2016 Legislative and Administrative Summary Acknowledgements This year’s budget and legislative session successes were a team effort between HARI staff, Nick Hemond of Capitol Communications Group, and our members. We would like to express our sincere gratitude to the staff and executives of HARI’s individual member hospitals who were willing to dedicate their time and efforts to provide technical support and guidance to HARI staff; appear at legislative hearings to advocate and help educate legislators; and provide written materials and statements in support of HARI’s efforts. HARI staff would also like to thank Providence College Health Management Program interns Jenna Wahl (’16) and Katelyn Lane (’18) for their hard work and dedication on the creation of this report. TABLE OF CONTENTS Page Introduction Enacted Legislation Good Samaritan Overdose Prevention Act of 2016 1 Rhode Island Family Home Visiting Act 1 Public Utilities Commission – Information Accessibility Service for Persons with 2 Disabilities Rhode Island Health Information Exchange Act of 2008 – Authorized Access 2 Business and Professions – Collaborative Pharmacy Practice 3 Freedom from Prone Restraint Act 3 Police Officers – Response to Mental Health/Substance Abuse Emergencies 4 Insurance – Off-Label Uses of Prescription Drugs 5 Behavioral Health Care – Certified Recovery Housing Facilities and Programs 5 Office of Health Insurance Commissioner – Rate Review 6 Medical Assistance – Long Term Care Uncompensated Care 6 Waiver of Medical Record Fees for Veterans 7 Insurance – Pricing and Pharmacy Benefit Manager Oversight 7 Business and Professions – Licensed Chemical Dependency Professionals 8 Telemedicine Coverage and Reimbursement 8 Mental Illness and Substance Abuse – Comprehensive Discharge Planning – The 9 Alexander Perry and Brandon Goldner Act Business and Professions – Nursing Assistants 11 Insurance – Coverage for Opioid Antagonists 11 Insurance – Coverage for Biological/Interchangeable Biological Products 12 Prescription Drug Monitoring Program – Designee Access 12 Uniform Controlled Substances Act – Electronic Transmission of Schedule V 13 Prescriptions Insurance – Synchronization of Prescriptions and Coverage for Less Than 30 Day Supply 13 Uniform Controlled Substances Act – Regulation of Opioid Prescribing 14 Prescription Drug Monitoring Program – System Enhancements 14 Legislation Passed and Awaiting Enactment Board of Medical Licensure and Discipline – Due Process Provisions 16 Business and Professions – Non-Competition Agreements 16 Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act – PTSD and Hospice 17 Care Freestanding Emergency Care Facilities – Regulation and CON Requirement 17 Health Care Facilities – Circulating Nurses 18 Health Care Facilities – Moratorium on Nursing Facility Licensure – Extended 19 Insurance – Medical Billing Innovation Act of 2016 19 Insurance – 30 Day Notice Requirement Prior to Coverage Changes for Prescription 19 Drugs Enacted Resolutions Special Legislative Study Commission – Health Literacy 21 Special Legislative Commission – Rare Diseases – Extending Expiration Date 21 Legislation Considered but not Enacted Access to Abuse-Deterrent Pain Medications 23 Hospital Leadership Compensation Limits 23 Insurance – Coverage for Residential Inpatient Mental Health or Substance Abuse 24 Treatment Insurance – Credentialing of Health Care Providers 24 Insurance – Prohibition of Collection of Patient Cost Sharing for Mental 25 Health/Substance Abuse Treatment Insurance – Surprise Bills for Medical Services 26 Interstate Medical Licensure Compact 26 Meaningful Access to Provider Directories 27 Nurses – Enhanced Licensure Compact 27 Nurses – Mandated Staffing Ratios 28 Nurses – Regulation of Agency/Temporary Nurse Hiring by Hospitals 28 Prescription Drugs – Creation of Critical Drug Prescription List and Manufacturer 29 Financial Disclosure Requirements Prescription Drug Monitoring Program – Access by Law Enforcement 29 Rhode Island Terminally Ill Patients’ Right to Try Act of 2016 30 Transparency – Hospital Charges and Payroll Reporting 30 Utilization Review Act 31 FY 17 Enacted State Budget 32 Commissions and Workgroups Special Legislative Commission – Council to Coordinate Resources for Individuals with 34 Rare Diseases EOHHS – 1115 Waiver Implementation Task Force 35 Governor’s Health Care Innovation Working Group 36 Governor’s Overdose Prevention and Intervention Task Force 38 Health Care Planning and Accountability Advisory Council 39 OHIC - Administrative Simplification Taskforce 40 State Innovation Model (SIM) 42 HARI Position Letters and Testimony Introduction After the 2015 legislative session ended abruptly on June 25th when leadership in both houses failed to reach agreement on several pieces