Weekly Legislative Update: May 1, 2020


Thank you to those OSMA Members who continue to prove their dedication to promoting and supporting 
Oklahoma’s public health while we all face the COVID-19 pandemic. You are to be applauded!

Please go to the OSMA website and visit our COVID-19 Resource Page for updated information.

Budget & Priority Legislation

As mentioned last week, the FY2020 state budget has been finalized. The state legislature is anticipated to go back into session the week of May 4th to deliberate the FY2021 budget and potentially other measures deemed pressing. In order to reiterate House of Medicine priorities for those issues under consideration this session, OSMA this week submitted a Memorandum to both majority and minority legislative leaders.

Liability Limits

OSMA continues to work with legislative leaders and other health-related organizations to establish liability limits for healthcare providers and facilities during our current pandemic crisis. Working with the Health Preparedness Coalition created by Senator Greg McCortney (R-SD13), Senator Paul Rosino (R-SD45) and Senator John Haste (R-SD36), OSMA and Oklahoma Hospital Association have taken lead roles in generating legal reform language. We have requested this to be a priority issue when the legislature reconvenes. In addition, OSMA continues to spearhead the effort supporting SJR 40 (Daniels/Sanders) to re-establish caps on non-economic damages which had been in effect for eight years. The Oklahoma Supreme Court last year overturned the law on the basis of treating those who are dead differently than those who are alive.

Telemedicine

In response to efforts by organized medicine, the Centers for Medicare & Medicaid Services (CMS) plans to increase payments for audio-only telephone visits between Medicare beneficiaries and their physicians to match payments for similar office and outpatient visits. This will increase payments for these services from a range of about $14-$41 to about $46-$110, and the payments are retroactive to March 1, 2020. This is a major victory for medicine that will enable physicians to care for their patients, especially their elderly patients with chronic conditions who may not have access to audio-visual technology or high-speed internet.

OSMA is also promoting the use of telemedicine through public service announcements (PSA’s) which are to be aired on Cox cable television stations. Many thanks to George Monks, MD (OSMA President); Larry Bookman,

MD (OSMA Immediate Past President); Kim Weaver, MD (OSMA Legislative Council Member); and, Karen Gold, MD (Tulsa County Medical Society President) for donating their time in this effort. A SPECIAL THANKS to Cox Communications for supporting OSMA efforts to promote public health for all Oklahomans!

In addition, OSMA recently provided a CME on updated rules and regulations regarding telemedicine. To watch the CME, click here.

SoonerCare Update to Well-Child Checks Via Telehealth*

OHCA will not require the pediatric behavioral health screen for each telemedicine well visit for children ages five and older. The screening requirement is annual unless something with the child has changed.

  • OHCA will continue to pay for immunization administration when delivered outside of a well-child visit. The vaccine code must be on the claim.
  • OHCA will not require an in-person follow-up well-child visit after a telemed visit. The provider will decide when they need to see the child again.
  • Providers do not need new consent for telemed well-visits if a patient has already signed a consent form to be treated at that clinic. During the COVID-19 emergency declaration, OHCA considers a telemedicine visit to be the same as an in-person visit. The provider and family are allowed to determine if the telemedicine visit is the right service to provide.
  • OHCA’s open telehealth codes will remain open until the emergency declaration has expired. We understand this helps to decrease no-shows and improves access to care in rural locations, so continuation of telehealth after the emergency will be evaluated.

(* Provider Types/Specialties: 08, 09, 10, 13, 316, 318, 322, 344, 345, 349, 359)

New Supervision Emergency Rules in Effect

The State Board of Medical Licensure and Supervision recently approved Emergency Rules allowing physicians to supervise “any number” of PAs or APRNs during the Catastrophic Health Emergency declaration. These rules are currently in effect.

Elective Surgery

Elective surgeries resumed in Oklahoma on April 24, Governor Stitt offered an Amended COVID-19 Executive Order and Executive Memorandum updating the parameters on elective surgeries or procedures. The Oklahoma State Department of Health (OSDH) also issued guidelines for elective surgery centers and hospitals.

Testing & Treatment

Oklahoma Commissioner of Health Gary Cox said state officials have a goal to provide COVID-19 tests to 90,000 Oklahomans in the next 30 days. The OSDH also plans to test all 42,000 Long-Term Care facility residents and employees statewide by the end of the month.

