MASCA Legislative Update: 4/1/2018
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MASCA Recognized in Senate Journal During Lobby Day:
Status of Priority Legislation:
Surprise Billing: The provider community has been in constant negotiation with the insurance lobby and several lawmakers in an attempt to find middle ground on balance/surprise billing, which occurs when a patient receives a bill from an out-of-network provider at an in-network facility. While both parties agree the patient should not be responsible for the out-of-network cost in that scenario, we are trying to negotiate a fare reimbursement for the provider. The insurance lobby has been pushing for the greater of 120% of Medicare and the average in-network rates for similar services within that geographic area. This is the California model that has proved extremely problematic for providers, which is why we have proposed the greater between the 80th percentile of usual and customary rates and the average in-network rates for similar services. Legislation on this issue could come up on the Senate floor as early as next week.
Designated Caregiver Act: MASCA President Cindy Young testified in opposition to HB 2293 this week, an act that would require all hospitals and ASCs to offer patients the option to disclose a designated caregiver who would have permission to view their medical information and any post-release care instructions. MASCA’s opposition was based on the fact that ASCs already do this through a patient privacy form that every patient has the option to sign. It is our goal to amend this to exempt ASCs who are using existing patient privacy forms.
Workers Compensation Claims Database: The Senate Small Business Committee held a public hearing on a bill last month that would have tied workers compensation claims to a medical fee schedule, similar to what is currently in place in 42 other states. The only testimony in support was from a defense attorney, while provider groups piled on in opposition, suggesting that a fee schedule would result in reduced physician participation and access to care. This bill has not been voted on in committee.
7 Day Opioid Limit: Restricts initial opioid prescription to seven day supply limit, unless designated in the medical record the reason for additional supply. This was amended onto another Senate pharmacy bill that has been approved by the full Senate and was heard in the House Professional Registration & Licensing Committee. Read bill summary.
Opioid Omnibus Bill: Rep. Keith Frederick, DO (R-Rolla) was successful in passing a bill out of the House that contains several provisions relating to opioids, including:
Drug Take-Back Program – public collection process for unused controlled substances
Prescription Abuse Registry – Anyone over 18 can volunteer to be listed in this registry, which providers can monitor to see if they are prescribing to someone who has a history of abuse. A person can petition to be removed after five years. In other words, this is a self-imposed rehab concept for those individuals who want to put in place barriers to access.
Patient Satisfaction Scores – Specifies that a patient scoring of pain control shall not be required when defining data standards for quality of care and patient satisfaction.
IATOA – An initiative designed for assistant physicians to address overdose situations in the emergency room and creates a path for assistant physicians to obtain prescriptive authority.
CME – We were successful in lobbying Rep. Frederick to offer an amendment on the House floor to remove a provision that would have required every physician to complete at least two hours of pain management and opioid addiction training every two years as part of their CME. Despite good intentions, we were concerned there could have been unintended consequences with this provision.
Right to Shop Act: Requires health carriers to publish specific information regarding the estimated cost of certain procedures. This was passed out of the House Health Policy Committee 8-3 and has been referred to the Rules Committee.