of legislation, the 2016 session picked right up where the last session left off and was one of the most productive in recent years. As of the printing of this report in early July 2016: • Forty-six (46) health and hospital related bills have been enacted; • another fourteen (14) bills are awaiting enactment; and • thirty (30) bills were considered, but did not pass this session. Please note that when this report was printed, fourteen bills had passed both houses and were eligible for enactment. However, they had not yet been transmitted by the General Assembly to the Governor for signature. When the remaining bills are enacted into law, there will be an update to this report reflecting the appropriate chapter numbers and effective dates. Enacted Legislation Good Samaritan Overdose Prevention Act of 2016 Chapter 1 Chapter 2 H.7003 S.2002 The laws reinstated the 2012 Rhode Island law that expired in July 2015 exempting from liability and providing immunity to persons on probation and/or parole when he or she has administered an opioid antagonist to another person in order to prevent a drug overdose. Furthermore, if a person does not have access to an opioid antagonist and seeks medical attention for the person experiencing a drug overdose or the person experiencing a drug overdose seeks medical attention, they shall not be charged for possession of illegal substances. In addition, those who have administered an opioid antagonist or sought medical attention for someone experiencing a drug overdose may use this as a mitigation tool in drug arrests. Lastly, the attorney general and local law enforcement agencies are required to submit a report describing the impact of this act, including the number of instances in which local law enforcement was unable to charge an individual for drug possession because he or she administered an opioid antagonist or sought medical attention for someone experiencing a drug overdose. HARI was in support of this bill in the 2015 legislative year and continued its support at the beginning of 2016. Effective date: January 27, 2016 Rhode Island Family Home Visiting Act Chapter 28 Chapter 23 H.7220 S.2096 The Rhode Island Family Visiting Act directs the Department of Health (DOH) to develop and coordinate a statewide home visiting system for children and families at risk in Rhode Island. DOH is directed to work with the Rhode Island Departments of Human Services and Children, Youth and Families to identify appropriate and effective evidence-based home visiting models that would meet the needs of families with young children in need of services. Home visiting programs must be based upon models with comprehensive standards that ensure high-quality service delivery and demonstrate positive outcomes in early child development, health, and family outcomes. Additionally, a referral system shall be developed to identify potential children and/or families in need of services. Beginning in October 2016 DOH will also be 1 required to develop and make publically available an annual report on the components and outcomes of the State’s family home visiting program. Effective date: May 23, 2016 Public Utilities Commission – Information Accessibility Service for Persons with Disabilities Chapter 52 Chapter 45 H.7014 S.2051 Adds access to wireless telephones in the adaptive telephone equipment loan program that serves the need of Rhode Islanders who are deaf, hard-of-hearing, severely speech impaired, or who have neuromuscular impairments. Effective date: June 6, 2016 Rhode Island Health Information Exchange Act of 2008 – Authorized Access Chapter 71 Chapter 67 H.7866 S.2898 Introduced at the request of the Executive Office of Human Services (EOHHS), these laws amend the Rhode Island Health Information Exchange Act of 2008 to allow authorized individuals to access a patient’s confidential health care information from the Rhode Island Health Information Exchange, also known as Current Care. The laws specifically allow a patient, or their authorized representative, to designate a family member, practitioner, or other individual to also access the patient’s confidential health care information to aid in better coordination of the patient’s care. Health insurers are also authorized to access a patient’s confidential health care information for the purpose of providing care management services to its members or for quality and performance measure reporting. Effective date: June 6, 2016 2 Business and Professions – Collaborative Pharmacy Practice Chapter 72 Chapter 64 H.7949 SUB A S.2498 SUB A These measures amend the collaborative pharmacy practice statute to redefine the type of advanced training and experience required for pharmacists to work in collaboration with one or more physicians for the purpose of