Gilead Sciences, Inc. antiviral drug has been cleared by U.S. regulators for emergency use in COVID-19 patients. The drug, remdesivir, has shown positive results in helping hospitalized patients recover more quickly. The Food and Drug Administration (FDA) cleared the drug under an emergency use authorization, a step by which the agency can bring products to market without full data on their safety and efficacy.

Contact Tracing

Oklahoma currently has 150 people currently trained in conducting contact tracing designed to trace and monitor contacts of COVID-19 infected people and support the quarantine of those contacts. There are also 50 national guard members, soon to become 100, participating in this tracing as well. The State plans to use 500 University of Oklahoma medical residents and medical students to participate. Another 500 independent contractors will be available based on need.

Emergency Declaration Extended

Governor Stitt extended the current declaration of a state health emergency by amending his Executive Order 2020-12 on May 1. The emergency declaration is now extended through May 30, 2020.

Governor Stitt’s “Open Up and Recover Safely Plan”

Governor Stitt’s Open Up and Recover Safely Plan, designed as a format to “reopen” Oklahoma’s economy, has reached the second stage of “Phase 1”. While maintaining social distancing and sanitation protocols, restaurant dining rooms, movie theaters, gyms and churches will be able to reopen. However, local municipal ordinances such as those established by Tulsa, Oklahoma City, Norman, and other municipalities shall not be pre-empted by the Executive Order.

As the state works to reopen businesses, several of Oklahoma’s physician groups have joined forces in communicating coronavirus guidelines to employers.

Medicaid Expansion

Governor Kevin Stitt has set June 30, 2020, the same as Oklahoma’s Primary Election, as the date on which Oklahomans will vote on SQ 802. If passed, this State Question would initiate full Medicaid Expansion in Oklahoma as presented in the federal Affordable Care Act (ACA). OSMA supports the acceptance of additional federal dollars redirected back to the state which are dedicated to expanding access to Medicaid health care services to Oklahomans in need.

The Stitt administration has moved forward with plans to charge Medicaid premiums and impose work requirements on Medicaid recipients who could be newly eligible for coverage as soon as July 1. The Oklahoma Health Care Authority has submitted to the federal government the state’s Healthy Adult Opportunitwaiver application. If approved by the Centers for Medicare and Medicaid Services, the waiver could allow state health officials to implement Gov. Kevin Stitt’s vision for Medicaid expansion on July 1, 2021.

State Department of Health

The Oklahoma State Department of Health COVID-19 page provides daily situation updates and incorporates a link to an Executive Order Reports page posting all Governor Stitt’s Executive Orders. This page also provides a daily listing of the PPE Strategic National Stockpile Inventory and links to daily COVID-19 Reports containing hospital status overview; detailed breakdown of COVID-19 cases; individual lab statistics collected from all reporting testing lab facilities; and other reporting information.

Help Fight Unemployment Compensation Fraud

We know many employers—including physician practices and OSMA—have been contacted by the Oklahoma Employment Security Commission (OESC) with the names of people fraudulently claiming they have previously worked for the employer and are applying for unemployment benefits. Additionally, other individuals whose identities had been compromised and whose personal information has been used to apply for unemployment benefits. This type of fraud is apparently widespread, and the Attorney General has created a new website on how to address such claims. For more information or to report unemployment fraud, visit http://www.oag.ok.gov/coronavirus-fraud-resources.

SESSION UPDATE

Although the legislature is anticipated to return to the Capitol the week of May 4th, the House and Senate continue to work on the FY2021 budget remotely. Some Senate Bills have been assigned “direct to calendar” in the House while several House Bills have now received committee assignments in the Senate. None of these assignments assure action.

As a point of information, the only Constitutional requirement placed upon the legislature is passing a budget. They maintain the option of foregoing any policy reform, passing a budget and going home. The OSMA lobby team continues to be in contact with the legislative leadership and monitor the status of any potential policy issue under consideration.

The following represents the current status on many pieces of legislation OSMA is continuing to track.

Medicaid Expansion

SB 1219 (McCortney/McEntire) – In the exclusive case of Oklahoma expanding Medicaid, this measure allows the Oklahoma Health Care Authority (OHCA) to contract with commercial health insurers to create a health

insurance “exchange”. This measure is designed to: facilitate the purchase of commercial health plans for those meeting the Medicaid Expansion population; seek federal matching funds; seek financial support for administrative expenses; and allow premium tax credits when purchasing coverage. (Title off; Passed Senate; to House) OSMA NEUTRAL

SB 1529 (David/Wallace) – Redirects TSET dollars for the purposes of providing funding to Medicaid Expansion. (Title off; Passed Senate; to House) OSMA OPPOSED

