Weekly Legislative Update: March 27, 2023
MEDICINE DAY WAS SPECTACULAR! WHITE COATS REPRESENTING MEMBERS, RESIDENTS AND MEDICAL STUDENTS FROM ALL OVER THE STATE FILLED THE CAPITOL AND DID A REMARKABLE JOB REPRESENTING THE “HOUSE OF MEDICINE”! SPONSORS INCLUDED OSMA, PLICO, FAMILY PHYSICIANS, OB/GYNS, OPHTHALMOLOGISTS, PSYCHIATRIST PHYSICIANS, PODIATRISTS, PEDIATRIC PHYSICIANS AND ANESTHESIOLOGISTS
Thursday, March 23 was the deadline for measures to pass the Floor of their respective chambers. Bills not considered on the Floor by this deadline have become dormant.
Apprehensions over implementing a statewide Health Information Exchange (HIE) took center stage as a priority issue for Medicine Day. Legislative leaders have stated there WILL be a statewide HIE, the question is “What will it look like?”. There are significant concerns over patient record confidentiality and physician participation expense. OSMA has developed this FAQ document summarizing the history and status Oklahoma’s effort to implement a HIE.
OHCA rules allow physicians to apply for an exemption from this mandate based on “type of health care provider, financial hardship, size, or technological capability of a health care provider or organization.”
To apply for an exemption, visit https://www.surveymonkey.com/r/9MXJ5MH.
Using state funds to reimburse physicians for costs associated with the HIE has been proposed but such a plan would consist of red tape and bureaucracy. The consistent message represented by OSMA was that costs associated by this unfunded mandate should be directly borne by the state, not by physicians. OSMA and other physician lead organizations continue to push for a delay in HIE implementation until these questions and concerns can be answered.
This week, as Medicine Day attendees walked the halls of the Capitol, OSMA was able to defeat SB303 (Daniels/Lepak) which would have provided the administration absolute autonomy when appointing and dismissing members of the Oklahoma Board of Medical Licensure & Supervision. OSMA currently provides a vetted lists of potential Board candidate to be considered by the Governor. This would have effectively removed OSMA from the appointment process which assures such nominations are from qualified nominees rather than political assignments.
OSMA maintains a strong voice for the physician profession, but politics continues to affect the relationship with your patients. YOUR personal voice is the strongest, but you must be involved!
WHEN RECEIVED, PLEASE RESPOND TO ALL OSMA ACTION CALLS! OUR AUTOMATED VOTER VOICE SYSTEM CONTACTS YOUR LEGISLATORS AND SHARES THE POSITION OF THE HOUSE OF MEDICINE. If you would like to confirm who your legislators are, please utilize this link: Find My Legislator
Please consider serving as DOCTOR OF THE DAY which provides an opportunity for you to be recognized on the House and Senate Floor and provide professional services if needed. Please contact Matt Robison.
LEGISLATIVE ISSUES IMPORTANT TO OSMA
SCOPE OF PRACTICE
HB1709 (Marti/Garvin) – Permits Advance Practice Registered Nurses to serve as primary care providers for
up to 2,500 SoonerCare recipients, this number subject to change at the discretion of the CEO of the Health
Care Authority. (Passed House; to Senate HHS Committee) OSMA OPPOSES
SB458 (Stanley/McEntire) – Allows certain qualified and certified nurse practitioners, clinical nurse
specialists, or certified nurse-midwives to apply to the Board of Nursing for Independent Prescribing
Authority. (Passed Senate Floor with Title Off**, to House Committee) OSMA OPPOSES (OSMA, along with
OOA, OAFP, and OSA met face-to-face with the bill author, the APRNs and Midwives three times to
discuss the measure. Discussions remain at an impasse, and we anticipate the Bill Title remained OFF
which allows further negotiation.)
