Weekly Legislative Update: May 21, 2021


Oklahoma State Legislature to ADJOURN by 5:00pm on Friday, May 28

Medicaid Managed Care Embraced by Legislature – With the passage of a dramatically amended SB 131, the Oklahoma legislature officially supports Medicaid managed care. This is a truly disappointing development. The new version of this measure now only provides statutory requirements in which Medicaid Managed Care Organizations (MCOs) must comply. The following represents some of those requirements:

 

  • Clean claims are to be processed within 14 days
  • Minimum reimbursement fee schedule is based on the 1/1/21 Medicaid fee schedule
  • Audit & “scorecard” requirement
  • Uniform review and appeals process
  • “Peer to peer” review for denial cases


Although the current MCO contracts are said to have some of these or similar provisions, requirements being placed in statute are extremely important since these contracts (or any new MCO contacts) must be re-negotiated annually.


Budget Sent to Governor – The legislature sent the Fiscal Year 2022 budget to the Governor this week. The budget provides state appropriations equaling $8.2 billion and is highlighted by:

 

  • Increasing common education funding by 6%
  • Increasing state reserves to more than $1 billion
  • Reducing the top personal income tax from 5% to 4.75% and corporate income tax from 6% to 4%
  • Providing tax incentive to expand broadband services in underserved and rural areas of the state
  • Full funding Medicaid expansion as constitutionally required with the passage of SQ 802
  • Restoring the historic sales tax exemption allowing the University of Oklahoma Health Sciences Center to train 110 additional nursing graduates, 50 new nurse practitioners and 70 additional medical residents within three years

 

LEGISLATIVE ISSUES IMPORTANT TO OSMA

SCOPE OF PRACTICE


HB 2009 (Townley/Coleman) – Permits certain death certificates to be signed by advanced practice registered nurses. (Passed House; Passed Senate; Signed by Governor) OSMA OPPOSES

HB 2164 (Roe/Pemberton) – Allows psychologists to be considered as a class of physician (Passed House Public Health; Failed on House Floor; Dormant) OSMA OPPOSES

HB 2595 (Roberts, S) – Expands from 30 days to 60 days the time period allowing physical therapists to evaluate and treat a patient without a referral from a licensed health care practitioner. (Passed House Public Health; Failed on House Floor; Dead this Session) OSMA OPPOSES

SB 388 (Rosino/West, Josh) – Directs that home care eligibility for patients be certified and overseen by healthcare providers, including physicians, physician assistants, or registered nurses and makes such eligibility and oversight retroactive. (Passed Senate; Passed House; Signed by Governor) OSMA OPPOSES

SB 516 (Montgomery/Pfeiffer) – Allows a delegating physician to supervise an unlimited number of physician assistants. Note: The Medical Licensure Board currently limits physician supervision of up to six P.A.s (Title and Enacting Clause Stricken*; Passed Senate; Passed House; to Conference Committee) OSMA OPPOSES

GENERAL GOVERNMENT

SB 79 (Thompson/Wallace) – Provides for a tax exemption on the transfer of tangible property or services to federally tax-exempt nonprofit entities which have entered into joint operations agreements with the Hospitals Trust which helps fund residencies (Passed Senate; Passed House; Signed by Governor) OSMA SUPPORTS

SB 548 (Daniels/Townley) – Provides that no medical service care or entity shall report a healthcare debt to a credit bureau or pursue collection activities unless certain facts relating to the incurrence of such debt are demonstratable and limits charges. (Title Stricken*; Passed Senate; Passed House State’s Rights; Failed on House Floor 35-58; Dead this session) OSMA OPPOSES

SB 574 (McCortney/McEntire) – Creates the Oklahoma State Health Information Network and Exchange (OKSHINE), charged with creating and maintaining a digital platform for the sharing and exchanging health related information among healthcare system participants. (Title Stricken* Passed Senate; Committee Substitute Passed House Public Health; Passed House Floor; Passed Senate as amended; Conference Committee report adopted; Passed House; Passed Senate; to Governor) OSMA SUPPORTS

SB 689 (Pugh/Miller) – Revises the make-up of the Oklahoma Health Care Authority Medical Advisory Board. (Passed Senate; Committee Substitute passed in House General Government; Passed House Floor; Senate Rejects House Amendments; to Conference Committee) OSMA NEUTRAL

SB 1031 (Treat/Echols) – Extends certain virtual meeting provisions established in response to the COVID-19 health emergency to until 30 days after the termination of the health emergency order (Passed Senate; Passed House; Signed by Governor) OSMA SUPPORTS

INSURANCE

HB 1006 (Bush/Pugh) – Creates the “Transparency in Heath Care Prices Act” which requires health care providers and facilities to make prices for certain health care services publicly available (Passed House; Passed Senate Health & Human Services as Amended; Passed Senate; Passed House; Signed by Governor) OSMA SUPPORTS

HB 2323 (Frix/Pemberton) – Prohibits insurers from removing medical providers from an existing insurance network while a policy is in effect for informing enrollees of the full range of physicians and providers available to them and requires certain notice upon referral (Passed House; Passed Senate; Signed by Governor) OSMA SUPPORTS

