Weekly Legislative Update: May 17, 2019

RECORD BREAKING BUDGET AGREEMENT…PROVIDER RATES TO INCREASE! Revenue raising measures passed last session combined with general revenue increases due to economic growth have paved the way for the legislature and the Governor to negotiate the largest budget in state history…$8.2 billion. The budget is currently going through the legislative process.

Highlights include: $200M going into the state’s Rainy-Day Fund (Oklahoma’s saving account); teacher pay raise; funding for the “Reading Sufficiency Act”; state employee pay raise; funding the Department of Transportation’s eight-year plan; and, increased funding for “Smart on Crime” and “Women in Recovery” programs.

The following highlights those appropriations which directly affect healthcare:
  • $62.8 million for Graduate Medical Education (GME) funding
  • $105 million to increase provider rates for physicians, hospitals and nursing homes (this represents a 5% provider rate increase across the board)
  • $29 million saved to a new preservation fund to maintain Medicaid provider rates when the Federal Medical Assistance Percentages (FMAP) 3-year rolling average results in a rate decline
  • $10 million to decrease the Developmental Disability Services wait list and increase provider rates
  • $4.6 million to increase immunizations and staff county health departments throughout the state

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. (PASSED Senate 45-0; PASSED House 88-0; SENT TO GOVERNOROSMA 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; SIGNED BY GOVERNOROSMA 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 GOVERNOROSMA 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; SIGNED BY 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; PASSED House 85-0; on Senate Agenda) OSMA SUPPORTS Extension of Sunset Clause

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 Committee) SB 86 (Jech/McEntire) is a similar measure (PASSED Senate 45-0; Amended and PASSED House 92-0; Sent to Conference Committee) 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).

*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.