Final Weekly Legislative Update, June 4, 2021


June 1 Update: Supreme Court Rules in Favor of OSMA

Late Tuesday, the Oklahoma Supreme Court ruled that the Oklahoma Health Care Authority’s plan to privatize the state Medicaid system and implement Medicaid managed care was unconstitutional.

Earlier this year, the OSMA—along with the Oklahoma Dental Association, Oklahoma Osteopathic Association, Oklahoma Society of Anesthesiologists and Oklahoma Chapter of the American Academy of Pediatrics—filed suit to block the Stitt administration’s efforts to issue over $2 billion in contracts to large private insurers to run most of the state Medicaid system under a capitated payment model. The OSMA suit argued that the OHCA lacked the authority to enter into such far-reaching contracts for a program that the Legislature had neither approved nor appropriated. In a 6-3 ruling, the Court agreed that the Health Care Authority had overstepped its bounds and that the proposed contracts were invalid.

Even with Tuesday’s ruling, the battle over managed care is not over. However, this is a MAJOR victory for protecting the health care of Oklahoma’s most at-risk patients.

OKLAHOMA STATE LEGISLATURE ADJOURNS SINE DIE*

Medicaid Managed Care “Guardrail” measure becomes law without governor's signature – Governor Kevin Stitt refused to sign SB 131 (McCortney/McEntire) which provides statutory requirements for Medicaid Managed Care Organizations (MCOs). The measure goes into effect on September 1, 2021. Although the medical community continues to have grave concerns about the implications of managed care for Medicaid, the passage of SB 131 provides some allowances for our concerns. The following represents some of the statutory constraints placed on MCO governance:

• 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
• Prompt payment provisions

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

Overall Successful Session – With COVID-19 still having a considerable impact on the state legislature, OSMA faced many measures which significantly addressed Oklahoman’s access to quality health care, both positively and negatively. Here are some of the victories in which OSMA played a significant role:

• Passed pay parity for telehealth services;
• Defeated several scope measures including:
o Physician Assistant (PA) supervision from an unlimited number of physicians;
o Psychologist to be considered physicians;
o Physical Therapist expanding diagnosis and treatment authorization;
o Allowing accredited nurse specialists to write prescriptions while under the supervision of a physician or independently
• Passed Denied Claims Processing reform;
• Defeated measure to disallow municipal mask ordinances;
• Passed Transparency in Health Care Pricing Act;
• Passed co-pay accumulator legislation for calculating total out-of-pocket pharmaceutical costs
• Passed needed opioid clean-up reform; • Passed the Oklahoma State Health Information Network and Exchange (OKSHINE) creating and maintaining a digital platform for the sharing and exchanging health related information;
• Restored 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;
• Passed requirement that public bodies which operate websites and utilize high-speed internet must stream and conduct meetings live.

MANY THANKS TO THOSE OSMA MEMBERS WHO TOOK THE MOMENT OF TIME NEEDED TO RESPOND TO OUR ACTION CALLS! OSMA had nine Action Calls resulting in approximately 700 contacts with legislators on issues important to the health of all Oklahomans. Your participation and leadership is something in which to be PROUD!

*Sine Die is a Latin term used on the last day of session meaning “with no appointed date for resumption.”

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; Conference Committee Unable to Agree; Dormant) OSMA OPPOSES

GENERAL GOVERNMENT
HB 2874 (Wallace/Thompson) – Restores 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 (Passed House; Passed Senate; to Governor as part of budget) OSMA SUPPORTS

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; Signed by Governor) OSMA SUPPORTS

SB 689 (Pugh/Miller) – Limits the membership of the Health Care Authority's Advisory Committee on Medical Care for Public Assistance Recipients to 15 persons, adjusts member qualifications and prohibits any Medicaid/SoonerCare transit plan from harming local transit. (Conference Committee Report Adopted; Passed Senate; Passed House; to Governor) 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
SB 131 (McCortney/McEntire) – REDRAFTED – Provides requirements by which Medicaid Managed Care Organizations (MCOs) must comply. (Conference Committee Report Adopted; Passed Senate; Passed House; Effective September 1, 2021 Without Governor’s Signature)

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 (Conference Committee Report Adopted; Passed Senate; Passed House; to Governor) 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; Signed by 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. (Conference Committee Report Adopted; Passed Senate; Passed House; to Governor) 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 (Conference Committee Report Adopted; Passed Senate; Passed House; to Governor) 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.