Weekly Legislative Update: May 15, 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.

SESSION UPDATE

SENATE/HOUSE PROVISIONALLY ADJOURN SINE DIE!


The House and Senate provisionally adjourned Sine Die this week pursuant to respective Resolutions allowing them to return to the Capitol to conduct business if needed before the Constitutionally required Sine Die date of the last Friday in May (May 29, 2020). This week continued legislative work under the same modified “suspended” rules previously developed. Measures can be placed directly to calendar (available to be heard on the Floor Agenda without receiving a committee hearing). In addition, amendments could be immediately offered to legislation without requiring 24 hours for review.

Although the capitol was officially open to the public, lobbies, hallways, offices, and access to legislators was highly restricted. This personal “isolation” from policy makers presented a significant challenge when attempting to influence health care policy under consideration. As always, the OSMA Lobby Team remained steadfastly engaged in the legislative process though offsite and virtual means. However, contact lobbyist Jim Dunlap braved social distancing and represented OSMA onsite at the Capitol.

Appointments

Gary Cox, appointed by Governor Kevin Stitt to be Oklahoma Commissioner of Health, was not considered in the Senate Health & Human Services Committee. Senator Greg McCortney, Committee Chair, stated there were not enough votes to confirm his Executive Nomination. Current statutes require the Commissioner of Health to be an MD or DO. Although the OSDH has been operating the past two and a half years with non-physician leadership under Commissioner Bates and Cox, this requirement placed a significant impediment to Mr. Cox’s nomination.

Kevin Corbett
was confirmed as Oklahoma Health Care Authority (OHCA) Chief Executive Officer in the full Senate by a vote of 46-0.

Scope of Practice

SB 1915 (David/Pfeiffer) – Legislative leaders from both the House and Senate insisted a PA measure be heard this session. This being the case, negotiations on SB 1915 continued throughout the week. The final version specifically states that PAs cannot “provide health care services independent of physician supervision”. The language allows PAs to be considered “primary care providers” allowing them to direct bill for service provided under their “delegating physician” agreement. The measure also states, “at all times a physician assistant shall be considered an agent of the delegating physician”. The language was reviewed by the Oklahoma Patients’ Coalition (all Physician specialty societies) before being considered in the legislature. OSMA, OOA and OAFP all became neutral on the bill. (Passed House 81-16; Passed Senate 43-1; To Governor) OSMA NEUTRAL

SB 801 (Rosino/McEntire) Signed by Governor – Requires that nurse anesthetists administer anesthesia and certain controlled substances in collaboration with, not under the supervision of, a physician. The negotiated definition of the term “collaboration” was agreed upon by the Oklahoma Society of Anesthesiologists and the Oklahoma Association of Nurse Anesthetists. (Passed Senate 44-0; Passed House 100-0; Signed by Governor) OSMA NEUTRAL

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

SB 1823 (Stanley/Roe) – Provides for oversight and licensing of midwifery and establishes their scope of practice. (Passed Senate 41-5; Passed House 85-12; to Governor) OSMA SUPPORTS

HB 3862 (Martinez/Rosino) – Allows optometrists to dispense certain drugs and drug samples. (Passed House; Passed Senate 31-12; to Governor; NOTE: OSMA joined OOA; OHA; OAFP; Dental Assn.; Pharmacy Assn.; Podiatric Assn; Psychiatric Physicians Assn; Ophthalmology Assn; Pediatric Assn; OB/GYN Academy; and, Society of Anesthesiologists requesting the Governor VETO this measure) OSMA OPPOSES

Liability Limits

SB 300 (Daniels/O’Donnell) COVID-19 Public Health Emergency Limited Liability Act. This measure places immunity from civil liability for a physician, other health care provider or health care facility resulting from an act or omission occurring when arranging or providing services for the treatment of a person with a suspected or confirmed diagnosis of COVID-19. Limits will not be in place if the act or omission was the result of gross negligence or willful or wanton misconduct. The provisions go into effect immediately upon being signed into law and will be in effect until October 31, 2020, or until such time as the Governor affirmatively concludes the health emergency declarations, whichever is later. (Passed House 95-2; Passed Senate 38-9; Governor signed into law) OSMA SUPPORTS

SB 1947 (Treat/McCall) – Product Liability: Provides that any entity that designs, manufactures, distributes, or donates disinfecting and cleaning supplies or personal protective equipment (PPE) in response to the COVID-19 pandemic that does not make such products in the ordinary course of business shall not be liable in a civil action alleging personal injury, death or property damage caused by or resulting from the product’s manufacturing or design, or a failure to provide proper instructions or sufficient warnings. (Passed Senate 33-11; Passed House 82-15; to Governor) OSMA NEUTRAL

