CRNA Independent Practice Bill On the Move!
Weekly Legislative Update: April 5, 2019


BREAKING (04/09/19)
: An amendment to SB 890 was offered just minutes prior to the House Public Health Committee Meeting and a Certified Registered Nurse Anesthetist (CRNA) independent practice bill is now headed to the House Floor. The amendment replaced all language in the bill and now allows, under certain conditions, a nurse anesthetist to administer anesthesia in collaboration with, not under the supervision of, a physician. The language also eliminates the requirement that a physician must be “on site” when the anesthesia is administered. PLEASE RESPOND TO YOUR ACTION CALL AND REQUEST YOUR REPRESENTATIVE TO VOTE “NO” ON SB 890. Find your legislator now

KEY DEADLINE UPCOMING! The deadline for bills to get out of Committee in the opposite House is the week of April 8. Bills not receiving a hearing will be dead for this year. Several measures of interest to the medical community will be considered.

Scope of Practice:
The delivery of health care is a TEAM EFFORT! When determining diagnosis and treatment, physicians have the highest level of training and experience to lead that team. M.D.s and D.O.s must remain at the helm of that structure. OSMA has been in a tremendous political battle with others within the medical profession regarding “scope of practice” issues.

As a reminder, three major scope of practice measures; SB 801 (CRNA); SB 839 (APRN); and, HB 2041 (Radiologist Technicians), all of which were opposed by OSMA, did not meet their hearing deadlines and are now dormant. As always, OSMA will remain conscientious toward efforts to amend such language into other measures.

HB 2194 (Randleman/Pemberton)
– Expands the definition of “physician” to include psychologist, therapist or counselor. (PASSED: House Floor 53-37; to Senate Health & Human Services Committee) OSMA OPPOSES (view an updated coalition letter spearheaded by OSMA regarding this scope measure) NOT PLACED ON April 8 Agenda

Pill Limits/Pain Management:


SB 848 (Rader/Echols)
– There continues to be misunderstanding regarding the intent of the language housed within last year’s “Pill Limit” bill, SB 1446. The intention was to address initial prescriptions dealing with acute pain. SB 848 clarifies language and also incorporates Oklahoma Bureau of Narcotics Emergency Rules passed last year which confirm the ability of a physician to write a second 7-day script at the same time as the initial script is written. Attorney General Mike Hunter and OBNDD continues to work closely with OSMA on language addressing this issue. (PASSED Senate Floor 45-0 with Title off; To be heard in House Public Health on Tuesday, 4/9) OSMA SUPPORTS

SB 242 (Standridge/C. Caldwell)
– Pain Management Clinics in Oklahoma should be licensed and regulated. Currently, they can be owned by non-physicians and provide 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. (PASSED Senate Floor 45-0; To House Rules) OSMA SUPPORTS

HB 2368 (Kannady/Thompson)
– Provides for the re-creation of the Commission on Opioid Abuse, to exist until July 1, 2023. (PASSED House 95-2; Passed Senate Health & Human Services and Senate Appropriations & Budget; Title off; to Senate Floor) OSMA SUPPORTS

Vaccinations:
Proper immunization is in the best interest of Oklahoma’s public health. The OSMA works diligently to promote the utilization of vaccinations.

SB 924 (McCortney/Bush)
– Requires immunization education to be provided at assisted living centers. (PASSED Senate Floor 27-19; To House Health Services & Long-Term Care) OSMA SUPPORTS

SB 925 (McCortney/Chad Caldwell)
– Requires school districts to report to the Oklahoma Department of Health the number and type of exemptions from vaccinations (PASSED Senate Floor 26-18; To House) OSMA SUPPORTS

HB 2339 (S. Roberts/Standridge)
– Provides students cannot receive vaccines on school grounds or by a mobile vaccination without prior authorization from parent or legal guardian for each vaccine given. (PASSED House 69-27; on 4/8 Senate Health & Human Services Committee Agenda) OSMA OPPOSES

Insurance Reform:
Physicians are constantly faced with administrative obligations by health insurance plans. These requirements can play a key role in the health outcomes of all Oklahomans.

SB 508 (Newhouse/McEntire)
– Requires insurance companies that have received an appeal of a denied claim by a healthcare provider to furnish written details of the reason for claim denial. (PASSED Senate Floor 45-0 with Title off; To House Insurance) OSMA SUPPORTS

HB 2638 (Munson/Rader) & SB 509 (Rader/Munson)
– Provides for guidelines and requirements on insurers offering step therapy protocols, requiring such therapy protocols to be based on clinical practice guidelines. (HB 2638 (PASSED House 94-0; PASSED Health & Human Services; To Senate Floor/SB 509 PASSED Senate 43-0; PASSED House Health Services & Long-Term Care; To House Floor) OSMA SUPPORTS

HB 2511 (McCall/Thompson)
– Provides a $25,000 exemption from taxable income for an M.D. or D.O. serving in a qualifying rural area municipality or unincorporated area not exceeding a population of 25,000. (PASSED House 92-2; on 4/9 Senate Finance Agenda) OSMA SUPPORTS

HB 1927 (Roe/Weaver)
– Expands unlawful assault and battery on medical care providers to include non-emergency personnel (Passed House 85-8 with Title off; PASSED Senate Public Safety; To House Floor) OSMA SUPPORTS

SoonerCare Budget:
The Oklahoma Health Care Authority (OHCA) FY2020 Budget Request restores Medicaid reimbursement rates back to 100% of Medicare levels…a level not realized since 2009. OSMA SUPPORTS

Public Health / Medicaid “Expansion” Funding: Federal tax dollars from Oklahoma are being reallocated to other states in support of their Medicaid delivery systems. OSMA has joined the Coalition to Expand Coverage spearheaded by the Oklahoma Policy Institute. This effort is designed to promote the acceptance of federal dollars to provide comprehensive health care coverage.

MEDICINE DAY – APRIL 16
An afternoon at the Capitol begins @ 1:30p – Room 535
Legislative Reception at OSMA 5:00p – 6:30p