Weekly Legislative Update: May 1, 2023


VICTORY ON APRN SCOPE MEASURE (SB458)
HEALTH INFORMATION EXCHANGE BILL (HB1688) DORMANT

OSMA continues to be the major player when negotiating and affecting measures important to the physician profession. These negotiations remain a priority. Thursday, April 27 was the deadline for bills to be considered on the opposite chamber’s floor. Measures now go to the opposite chamber to either consider amendments or be assigned to a Conference Committee where language is drafted and, if considered, is non-debatable and non-amendable. The Legislature must adjourn by 5:00p on May 26, the last Friday in May. Currently:

  1. Just over 200 House Bills remain active (93 became dormant)
  2. Approximately 300 Senate Bills remain (85 became dormant)
  3. The Governor has 106 bills on his desk awaiting action.
  4. The Governor vetoed 20 bills mainly due to a dispute with the Senate over common education reform.
  5. The following are OSMA supported measures VETOED by the Governor:
  • SB249 (McCortney/Caldwell) – Adjusts provisions related to illegal drugs to include a definition of palliative care and exempts such care from certain electronic prescription requirements. VETOED
  • SB711 (Rosino/Boatman) – Directs the Dept. of Mental Health to provide opioid antagonists to the Dept. of Corrections and to county jails to be provided to inmates with a known opioid addiction or related condition upon release. VETOED
  • SB712 (Rosino/McEntire) – 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. VETOED
  • 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. VETOED
  • 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. VETOED
OSMA is now tracking 39 pieces of legislation (not including marijuana or budget related measures)

APRN SCOPE: SB458 (Stanley/McEntire) was not considered before Thursday’s deadline and is officially dormant for the year. This measure would have allowed Advanced Practice Registered Nurse (APRNs) to pursue enhanced prescriptive authority statewide without physician supervision. Unfortunately, the APRN representatives politically and personally attacked the OSMA Lobby team which includes Matt Robison; Pat Hall, CAE; Jim Dunlap; Tonya Lee Noon; Bruce Robertson and Luke Martin. The OSMA team did an INCREDIBLE JOB representing the House of Medicine and defeating the perpetual APRN SCOPE measure this year.

OSMA’s H.E.R.O. (Healthcare Expansion in Rural Oklahoma) Plan DID THE JOB!!!

OSMA devised several Amendments authored and ready for consideration if SB458 was brought to the House Floor. These amendments included:
  • MD or DO Licensure Boards must play an integral part in APRN evaluation and authorization.
  • APRN enhanced prescribing authority would require the passage of Board authorized pharmacology exam and CME.
  • Expanded practice APRNs MUST ONLY work in Rural Oklahoma counties (under 200K population).
  • A “sunset clause” provision be added so the legislature could evaluate the results.

OSMA also helped develop and lobby for a separate Floor Substitute authored by Rep. Carl Newton (R-58). His bill ONLY defined APRN supervision and fee requirements and did not expand scope. The H.E.R.O. plan language proved to be a major benefit to OSMA when combating and defeating this effort by the APRNs.

This ALL circles back to the OSMA CAMPAIGN. The physician profession is building a political force supporting the House of Medicine. This is a long-term game and MUST be considered as such. OSMA’s impact on the political landscape has only begun and we need to commit to this effort. PLEASE recall that OMPAC plays a MAJOR roll in OSMA’s political strength. YOU CHOOSE to make a difference…INVEST IN OMPAC!

Another major issue affecting the House of Medicine is the Health Information Exchange (HIE) which is still scheduled to begin reporting requirements on July 1, 2023. There continues to be significant concerns over the HIE implementation due to patient record confidentiality and physician participation expenses.

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/MyHealthAccessNetwork.

OSMA’s position is that costs associated by this unfunded mandate should be directly borne by the state, not by physicians. OSMA and other physician led organizations pushed for a delay in the HIE legislation to allow organized medicine to have more input when determining the implementation of the system until questions and concerns can be addressed. HB1688 (McEntire/Haste) contained language addressing some concerns over program implementation, but the measure was “held for consideration” and was never brought back to the Senate Floor. The measure is dormant for the year.

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 IN MAY. This 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

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**; NOT heard on the House Floor House Floor; Dormant) OSMA OPPOSES

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 (HIE) under the Health Care Authority (Passed House; NOT heard on Senate Floor; Dormant) OSMA WAS IN NEGOTIATIONS.

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; NOT heard on House Floor; Dormant) OSMA SUPPORTS

INSURANCE

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; 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; passed House Floor; to Senate for consideration of Amendments) OSMA SUPPORTS

SB442 (Montgomery/Sneed) – Requires health benefit plans to make available a directory of providers within their network plans. (Passed Senate; Passed House; to Governor) OSMA SUPPORTS

SB513 (Rosino/Miller) – Requires insurers, including the state's Medicaid program, to cover biomarker testing in certain instances. (Passed House Floor; Passed Senate; to Senate for consideration of Amendments) 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; Passed Senate; to Governor) 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, Passed House Public Health; NOT heard on House Floor; Dormant) OSMA SUPPORTS

MEDICAID

HB1657 (McEntire/Rosino) – 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 Senate Floor as Amended; Passed House; to Senate for consideration of amendments) 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; Passed House; VETOED by Governor) 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**; Passed Senate with restored Title; to House for consideration of amendments) OSMA SUPPORTS

HB2746 (Kirt/Miller) – Creates the Courtney Smith Law, allowing for the transportation of a ward by county or municipal officials to an inpatient treatment facility under the direction of a guardian in certain circumstances. (Passed House; Passed Senate; to Governor) 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; Passed House; to Senate for consideration of amendments) 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; House; to Senate for consideration of amendments) 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; Passed House; to Governor) 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; Passed Senate; to Governor) OSMA SUPPORTS

HB2424 (May/Stephens) – Allows pharmacies to dispense and sell a wider variety of opioid antagonists to counteract overdoses. (Passed House; Passed Senate; SIGNED by Governor) 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; Passed House; VETOED by Governor) OSMA SUPPORTS

WOMEN & CHILDREN HEALTH

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; Passed House; SIGNED by Governor) 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; Passed House; to Senate for consideration of amendments) 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; Passed House Public Health; NOT heard on House Floor; Dormant) OSMA SUPPORTS

*OSMA continues 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.