Weekly Legislative Update: February 16, 2018

Medicine Day Legislative Reception

The Annual Medicine Day Legislative Reception is scheduled for Tuesday, Feb. 20, from 5 - 6:30 p.m. at the OSMA Office (313 NE 50th Street, OKC). Please attend and wear your WHITE COAT! This is a critical time in budget negotiations which will directly affect the future of healthcare in Oklahoma. Be a part of the solution and join your peers to assure our legislators understand the healthcare needs of Oklahoma.

Budget Update

This week, the Legislature considered HB 1033X, the so-called Step Up Oklahoma state budget proposal containing several revenue-raising provisions including a $1.50 per pack cigarette tax. The cigarette tax would have a significant long-term positive affect on the health status of all Oklahomans. OSMA endorsed the proposal.

“Revenue-raising” measures must pass the Legislature by a super-majority 75 percent vote (i.e. 76 votes in the House). Although HB 1033X passed the House 63-35, the super majority was not attained. The measure moved to the Senate as a State Ballot Question initiative. Unfortunately, a State Question would not occur in a timely fashion to address the underfunded 2018 budget.

Graduate Medical Education (GME) Funding: In December, the Oklahoma Health Care Authority (OHCA) received a letter from the Centers for Medicare and Medicaid Services (CMS) indicating that, due to a previous contractual agreement, federal funding for that program would cease. Since the budget measure did not pass, Gov. Fallin issued her Third Special Session Call on Wednesday directing the Legislature to fund the Graduate Medical Education (GME) program.

Without funding, the residency programs at the university hospitals would effectively be eliminated. This would provide a devastating blow to Oklahoma’s efforts to educate and place new MDs and DOs in our state’s healthcare system. As a result of the Third Special Session Call, HB1022XX, allocating $142 million to OHCA to make up for the lost federal match for OU and OSU, has passed out of both the House and Senate appropriations committees. The measure is set for a vote on the House Floor on Monday, Feb. 19.

Many Other Important Issues to the OSMA

March 1 serves as the deadline for measures to be out of Committees in their House of Origin (House Bills out of House Committees and Senate Bills out of Senate Committees). Although this deadline will significantly reduce the number of measures under legislative deliberation, bills held over from last year still pose a threat of consideration.

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. OSMA remains pro-active 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. 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 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 (APRN’s) 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 health care. Medical Doctor’s 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

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

HB 1447 (Sykes/Calvey) Legal Reform – States a health care provider acting in good faith shall not be held liable, criminally or civilly, for making health care decisions that are consistent with best practices of their profession and the laws and regulations governing their practice. Passed Senate Judiciary/to Senate Floor OSMA SUPPORTS

AMA National Advocacy Conference

This week, several OSMA leaders traveled to Washington, D.C. to participate in the American Medical Association (AMA) National Advocacy Conference. The top priority of the OSMA delegation was to stress the importance of continued CMS federal funding of the state’s Graduate Medical Education (GME) program.

Visits with the Oklahoma members of the U.S. House and U.S. Senate confirmed our congressional delegation is extremely aware of this critical funding issue. Senator Jim Inhofe, member of the Senate Rural Health Caucus; Congressman Tom Cole, member of the House Appropriations and Budget Committees; and, Congressman Markwayne Mullin, member of the House Committee on Energy and Commerce Subcommittee on Health, serve as key leaders on this issue.