MASCA Legislative Update: 4/8/2018
Trending Articles: MO Scout: Who Won the Week?
MO Scout: Weekly Political Insider Summary AP: Greitens OKs $700M budget hike, mainly for Medicaid The Missouri Times' Jennifer Bukowsky: Change the terms of the limits
P-D: Jefferson City braces for committee's release of Greitens report
P-D: Barnes says 'no' to Greitens' request for delay Missourinet: Missouri House gives initial approval to massive tax plan AP: Missouri House advancing bill on opioids
MO Scout Poll – Senate District 17 (Northern KC/Platte County): Note that this seat was held by Sen. Ryan Silvey (R) for two terms prior to his recent appointment to the Public Service Commission. It is now a very contested race between Republican State Representative Kevin Corlew and Democrat State Representative Lauren Arthur.
Q1: Do you approve or disapprove of Donald Trump’s job performance as President of the United States?
Not sure: 7%
Q2: Do you approve or disapprove of Eric Greitens’ job performance as Governor of Missouri?
Not sure: 12%
Q3: Possible candidates in the 2018 General Election for United States Senate are the Republican Josh Hawley and the Democrat Claire McCaskill. If the election were held today, for whom would you vote?
Josh Hawley: 47%
Claire McCaskill: 48%
Q4: The candidates in the 2018 Special Election for State Senate are the Republican Kevin Corlew and the Democrat Lauren Arthur. If the election were held today, for whom would you vote?
Kevin Corlew: 42%
Lauren Arthur: 44%
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: 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. This was not voted on in the House Health Policy Committee this week, but the Senate is scheduled to hear the companion bill next week.
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 House Professional Registration Committee. It is currently in the House Rules Committee, one step away from the House floor. 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.
Drug Trafficking – Fentanyl: Legislation that would make it a crime to distribute, deliver, produce or attempt to purchase more than 10 grams of fentanyl. Anything more than 60 grams would be considered a felony. The MO State Troopers Association, MO Prosecuting Attorneys Association and other law enforcement groups testified in support of the bill. This was passed out of the committee 8-0 and was referred to the Rules Committee.
Upcoming Public Hearings:
MONDAY - 04/09/18
House-Fiscal Review (POSTING CHANGE) MONDAY - 04/09/18 2:00 PM, HR 4 Executive Session:
Requires certain health care professionals to complete two hours of suicide prevention training as a condition of licensure.
Establishes the Opioid Addiction Prevention and Treatment Act of 2018
Senate-Professional Registration MONDAY - 04/09/18 2:00 PM, SCR 1
Establishes the "Professional Employer Organization Act".
Changes the laws relating to professional registration.
House-General Laws MONDAY - 04/09/18 5:00 PM or Upon Adj., whichever is later, HR 6 Public Hearing:
Modifies provisions relating to hospital regulations
House-Rules-Administrative Oversight (POSTING CHANGE) MONDAY - 04/09/18 5:00 PM or Upon Adj., whichever is later, HR 3 Public Hearing:
Modifies provisions relating to opioids.
Allows certain physician assistants, assistant physicians, and advanced practice registered nurses who are licensed under chapter 334 to provide psychiatric treatment to certain mental health patients.
Modifies provisions relating to pharmacy, including drug disposal, prescription limitations for controlled substances, and vaccine protocols
Modifies provisions relating to opioids.
TUESDAY - 04/10/18
House-Special Committee/Employment Security TUESDAY - 04/10/18 9:00 AM, HR 6 Executive Session:
Modifies provisions relating to workers' compensation.
House-Insurance Policy TUESDAY - 04/10/18 12:00 PM or upon conclusion of morning session, HR 4 Public Hearing:
Provides that a managed care plan's network is adequate if the health carrier is accredited by the Accreditation Association for Ambulatory Health Care
Modifies provisions relating to methods of self-insurance for workers' compensation
Requires an insurance carrier to post a current provider directory on its website.
WEDNESDAY - 04/11/18
Senate-Seniors/Families and Children WEDNESDAY - 04/11/18 8:00 AM, Senate Lounge
Allows for a patient's designation of a caregiver to provide care following discharge from a hospital or ambulatory surgical center
House-Health and Mental Health Policy WEDNESDAY - 04/11/18 12:00 PM or upon conclusion of morning session, HR 7 Executive Session:
Establishes a Prescription Abuse Registry