SB 550 (Newhouse/Pae) – Requires insurance providers to make certain notifications when clean claims are denied, and allows for the insured to appeal, if denied again the insurer must provide certain additional info, including contact info to speak to someone (Passed Senate; Passed House; Signed by Governor) OSMA SUPPORTS

MEDICAID MANAGED CARE

HR 1019 (McEntire) – Declares privatized managed care to be a failed health care model and encourages the Health Care Authority to create an Oklahoma-based managed care system. (to House Floor) OSMA SUPPORTS

SB 131 (Garvin/McEntire)REDRAFTED – Provides requirements by which Medicaid Managed Care Organizations (MCOs) must comply. (Conference Committee Report Adopted; Passed Senate; Passed House; to Governor)

PAIN MANAGEMENT/OPIOIDS/PHARMA

HB 1019 (Worthen/Simpson) – Places a cap on required payments for insulin by insureds, regardless of total amount or type of insulin necessary, such provisions not to prevent providers from charging insureds less than the cap (Passed House; Passed Senate; Signed by Governor) OSMA SUPPORTS

HB 2678 (Marti/McCortney) – Co-Pay Accumulator: Makes failing to include certain payments on behalf of enrollees when calculating total contributions towards out-of-pocket maximums an unfair claim settlement practice for pharmacy benefits providers (Passed House; Passed Senate; Signed by Governor) OSMA SUPPORTS

SB 57 (Rader/Echols) – Permits access to certain information contained in the central repository regarding controlled dangerous substances to the members of the Opioid Overdose Fatality Review Board (Passed Senate; Passed House as Amended in Committee; Passed Senate; Signed by Governor) OSMA SUPPORTS

SB 58 (Rader/Echols) – Permits a practitioner to electronically order a controlled dangerous substance when administered through a hospice program (Passed Senate; Passed House; Signed by Governor) OSMA SUPPORTS

PUBLIC HEALTH

HB 2335 (Steagall/Jett) – Prohibits government entities from mandating vaccinations (Passed House; Committee Substitute Passed Senate Health & Human Services; not heard on Senate Floor; Dormant) OSMA OPPOSES

HB 2381 (Sterling/Simpson) – Requires school districts to conduct an annual fitness assessment for students in grades three through twelve within a course that satisfies the physical education program currently in statute. (Passed House; Passed Senate Education and Senate Appropriations; not heard on Senate Floor; Dormant) OSMA SUPPORTS

SB 658 (Standridge/West K.) – Requires the Dept. of Education and school districts to provide information on exemptions in any notice or publication regarding immunization requests and requirements; provides that no school district (common; career tech; institution for higher learning) can require a COVID-19 vaccination as a condition of admittance; provides mask mandate restrictions (Passed Senate; Floor Substitute passed House; Senate rejects House Amendments; to Conference Committee; Conference Committee Report Submitted) OSMA OPPOSES

SB 905 (Bullard/Davis) – Provides a tax credit for employers that host blood drives for each donating employee. (Passed Senate; Title Stricken*; Passed House as amended; Senate rejects House Amendments; to Conference Committee; Conference Committee Report Adopted; Passed Senate; Passed House; to Governor) OSMA SUPPORTS

TELEHEALTH

SB 673 (McCortney/McEntire) – Creates the Oklahoma Telemedicine Act which expands definitions and standards for telemedicine within statute (Passed Senate; Passed House; Signed by Governor) OSMA SUPPORTS

SB 674 (McCortney/McEntire) – Requires health care plans to provide coverage for telemedicine and remote care services (Passed Senate; Floor Substitute Passed House; Passed Senate; Signed by Governor) OSMA SUPPORTS

WOMEN & CHILDREN


HB 1102 (Olsen/Daniels) – Makes performing an abortion that is not deemed medically necessary to preserve the life or prevent irreversible impairment of a major bodily function of the woman, grounds for a physician to lose or have their license suspended (Passed House; Passed Senate; Signed by Governor) OSMA OPPOSES

HB 2441 (Russ/Daniels) – Prohibits the performance of abortions on pregnant woman after such time that the unborn child has a detectable heartbeat. (Passed House; Passed Senate; Signed by Governor) OSMA OPPOSES

SB 778 (Daniels/Lepak) – Creates the OK Abortion Inducing Drug Risk Protocol Act, which may only be utilized by physicians in specific settings and requires certain notification to be made to those receiving such drugs. (Passed Senate; Title Stricken*; Passed House as Amended; Senate rejects House Amendments; Conference Committee Report Adopted; Passed Senate; on House Floor Agenda) OSMA OPPOSES

SB 779 (Daniels/Lepak) – Creates the OK Abortion Inducing Drug Certification Program for physicians performing such services and requires them to report annually certain information regarding patients receiving abortions, also defines penalties for certain violations (Passed Senate; Title Stricken*; Passed House as Amended; Senate Rejects House Amendments; Conference Committee Report Adopted; Passed Senate; on House Floor Agenda) OSMA OPPOSES

SB 918 (Treat/McCall) – Repeals sections of law relating to abortion, to be effective should the U.S. Supreme Court, or an amendment to the U.S. Constitution is adopted to overturn Roe v. Wade (Passed Senate; Passed House; Signed by Governor) OSMA OPPOSES

*Title Stricken means the language in the measure continues to be a work in progress.