Budget Update

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. 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 health care system.

This being the case, Gov. Fallin issued her Third Special Session Call last week directing the legislature to fund the Graduate Medical Education (GME) program. HB1022XX, allocating $142 million to OHCA to make up for the lost federal match for OU and OSU, passed the House Floor 94-0. The bill has been sent to the Senate Floor for consideration.

Based on procedural rules, the funding measure could have been voted upon on Thursday; however, due to inclement weather, the legislature remained in recess. The bill is anticipated to be voted upon by the full Senate on Monday then sent to Gov.r Fallin for her signature into law. This would finalize the current 2018 budget and fully fund Oklahoma’s GME Program through the 2019 Budget.

Many Other Important Issues to OSMA

Next week 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. 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. (Set for 2/26 Hearing - 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.  (Set for 2/26 Hearing - 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. (Set for 2/26 Hearing - Senate Health & Human Services) OSMA Active in Negotiations

SB 1367 (Yen) Good Samaritan LawInstances 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 – Agenda not yet announced) OSMA SUPPORTS

Scope of Practice: Several “Scope of Practice” measures have been filed this legislative session. OSMA OPPOSES efforts to undermine the authority and experience MD’s and DO’s bring to the medical profession. They should continue to provide proper oversight of every patient’s well-being. In addition, in light of the opioid epidemic faced by our state and nation, the legislature should not be considering the expansion of prescriptive authority.

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”. (Set for 2/21 Senate Rules – Meeting Postponed due to weather) OSMA SUPPORTS

Congressional Activity

Congress will begin a series of legislative hearings next week as the first step in an effort to pass bipartisan bills addressing the opioid crisis. The plan from the House Energy and Commerce Committee, which will hold the first hearing on Feb. 28, will likely require additional funding from Congress. Bills to be considered will focus on law enforcement, public health and prevention, and insurance coverage issues.

A bipartisan budget deal that passed this month would direct $6 billion over two years for opioid abuse treatment and mental health.