SB931 (Garvin/Marti) – Broadens the definition of practice of pharmacy to include testing, certain drug,
hormonal, and nicotine replacement therapies, as well as treatment for minor, nonchronic health
conditions – OSMA negotiating language: (Passed Senate; to House Committee) OPPOSES LANGUAGE RE:
NONCHRONIC CONDITIONS; OSMA SUPPORTS GREATER AVAILABILITY OF ORAL CONTRACEPTIVES
GENERAL GOVERNMENT
HB1688 (McEntire/Haste) – Creates the Health Care Transparency Initiative Act which provides for
standards and guidelines related to the management of the state health information exchange under the
Health Care Authority (Passed House, to Senate Committee) OSMA IN NEGOTIATIONS
HB1890 (Schreiber/Bullard) – Prohibits health care providers who are out of compliance with the Health
Care Prices Act to pursue collection activities on any unpaid medical debt and allows patients to file related
lawsuits. (Passed House Public Health; not heard on House Floor - DORMANT) OSMA SUPPORTS
HB2152 (Roe/Dossett) – Adjusts the membership of the Maternal Mortality Review Committee to remove
a home visiting program director and directs birthing centers report certain information related to maternal
deaths. (Passed House; to Senate HHS Committee) OSMA SUPPORTS
HB2351 (Dempsey/Hicks) – Directs the creation of a discount program to allow participants to purchase
insulin at a discounted, post-rebate rate. (Passed House Floor with Title Off**; to Senate Committee) OSMA
SUPPORTS
SB 303 (Daniels) – Adjusts the structure and appointment process for the Board of Medical Licensure and
Supervision to grant the Governor broad authority when choosing appointees and allows members to be
removed and replaced without cause. There are several measures revising the appointment process for
various health related licensure Board appointments. (Passed Senate HHS with Title Off**; not heard on
Senate Floor – DORMANT) OSMA OPPOSES
SB597 (Newhouse/Hasenbeck) – Allows physician members of the Board of Medical Licensure to have
obtained training from foreign medical schools and retired physicians to serve, confidentiality of
disciplinary actions, adjusts other related qualifications. (Passed Senate; to House Committee) OSMA
SUPPORTS
INSURANCE
HB1398 (Lepak/Jett) – Classifies certain insurer actions to either deter enrollees, or unjustly deny claims from emergency medical care as unfair methods of competition or deceptive acts of practice. (Passed House; to Senate Committee) OSMA SUPPORTS
HB1712 (Marti/Garvin) – Prohibits health insurers from refusing coverage for medical equipment prescribed to individuals by healthcare providers and requires equal reimbursement for both in and out-of-network suppliers under certain conditions. (Passed House; to Senate Committee) OSMA SUPPORTS
HB1843 (Kerbs/McCortney) – Places the responsibility for certain oversight of pharmacy benefit managers with the Attorney General rather than the Insurance Dept. (Passed House; to Senate Committee) OSMA SUPPORTS
HB1963 (Newton/Jech) – Requires health benefit plans from certain insurers provide coverage of health care services provided through telemedicine when referred to out of state professionals by an in-state physician or practitioner. (Passed House; to Senate Retirement & Insurance) OSMA SUPPORTS IF AMENDED TO ASSURE ALL PHYSICIANS PRACTICING TELEMEDICINE IN OKLAHOMA HAVE A STATE MEDICAL LICENSE.
SB143 (Hicks) – Requires high deductible health insurance plans to offer insureds the ability to set aside funds on a tax-free basis to pay for out-of-pocket diabetes expenses. (Passed Senate Retirement & Insurance; Passed Senate Finance; not heard on Senate Floor – DORMANT) OSMA SUPPORTS
SB254 (Garvin/Boatman) – Requires insurers to charge no more for out-of-network care than they would for in-network care in cases where the insured is unable to obtain covered services in a timely manner. (Passed Senate; to House Committee) OSMA SUPPORTS
SB442 (Montgomery/Sneed) – Requires health benefit plans to make available a directory of providers within their network plans. (Passed Senate; to House Committee) OSMA SUPPORTS
SB513 (Rosino/Miller) – Requires insurers, including the state's Medicaid program, to cover biomarker testing in certain instances. (Passed Senate; to House Committee) OSMA SUPPORTS
LEGAL REFORM
HB2154 (Roe/K. Thompson) – Extends certain protections against assault and battery against health care professionals to all health care facility personnel and directs health providers to share related data with the Dept. of Health. (Passed House; to Senate Committee) OSMA SUPPORTS
SB707 (Rosino/Roe) – Requires medical examiners declining to conduct an autopsy of a deceased person to notify the person entitled to custody of the body in writing. (Passed Senate, to House Committee) OSMA SUPPORTS
MEDICAID
HB1650 (McEntire/Haste) – Provides that anesthesia will continue to be reimbursed equal to or greater than the HCA's current fee schedule and allows providers to enter into value-added based payment arrangements for Medicaid enrollees. (Passed House; to Senate Committee) OSMA SUPPORTS
HB1657 (McEntire) – Requires the Health Care Authority to streamline the process for Medicaid provider enrollment and credentialing for any fee-for-service and managed care delivery systems. (Passed House; to Senate Committee) OSMA SUPPORTS
