Weekly Legislative Update: March 1, 2019

Because of your involvement, OSMA negotiated SB 839 (Nurse Practitioner Independent Practice) whereby the measure was pulled from the Senate Health & Human Services Committee. This is a tremendous victory in one battle, but the war continues! We are certain the same or similar language will be amended into another piece of legislation and OSMA will be prepared. THANK YOU for supporting OSMA efforts to protect your practice!

The State Legislature has met the first deadline of this year’s Session: measures to be heard in Committees of the House of Origin. The following measures represent some of the issues in which OSMA is involved. Measures must now be heard by their respective House by March 14.

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. Several “scope of practice” measures have been filed, including the following:

SB 801 (Smalley/McEntire) – Requires that nurse anesthetists administer anesthesia and certain controlled substances in collaboration with, not under the supervision of, a physician. (DO PASS: Senate Health & Human Services Committee; To Senate Floor) OSMA OPPOSES

SB 839 (Smalley/McEntire) – A “Waiver of Supervision” for APRN may be authorized by the Board of Nursing under certain conditions: Current CNP with 7 years’ experience may request waiver of supervision; Does not allow for Schedule II prescriptive authority. (Pulled from 2/25 Agenda – Senate Health & Human Services) OSMA OPPOSES (Although SB 839 was not heard in committee, OSMA anticipates this or similar language to resurface in another measure)

SB 955 (Scott) – Expands the “scope of practice” for radiologist technicians and assistants by allowing for independent licenses and certifications. (Failed in Senate Health & Human Services Committee) OSMA OPPOSED

HB 2041 (Moore) – Committee Substitute added the same language as SB 955 above. (DO PASS: House Public Health Committee; to House Floor) OSMA OPPOSED

HB 2194 (Randleman) – Expands the definition of “physician” to include psychologist, therapist or counselor. (DO PASS: House Business & Commerce; To House Floor) OSMA OPPOSES

Pill Limits/Pain Management

SB 848 (Rader) – 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. This measure 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. (DO PASS: Senate Health & Human Services; To Senate Floor) 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. (DO PASS: Senate Appropriations; To Senate Floor) 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; To Senate) OSMA SUPPORTS

Vaccinations: There are several measures dealing with vaccinations. Proper immunization is in the best interest of Oklahoma’s public health.

SB 924 (McCortney/Bush) – Requires immunization education to be provided at assisted living centers. (DO PASS: Senate Health & Human Services; To Senate Floor) OSMA SUPPORTS

SB 925 (McCortney) – Requires school districts to report to the Oklahoma Department of Health the number and type of exemptions from vaccinations (DO PASS: Senate Health & Human Services Committee; To Senate Floor) OSMA SUPPORTS

HB 2420 (Moore) – Prohibits managed care entities form mandating certain immunization protocols or limiting an enrollee’s benefit for immunizations or vaccinations and from assessing penalties on physicians who refuse to issue vaccinations. (DO PASS: House Insurance Committee; To House Floor) 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.

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 (DO PASS: House Health Services & Long-Term Care Committee; To House Floor/SB 509 DO PASS: Senate Health and Human Services; To Senate Floor) OSMA SUPPORTS

SB 508 (Newhouse/McEntire) – Requires insurance companies that have received an appeal of a denied claim by a healthcare provider to provide written details of the reason for claim denial. (DO PASS: Sen. Retirement & Insurance with Title Stricken; To Senate 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. Governor Stitt as well as Legislative leadership have indicated an interest in pursuing federal dollars to help support Oklahoma’s SoonerCare program.

SB 605 (McCortney) – Expand InsureOklahoma! program to accept federal funding for Medicaid Services. (To Senate Appropriations) OSMA SUPPORTS

HB 2288 (Wright/Stanislawski) – “Oklahoma Workplace Clean Air Act” prohibits smoking in all enclosed public places, private clubs and indoor & outdoor recreational areas. (DO PASS: House Public Health; To House Floor) OSMA SUPPORTS

Graduate Medical Education (GME) Funding: Oklahoma is no longer receiving federal matching dollars to help fund GME Residency program funding. The State of Oklahoma is now responsible to appropriate those dollars which will help develop more Oklahoma physicians. OSMA SUPPORTS

An afternoon at the Capitol
Legislative Reception at OSMA