Scope of Practice

SB 801 (Rosino/McEntire) – Requires that nurse anesthetists administer anesthesia and certain controlled substances in collaboration with, not under the supervision of, a physician. OSMA helped negotiate “collaboration” definition language agreed upon by the Oklahoma Society of Anesthesiologists and the Oklahoma Association of Nurse Anesthetists. (Passed Senate with Title on; To House Rules) OSMA NEUTRAL

SB 1915 (David/Pfeiffer) – Allows Physician Assistants (PAs) to practice under a collaborative agreement with a physician rather than being supervised and shall allow for direct payment for services provided. This measure allows PAs to be considered primary care providers. (Title off; Passed Senate; to House); Companion bill: HB 1735 (Pfeiffer/David) (Title off; Passed House; to Senate Health & Human Services) OSMA OPPOSES

HB 2194 (Randleman/Pemberton) – Expands the definition of “physician” to include psychologist, therapist or counselor (Passed House; to Senate from 2019 Session and remains available for consideration but not anticipated to be heard). OSMA OPPOSES

SB 1823 (Stanley/Roe) – Provides for oversight and licensing of midwifery and establishes their scope of practice. (Passed Senate with Title on; to House Calendar) OSMA SUPPORTS

HB 3862 (Martinez/Rosino) – Allows optometrists to dispense certain drugs and drug samples. (Passed House; to Senate Business, Commerce and Tourism; Senate A&B) OSMA OPPOSES

Licensure

SB 1892 (Rader/Mize) – Allows a tax credit for a medical school “preceptor” (uncompensated trainer) for allopathic; osteopathic; APRN and PA training programs. (Title off; Passed Senate; to House) OSMA SUPPORTS

SB 1525 (Pugh/Caldwell) – Allows Licensure Boards authority to conduct FBI background checks in order to comply with the state medical licensure compacts. (Passed Senate with Title on; to House Calendar); Companion Bill: HB 3877 (Caldwell/Pugh) (Passed House with Title on; to Senate Health & Human Services) OSMA SUPPORTS

HB 1182 (Olsen/Daniels) – Provides that performing an abortion, a legally allowable procedure, for reasons other than saving the life of the mother shall be grounds for license revocation. (Passed House with Title on; to Senate Health & Human Services) OSMA OPPOSES

Insurance Reform

SB 1556 (Newhouse/McEntire) – Requires insurance companies to address the specific details of a physician appeal in any clean claim re-denial (rather than issue a generic re-denial) and provide specific telephone contact information to facilitate a telephone conference for further discussion of the claim. (Passed Senate with Title on; to House) OSMA SUPPORTS

SB 1718 (Montgomery/Echols) – Provides for mental health insurance coverage parity by mirroring current federal law. This would better allow Oklahoma enforcement to require mental health care to be covered at the same level as physical health care on plans authorized by the state. (Passed Senate with Title on; to House) OSMA SUPPORTS

HB 3483 (McEntire/McCortney) Oklahoma Surprise Billing Protection Act: This measure provides standards and limits on surprise billings while creating a mediation process to best accommodate payment to out-of- network providers for patient services rendered during an in-network medical procedure. (Title off; Passed House; to Senate Retirement & Insurance). OSMA SUPPORTS

HB 3388 (Sneed/David) Oklahoma Out-of-Network Surprise Billing and Transparency Act: Provides parameters for determining payments for health care services provided by out-of-network providers through benchmarking as well as methods of mediation and arbitration. (Title off; Passed House; to Senate Retirement & Insurance) OSMA SUPPORTS

HB 3029 (Bush/Pugh) – Oklahoma Health Care Cost Transparency Act: Requires a health care facility/provider to publicly disclose the cost for the most utilized procedures if purchased on a cash basis regardless of insurance coverage. (Passed House with Title on; to Senate Health & Human Services) OSMA SUPPORTS

Public Health

SB 1423 (McCortney/Wallace) – Raises the age to purchase tobacco products from 18 to 21. This would mirror federal law and allow enforcement to be conducted at a state and local level. (Passed Senate with Title on; to House Calendar) OSMA SUPPORTS

HB 3384 (Wright/Stanislawski) – Creates the Oklahoma Workplace Clean Air Act by prohibiting smoking in most enclosed public places. (Title off; Passed House; to Senate Health & Human Services and Senate A&B) OSMA SUPPORTS

HB 3823 (McCall/Hall) – Provides tax credit for MD’s or DO’s NEWLY LICENSED within the past two (2) years and serving in certain rural areas of the state with their primary address in the same county. (Passed House with Title on; to Senate Finance and Senate A&B) OSMA SUPPORTS