SB563 (Haste/McEntire) – Includes that anesthesia is to continue to be reimbursed equal to or greater than the established Fee Schedule, with value-based payment arrangements possible for services furnished to Medicaid members. (Passed Senate; to House Committee) OSMA SUPPORTS
MENTAL HEALTH
HB1035 (Rosecrants/Pemberton) – Provides exemptions for school absence requirements to students missing class for mental health assessments and therapy sessions. (Passed House with Title Off**; to Senate Committee) OSMA SUPPORTS
SB444 (Montgomery/Miller) – Requires health benefit plans that provide mental health or substance abuse disorder benefits to provide reimbursement for benefits that are delivered through certain collaborative care models. (Passed Senate; to House Committee) OSMA SUPPORTS
SB844 (R. Thompson/Miller) – Places supervisory authority over the County Community Safety Investment Fund within LOFT and permits counties to submit requests for money from the fund to support certain programs and projects related to mental health and substance abuse. (Passed Senate; to House Committee) OSMA SUPPORTS
PhRMA/PAIN MANAGEMENT/OPIOIDS
HB1987 (Dollens/Rader) – Clarifies that drug testing strips for the purposes of detecting fentanyl or related compounds are not considered drug paraphernalia. (Passed House; to Senate Committee) OSMA SUPPORTS
HB2424 (May/Stephens) – Allows pharmacies to dispense and sell a wider variety of opioid antagonists to counteract overdoses. (Passed House Floor; to Senate Committee) OSMA SUPPORTS
SB386 (Rader/Echols) – Provides a tax credit for the purchase of naloxone to be used in retail and service establishments and adds certain legal Good Samaritan protections to the use of naloxone in life saving efforts. (Passed Senate Finance with Title Off**; Passed Senate Appropriations; not heard on Senate Floor – DORMANT) OSMA SUPPORTS
SB711 (Rosino/Boatman) – Directs the Dept. of Mental Health to provide hospitals with opioid antagonists to be given to persons presenting to emergency departments with the symptoms of an opioid overdose or related disorder upon discharge from the hospital. (Passed Senate; to House Committee) OSMA SUPPORTS
WOMEN & CHILDREN HEALTH
HB2014 (Ranson) – Provides Medicaid coverage for women up to twelve months after giving birth, adjusts the qualifying poverty rate and creates certain exemptions. (Passed House; to Senate Committee) OSMA SUPPORTS
HB2177 (K. West/Bullard) – Prohibits any gender affirming care by health care professionals on anyone under 18 years of age, prohibits state money to be granted to facilities that perform such services, restricts private insurance reimbursement for such services. (Passed House; to Senate Rules and Senate Appropriations) OSMA OPPOSES*
SB292 (Stanley/Roe) – Requires testing for syphilis on women at various stages of pregnancy, as well as if there is a stillbirth or spontaneous miscarriage, such required testing to be covered by certain health benefit plans. (Passed Senate; to House Committee) OSMA SUPPORTS
SB368 (Garvin/Hasenbeck) – Establishes that laws pertaining to abortion will not be construed to prohibit or otherwise affect the provision of contraceptive care by authorized healthcare providers (Passed Senate; to House Committee) OSMA SUPPORTS
SB382 (Garvin/Roe) – Provides for a sales tax exemption on feminine hygiene products to certain organizations which provide and distribute such products and appropriates $1MIL to a Feminine Hygiene Program for grants to local partners for women living in period poverty. (Passed Senate; to House Committee) OSMA SUPPORTS
HB834 (Daniels) – Provides certain exemption to the criminalization of abortion providers in cases of rape, incest, or the life of the mother is in danger (Not heard on Senate Floor – DORMANT) OSMA SUPPORTS*
*OSMA understands the moral implications of issues such as abortion and gender related medical treatment; however, OSMA has a long-standing policy to oppose measures which interfere with the patient/physician relationship.
**“Title Off” means the statutory reference is removed from the legislation to assure further negotiation.
Supreme Court Ruling on 2022 Abortion Law
The Oklahoma Supreme Court Ruled Tuesday that the state constitution grants women the inherent right to terminate a pregnancy to preserve their life. The court said the ruling was based on provisions of the state constitution that address due process rights and inherent rights.
The Court’s decision nullified SB612 (Dahm/Olsen) passed last year, which criminalized abortion except when the mother was in a medical emergency. Tuesday's ruling stated the 2022 Law restricts "the performance of an abortion to only a pregnant woman who is 'in a medical emergency,' which includes that her life 'is endangered.'"
The majority opinion stated: "We read this section of law to require a woman to be in actual and present danger in order for her to obtain a medically necessary abortion."
“We know of no other law that requires one to wait until there is an actual medical emergency in order to receive treatment when the harmful condition is known or probable to occur in the future,” the ruling said.