MASCA Legislative Report 4/8
Attorney Letter from Radiology Group on Pending “Physician Employee” Legislation
Top News of the Week
P-D: Missouri House approves budget, sends $27.8B plan to Senate Columbia Missourian: Senate prepares to hear prescription drug monitoring program bill Fulton Sun: Calloway County cancer advocates visit Capitol
AP: House advances bill pushing medical help for overdoses KC Star: McCaskill calls for GAO report on closing of rural hospitals
The Missouri Times: 8 changes to note in the House budget: Education spending, Medicaid, circuit breaker, more SE Missourian: Holly Rehder talks about her bid for Speaker of the House, PDMP legislation
Key Updates — First Half of Session
Budget: The House approved a $27 billion proposed budget this week for the next fiscal year, which goes into effect on July 1, 2017. The budget bills now head to the Senate, which has until the first week of May to find a compromise with the House and send a final budget to the Governor. At this point, there are no changes to workers compensation rates or any significant changes to Medicaid reimbursement. Link to 2018 budget requests from each department.
Radiology Techs: As a follow up from last week, we spoke to the MO Radiological Society and the radiologists are going to work over the summer with the radiological tech’s to see if they can find a compromise. However, there will not be anything else pursued this legislative session. I suggested that we want to be part of those discussions to ensure any new proposal/negotiation does not put ASCs at a disadvantage.
Physician-Employee Tort Reform: We spoke with an attorney earlier this week who represented the radiology group involved in the Jefferson v Missouri Baptist Medical Center case that has prompted pending legislation about how the definition of a physician employee in a medical malpractice case. We wanted to verify with the attorney that the pending legislation, which has already passed each chamber, is in the best interest of independent physicians. The legislation seeks to fix the court’s interpretation of a 2005 law, which has resulted in hospitals being held liable for the actions of non-employed physicians who have staff privileges at a hospital. The attorney confirmed that the legislation is necessary, as the court’s current interpretation could result in a hospital counter-suing a physician after the physician/medical group has settled the case. In summary, the current interpretation pins physicians and hospitals against each other. – see attached letter from another attorney who represents radiology groups
PDMP: A Senate committee approved the House version of a PDMP on Thursday with a 7-0 vote, putting the bill in a strong position to advance with five weeks left in session. However, Sen. Rob Schaaf, MD (R-St. Joseph), who has led the opposition to PDMP over the last decade, held a press conference this week saying he would allow PDMP to pass if an amendment was added to mandate physicians use of the program. This is problematic in that it is not practical to require every physician to use a PDMP for every patient across every specialty, meaning this may be more of a political play from Schaaf to deflect the blame onto physicians if the legislation does not pass.
PTs & Athletic Trainers: The House Professional Registration & Licensing Committee held a hearing this week that involved three bills relating to physical therapy and athletic trainers.
PT referrals: HB 429 would allow physicians to employ physical therapists. This was supported by Signature Medical Group, Missouri State Medical Association, Missouri Association of Osteopathic Physicians & Surgeons, and Missouri State Orthopaedic Association. The Missouri Physical Therapy Association opposed the measure, arguing they would go out of business if this law were to pass.
PT direct access: HB 211 would allow physical therapists to see patients without a physician’s prescription. The committee, which defeated a bill last week to expand nurses’ scope of practice, appeared to be very hesitant to grant PTs with the ability to see patients without physician involvement. The bill was supported by the Missouri Physical Therapy Association and opposed by the Missouri State Medical Association, Missouri Association of Osteopathic Physicians & Surgeons and the Missouri Academy of Family Physicians.
Athletic Trainers: The last bill heard on Wednesday evening was HB 882 to expand scope of practice for athletic trainers. This was supported by the Missouri Association of Athletic Trainers and opposed by the Missouri Physical Therapy Association and Missouri State Medical Association.
Sports Medicine: The Senate Professional Registration & Licensing Committee held a public hearing on SB 122 this week, an act related to out-of-state sports medicine/team doctors. The intent of this legislation is to allow out-of-state team doctors practice in Missouri without any liability concerns, provided they are practicing under their scope. Rep. Keith Frederick (R-Rolla) told the committee that he is hopeful that other states will follow with similar legislation that will benefit Missouri physicians traveling to other states as team doctors.