SB 1290 (Weaver/Roe) Medical Care Provider Protection Act – Expands unlawful assault and battery on medical care providers to include non-emergency personnel. (Passed Senate with Title on; to House Calendar) OSMA SUPPORTS

HB 3028 (Bush/Montgomery) – Defines provisions for “harm-reduction services” designed to reduce the spread of infectious diseases related to intravenous drug use. (Title off; Passed House; to Senate Health & Human Services) OSMA SUPPORTS

Vaccinations: Proper immunization is in the best interest of Oklahoma’s public health. OSMA has spearheaded the creation of an Oklahoma Vaccination Coalition consisting of nearly 30 medical; professional; social; and tribal organizations which support new draft Oklahoma State Department of Health (OSDH) rules requiring personal and religious immunization exemptions be processed through the OSDH. OSMA SUPPORTS

General Government

HB 4064 (McCall/McCortney) – Consolidates the Department of Mental Health and Substance Abuse Services into the Health Care Authority, transferring related powers, duties, responsibilities, and authority. (Title off; Passed House; to Senate Health & Human Services and Senate A&B) OSMA OPPOSES

SB 1870 (Murdock/McEntire) – Dissolves Commissioner of Mental Health & Substance Abuse Services. (Title off; Passed Senate; to House) OSMA OPPOSES

SB 1863 (Murdock/McEntire) – Removes professional qualifications of the Commissioner of Health. (Title off; Passed Senate; to House) OSMA OPPOSES

Opioids

SB 1277 (Rader/Echols) – Allows members of the Opioids Overdose Facility Review Board to have access to opioid overdose data and corrects scrivener’s error from the 2019 Opioids Reform legislation. (Passed Senate with Title on; to House Calendar) OSMA SUPPORTS

SB 1278 (Rader/Echols) – Exempts hospice program practitioners from pill limit restrictions. (Passed Senate with Title on; to House Calendar) OSMA SUPPORTS

Legal Reform

SJR 40 (Daniels/Sanders) – Creates a State Question reinstituting a cap on non-economic damages. (Passed Senate with Title on; to House) OSMA SUPPORTS

SB 1728 (Bullard/Gann) “Unborn Person Wrongful Death Act”: In cases of performing an abortion, this measure provides physician with liability if the pregnant woman is not properly screened or is coerced into having the procedure. (Passed Senate with Title on; to House Calendar) OSMA OPPOSES

Funding

SB 1276 (Thompson/Wallace) – Increases the percentage of funds available for physician/health care providers under the Physician Manpower Training Commission (PMTC) from 50% to 75%. Also revises the PMTC Board membership to three (3) MDs, three (3) DO’s and one (1) lay person. (Passed Senate with Title on; to House Calendar) OSMA SUPPORTS

HB 3392 (McEntire/McCortney) – Includes “general surgery” to the definition of a “primary care physician” for the purposes of the Physician Manpower Training Commission (PMTC) Loan Repayment Program. (Passed House with Title on; to Senate Health & Human Services) OSMA SUPPORTS

Candidate Filing*

More than 250 candidates filed for the state legislature: 64 in the Senate and 194 for the House. Two physicians have filed for office: Chris Emerson, MD (R) (OSMA Member) for SD 37, currently held by Sen. Allison Ikley-Freeman-D, and Aaron Means, Sr., DDS (R) for HD 34, currently held by Rep. Trish Ranson-D.

Thank you to all those who filed thereby showing their dedication to public service. After session has concluded, OMPAC will send a questionnaire to all state legislative candidates and will begin the evaluation process for determining support…STAY TUNED!

*ESPECIALLY in today’s health environment, the House of Medicine voice MUST be LOUD and CLEAR! Provide financial assistance and SUPPORT OMPAC TODAY!!!

Other Issues

Join OSMA Lobbyists Pat Hall, CAE and Jim Dunlap on their Majority Plus Facebook page to receive insight on Oklahoma politics by watching their Inside the Issues interviews with key state legislative leaders and policy makers.

OSMA encourages available physicians, residents and medical students to register with the Oklahoma Medical Reserve Corps. This statewide organization partners with county health departments to help provide health services in times of medical crisis. You can find more information and fill out an application at https://www.okmrc.org/.

REMAIN HEALTHY AND SAFE TELL PATIENTS TO WASH THEIR HANDS AND RETAIN SOCIAL DISTANCING