevention (CDC) limits for post-surgery; acute and chronic. (Senate Health & Human Services) OSMA Active in Negotiations

SB 1124 (Yen) Pain Management Clinic Regulation: Pain management clinics in Oklahoma should be licensed and regulated. Currently, they can be owned by non-physicians and prescribe limited oversight. Clinics should be owned by an individual or group of M.D.s or D.O.s and should designate a physician who is responsible for complying with clinic operations. (Senate Health & Human Services) OSMA Active in Negotiations

SB 1367 (Yen) Good Samaritan Law: Instances whereby a person is attempting to help another in the case of a suspected overdose should be immune from prosecution based solely on an offense of drug possession or use. (Senate Public Safety) OSMA SUPPORTS

HB 3091 (Cockroft) – Authorizes Advanced Practice Registered Nurses (APRNs) independent prescriptive and operational authority without physician oversight. OSMA believes expanding prescriptive authority should not be a focus for this Legislature. Maintaining quality care and patient safety should be the top priority for healthcare. Medical doctors and doctors of osteopathy maintain a superior level of training and clinical expertise and should maintain supervision in order to better assure quality care. (House Rules; the Carryover measure, HB 1013 (Cockroft/Griffin), is currently in the Senate Health and Human Services Committee) OSMA OPPOSES

HB 3231 (Moore) Elimination of Maintenance of Certification (MOC): In addition to state licensure board requirements, some hospitals demand M.D.s and D.O.s conform with additional licensing certification. These additional obligations have been utilized to restrict a physician’s access to that hospital and thereby reduces the availability to quality care. The OSMA believes current state licensing board requirements represent a high standard of care and are adequate for hospital access. (House Public Health - Since a similar measure died on the House Floor last year, this bill was considered redundant and was “laid over.”) OSMA SUPPORTS

SJR 68 (Sykes) Legal Reform – Creates 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”. (Senate Rules) OSMA SUPPORTS

Congress Passes Federal Budget 

Congress overcame a filibuster by Kentucky Sen. Rand Paul as well as opposition from both the right and left in the House to pass a budget deal that keeps the government funded for another six weeks. The measure not only keeps the government operating, but also has several pieces of good news for physicians. Among other things, the bill:

  • Repeals the Independent Payment Advisory Board (IPAB)
  • Gives CMS more flexibility in MIPS improvement scoring through 2024
  • Removes mandate that meaningful use standards become more stringent over time
  • Extends CHIP for an additional four years (beyond the six already authorized)
  • Provides two years of funding for federally qualified health centers
  • Appropriates $6 billion in mental health and opioid abuse services
  • Increases NIH research funding by $2 billion
  • Closes the “donut hole” gap in Medicare drug coverage.
  • Reduces the physician fee schedule conversion factor for FY 2019 from 0.5 percent to 0.25 percent (which sounds bad, but is actually an improvement over the language in the original House bill that would have extended a “misvalued codes” provision for another year which would have essentially reduced the factor from 0.5 percent to 0.05 percent).

The bill passed the Senate 71-28 shortly after midnight and the House 240-186 at about 5:30 on Friday, February 9, then was hurried over to the White House for President Trump’s immediate signature.

OKALHOMA CONGRESSIONAL DELEGATION VOTES ON BUDGET:

YES: Sen. Inhofe; Rep. Cole; Rep. Lucas; Rep. Mullin; and, Rep. Russell

NO: Sen. Lankford

ABSENT: Rep. Bridenstine