Firearm Liability (BAD FOR ASCs): Pending legislation in the Missouri House would make business owners liable for any injuries that occur on the property if the owner has elected to post signs prohibiting the possession of firearms on the property. Specifically, the bill suggests that the business owner is assuming custodial responsibility for the safety and defense of any person who can legally possess a firearm. As you can imagine, this legislation has generated substantial opposition from the business community. The public hearing was initially scheduled last week, but the General Laws Committee ran out of time to hold the hearing. It’s likely that this bill will have another hearing in the next week or two, but it is unlikely to gain much traction this late in session. Read more.
Hearings this week
MONDAY - 04/10/17
House-General Laws MONDAY - 04/10/17 1:00 PM, HR 5 Public Hearing:
Allows persons authorized to carry firearms under chapter 571 to sue for certain injuries sustained on the property of business enterprises that voluntarily prohibit firearms.
Committee Members: Cornejo, Robert (R) / Mathews, Kirk (R) / Carpenter, Jon (D) / Anderson, Sonya (R) / Arthur, Lauren (D) / Basye, Chuck (R) / Cross, Gary (R) / Evans, Jean (R) / McCreery, Tracy (D) / Merideth, Peter (D) / Roeber, Rebecca (R) / Schroer, Nick (R) / Taylor, Jared (R)
Senate-Judiciary/Civil and Criminal Juris. MONDAY - 04/10/17 2:00 PM, Senate Lounge
Authorizes a health care decision-maker to make health care decisions for a incapacitated patient who does not have a person with legal authority to consent for the patient.
Committee Members: Dixon, Bob (R) / Onder, Bob (R) / Chappelle-Nadal, Maria (D) / Emery, Ed (R) / Koenig, Andrew (R) / Sifton, Scott (D) / Silvey, Ryan (R)
TUESDAY - 04/11/17
House-Insurance Policy (POSTING CHANGE) TUESDAY - 04/11/17 12:00 PM or upon morning adj., whichever is later, HR 4
Specifies the minimum reimbursement amount for covered physical therapy services delivered under health benefit plans.
Creates standards for predetermination of health care benefits requests and responses.
Committee Members: Engler, Kevin (R) / Wiemann, John D. (R) / Ellebracht, Mark (D) / Burnett, Ingrid (D) / Burns, Bob (D) / Messenger, Jeff (R) / Morris, Lynn (R) / Muntzel, Dave (R) / Pfautsch, Donna (R) / Shull, Noel (R) / Stephens, Mike (R)
Senate-Education TUESDAY - 04/11/17 12:00 PM, SCR 1
Modifies various provisions relating to degree offerings at public institutions of higher education
Committee Members: Romine, Gary (R) / Eigel, Bill (R) / Chappelle-Nadal, Maria (D) / Emery, Ed (R) / Holsman, Jason (D) / Koenig, Andrew (R) / Libla, Doug (R) / Onder, Bob (R) / Schupp, Jill (D)
House-Judiciary TUESDAY - 04/11/17 4:00 PM or upon conclusion of afternoon session, HR 1
McGaugh, Joe Don
Modifies the definition of dependent for purposes of workers' compensation claims.
Committee Members: McGaugh, Joe Don (R) / Corlew, Kevin (R) / Mitten, Gina (D) / Beard, Nathan (R) / DeGroot, Bruce (R) / Ellebracht, Mark (D) / Gregory, David (R) / Marshall, Nick (R) / Roberts, Steve (D) / Reisch, Cheri (R) / White, William (R)
WEDNESDAY - 04/12/17
Senate-Government Reform WEDNESDAY - 04/12/17 8:00 AM, SCR 1 Executive Session:
Modifies definitions of 'employee' and 'physician employee' in actions against health care providers for personal injury or death.
Committee Members: Emery, Ed (R) / Schatz, Dave (R) / Eigel, Bill (R) / Munzlinger, Brian (R) / Rizzo, John (D) / Rowden, Caleb (R) / Sifton, Scott (D)
Senate-Health and Pensions (TIME CHANGE) WEDNESDAY - 04/12/17 10:00 AM, SCR 1
Changes the laws regarding health care records of deceased patients.
Committee Members: Schaaf, Rob (R) / Koenig, Andrew (R) / Chappelle-Nadal, Maria (D) / Onder, Bob (R) / Sater, David (R) / Schupp, Jill (D) / Silvey, Ryan (R)