SB 1946 (Treat/McCall) – Civil Liability: Provides that an Oklahoma individual, business or corporation shall not be liable in a civil action claiming an injury from exposure or potential exposure to COVID-19 if that individual, business or corporation was in compliance or consistent with federal or state regulations, a Presidential or Gubernatorial Executive Order, or guidance applicable at the time of the alleged exposure. (Passed Senate 34-11; Passed House 76-20; to Governor) OSMA NEUTRAL

Budget

FY2021 Budget
– The legislature passed the FY2021 budget SB 1922 (Thompson/Wallace) which went to Governor’s desk last week. Under the budget agreement, most of the $1.4 billion in less revenue compared to the current budget is filled by using reserve funds, cutting one-time spending, temporarily redirecting non-appropriated money into the budget, and agency appropriation reductions of 4% or less in most cases. The Oklahoma Health Care Authority budget is not cut in this agreement. (Passed Senate 36-11; Passed House 77-23; VETOED by the Governor; Legislature veto override: Passed Senate 35-11; Passed House 79-20; Budget becomes law over the objections of the Governor). OSMA NEUTRAL

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. (Passed Senate; to House Calendar, not heard) OSMA NEUTRAL

SB 1046 (Thompson/Wallace) – Relates to Medicaid and the Supplemental Hospital Offset Payment Program (SHOPP) by defining newly eligible Medicaid populations, establishes parameters for hardship considerations and prospectively allows for Medicaid managed care. (Passed Senate 29-17; Passed House 54-38; to Governor) OSMA OPPOSES

SJR 27 (David/Wallace) – Provides for a State Question to redirect the majority of future Master Settlement Agreement payments away from the TSET endowment. SJR 27 would create a state question to redirect 75% of future lawsuit settlement payments away from the voter-created TSET endowment. The Legislature would receive that 75% of each payment for use to help fund Oklahoma’s Medicaid program. (Passed House 81-17; Passed Senate 34-11; to Secretary of State) OSMA OPPOSED

SB 1529 (David/Wallace) – Redirects TSET dollars for the purposes of providing funding to Medicaid Expansion. (Passed House 75-14; Passed Senate 33-12; to Governor) OSMA OPPOSED

Licensure

SB 1892 (Rader/Mize) – Allows a tax credit for a medical school “preceptor” (uncompensated trainer) for allopathic; osteopathic; APRN and PA training programs. (Passed Senate 40-2; to House Calendar; not heard) 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. (Senate 44-2; Passed House 84-1; to Governor) 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 Calendar; not heard) 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 46-0; to House Calendar; not heard) 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 44-1; Passed House 100-0; to Governor) 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 93-0; to Senate Calendar; not heard) 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 28-19; Passed House 79-20; To Governor) 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; not heard) 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; not heard) 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 43-4; Passed House 74-26; to Governor) 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; not heard) OSMA SUPPORTS

Immunizations

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. (HJR 1040 by Gann was a resolution to reject these rules and passed the House 69-29; Senate did not reject clearing the way for them to become effective) OSMA SUPPORTS THESE RULES

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. (Passed House with Title off 61-28; to Senate calendar; not heard) OSMA OPPOSES

SB 1870 (Murdock/McEntire) – Dissolves Commissioner of Mental Health & Substance Abuse Services. (Passed Senate with Title off 31-14; to House Calendar; not heard) OSMA OPPOSES

SB 1863 (Murdock/McEntire) – Removes professional qualifications of the Commissioner of Health. (Passed Senate with Title off 31-13; to House Calendar; not heard) OSMA OPPOSES

SB 1276 (Thompson/Wallace) – Increases the percentage of the certain subsidies managed by the Physician Manpower Training Commission (PMTC) that are used in the training of primary care health professionals from 50% to 75% and adjusts Board membership. (Passed Senate 44-1; Passed House 98-0; to Governor) OSMA SUPPORTS

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 46-1; to House Calendar, not heard) OSMA SUPPORTS

SB 1278 (Rader/Echols) – Exempts hospice program practitioners from pill limit restrictions. (Passed Senate 45-0; to House Calendar; not heard) OSMA SUPPORTS

Legal Reform

SJR 40 (Daniels/Sanders) – Creates a State Question reinstituting a cap on non-economic damages. (Passed Senate 26-16; to House Calendar; not heard) 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 37-9; Passed House 76-18; to Governor) 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 44-1; Passed House 98-0; to Governor) 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 89-0 with Title on; to Senate Health & Human Services; not heard) OSMA SUPPORTS

Telemedicine

OSMA is promoting the use of telemedicine through public service announcements (PSA’s) which are currently being 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 for 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.

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.

Emergency Declaration Extended

Governor Stitt extended the current declaration of a state health emergency from May 1, 2020 to May 30, 2020 by amending his Executive Order 2020-12.

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 are able to be open. 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, 2020. The Oklahoma Health Care Authority has submitted to the federal government the state’s Healthy Adult Opportunity waiver application. If approved by CMS, the waiver could allow state health officials to implement Governor Stitt’s SoonerCare 2.0 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

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.

Elections – 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. Next week, 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