Weekly Legislative Update: May 10, 2019

SHOW ME THE MONEY! The major legislative item on the table continues to be the STATE BUDGET. Negotiations between the legislature and the Governor appear to be progressing and an announcement is anticipated very soon. Once the budget is passed and sent to the Governor, the legislature can adjourn Sine Die. The State Constitution requires that session must end by the last Friday in May at 5:00pm (this year is May 31).

To strengthen Oklahoma’s budget, OSMA continues to support the return of our own federal tax dollars (on a 9:1 match) for use in our state’s health care system. Oklahoma federal tax dollars are being reallocated to other states in support of their Medicaid delivery systems. We want that money back in our state! To enhance our voice, the OSMA has joined the Coalition to Expand Coverage designed to promote the reduction in the number of uninsured Oklahomans and also provide access to comprehensive statewide health care coverage. Unfortunately, the FY2020 budget agreement is not likely to contain language to accept federal dollars for that purpose.

However, with the leadership of his Health Care Transition Team (on which OSMA President Larry Bookman, MD is a member), Governor Stitt has stated he will release his statewide health care policy plan this fall. The OSMA is eagerly awaiting that plan!

Here are some of the other issues which are important to the House of Medicine:

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. (Amended and PASSED House 94-0; Senate rejects amendments; to Conference Committee) OSMA SUPPORTS

HB 2368 (Kannady/Thompson) – Provides for the re-creation of the Commission on Opioid Abuse, to exist until July 1, 2023. (Amended and PASSED Senate 43-1; PASSED House 91-3; to Governor) OSMA SUPPORTS

Access to Healthcare

SB 746 (Smalley/Pfeiffer) – This bill, designed to provide a tax credit for cybersecurity software businesses, was amended to add language similar to HB 2511 (McCall/Thompson) which allows a $25,000 tax exemption for an MD or DO serving in any qualifying rural areas. These areas are defined as a county with a population of less than 36,000 and any municipality not exceeding a population of 25,000. (PASSED House 85-5 as Amended and Title Restored; back to Senate for consideration) OSMA SUPPORTS

HB 2351 (Caldwell, C./McCortney) – Provides for Oklahoma’s participation in the Interstate Medical Licensure Compact allowing for an expedited pathway to licensure for qualified physicians who wish to practice in multiple states. (PASSED House 97-0; PASSED Senate 43-0; SIGNED BY GOVERNOR) OSMA SUPPORTS

HB 1439 (Gann/Smalley) – Amended to provide a sunset clause extension of the Oklahoma State Medical Licensure Board to July 1, 2024 and also adds two additional “lay persons” (four total) to the Board as appointed by the Governor. The Medical Licensure Board will now be comprised of eleven (11) total members. (PASSED Senate 43-2; PASSED House 89-0; to Governor) OSMA SUPPORTS Extension of Sunset Clause

HB 1445 (Gann/Smalley) – Extends the sunset clause of the State Board of Osteopathic Examiners to July 1, 2023. (PASSED House 95-0; Amended and PASSED Senate 40-2; to Conference to change 2023 to 2024) OSMA SUPPORTS Extension of Sunset Clause

Vaccinations: Proper immunization is in the best interest of Oklahoma’s public health. The nation continues to witness the advancement of a measles outbreak which could easily be prevented. The OSMA works diligently to promote the proper utilization of vaccinations.

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. NOTE: Current law already requires parental consent before medications can be administered at schools. This bill is unclear as to whether each vaccine (or group of vaccines such as MMR) requires a separate consent form which could negatively impact immunization rates. At the very least, the measure is unnecessary. Vaccination legislation should be designed to be proactive in protecting public health. (PASSED Senate Floor 42-0; placed on House Floor Agenda) OSMA OPPOSES

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; PASSED House Floor 94-0 with Title off; to Conference Committee – OSMA has agreed to work on compromise language over the interimOSMA SUPPORTS

SB 509 (Rader/Munson) – Provides for guidelines and requirements on insurers offering “step therapy” protocols for pharmaceuticals, requiring such therapy protocols to be based on clinical practice guidelines. (PASSED Senate 43-0; PASSED House 94-0; SIGNED BY GOVERNOROSMA SUPPORTED

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 Floor 43-0 with Title restored; Sent to Conference Comm.) SB 86 (Jech/McEntire) is a similar measure (PASSED Senate 45-0; Amended and PASSED House 92-0; back to Senate for consideration) OSMA SUPPORTS

SB 614 (Daniels/Lepak) – Mandates facilities providing medication abortions must provide signage claiming that such procedures can be reversed in certain circumstances. Evidence surrounding the medical abortion “reversal” treatment information does not meet clinical standards and should not be mandated upon the medical community. (PASSED Senate 39-8; PASSED House 74-24; Signed by GovernorOSMA OPPOSED

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. MDs and DOs must remain at the helm of that structure.

The OSMA lobby team remains diligent in our efforts to defeat “scope of practice” measures attempting to remove physicians from leading the quality health care team Oklahoman’s deserve. We’ve defeated or stalled several “scope” measures during this year’s session including: SB 801*/SB 890* (CRNA); SB 839 (RN); HB 2194 (Psychologists defined as “physicians”); HB 2041 (Radiologist Technicians); SB 497 (Pharmacists considered equal with physicians).

Another measure this week, SB 100 (David, Newton), allowing optometrists to place their operations within retail outlets (such as Wal-Mart), was amended to include requirements placed upon MD or DO ophthalmologists. The OSMA, OOA and Oklahoma Academy of Ophthalmology joined forces and were successful in lobbying against the inclusion of this Scope of Practice language.

*The OSMA leadership has met with the CRNA leadership who confirmed they will not further pursue independent practice legislation this session. In an attempt to formulate a resolution, OSMA is committed to meet after session with all interested parties affected by this issue.