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OAR 2020 Legislative Summary

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OAR 2020 Legislative Summary OAR 2020 Legislative Summary As 2020 comes to an end, the Ohio Association of Rheumatology is proud to say that despite the disruptions and unexpected challenges of the COVID-19 pandemic, we made considerable strides with our advocacy goals this year and built upon a foundation that will hopefully help us achieve more in the coming year. With a new general assembly set to begin in January, any introduced legislation not passed by the end of December must start back at the beginning of the legislative process. Even though our major bills were not passed out of the legislature in 2020, we are pleased with the progress made on the issues our members care deeply about, and we will continue to push for meaningful change for Ohio into 2021. Here's a summary of the work on our major legislative issues from this year: • Non-Medical Switching Non-medical switching occurs when patients are forced to switch to a different medication in the middle of a plan year for no medical reason due to formulary changes from the health insurer. HB 418 proposed placing restrictions on removing a medication from a prescription drug formulary during a plan year. Additionally, the bill sought to prohibit private health plans from increasing patient cost-sharing or from moving drugs to a more restrictive tier during a plan year. OAR supported HB 418 as a major priority issue, and the bill was deliberated upon in several hearings in the House Health Committee since its introduction in November 2019. In January, Dr. Stephanie Ott, OAR President, provided proponent testimony on HB 418, alongside a number of other witnesses testifying on behalf of Ohio physicians and health care organizations. In her testimony, Dr. Ott described the often difficult process of managing disease and chronic conditions, and how many patients need to try several medications before finding the most effective treatment. “Even slight derivations in treatment and variations between drugs, even those in the same therapeutic class, can cause serious adverse events. Aside from needless suffering, the resulting disease progression can be irreversible, life threatening, and cause the patient’s original treatment to lose effectiveness. It cannot be assumed that a treatment that works for one patient will work for each patient.” Because non-medical switching disrupts a physician’s ability to exercise their medical expertise and help their patients, this issue remains a huge priority for OAR and we will seek to have this legislation reintroduced in the 134th General Assembly next year. • Co-pay Accumulator Health plans and pharmacy benefit managers (PBMs) may apply co-pay accumulator adjustment policies when patients attempt to use copay assistance programs. These prohibit a patient’s copay assistance amount from count toward their deductible and maximum out-of-pocket cap. HB 469, introduced in January 2020, would require health insurers and PBMs to count all payments made by patients directly or on their behalf toward their deductibles and out-of- pocket costs, increasing predictability as vulnerable patients face high out-of-pocket costs for their prescriptions. The physician community has raised their voices about the devastating financial impact, and in turn, poor health outcomes patients face due to policies like copay accumulators. OAR was a supporter of this bill, which was sponsored by Rep. Susan Manchester (R- Waynesfield) and Rep. Thomas West (D-Canton). The bill had a series of hearings in the House Health Committee. Dr. Ott also submitted proponent testimony in written form for this bill’s June hearing, expressing deep concerns about co-pay accumulator programs allowing insurers to “double-dip” on a patient’s deductible, making treatments even more difficult for patients to access and maintain. “…without placing restrictions on the use of copay accumulator adjustment programs, patients will be unable to afford the medications they need for treating their chronic disease,” Dr. Ott urged the committee to support HB 469 in order to uphold continuity of care for Ohio patients. The federal government has not made progress on solving this problem, and OAR hopes to get Ohio into a better place with regard to restriction of patient’s access to their treatments. We will seek to pick up with this issue again in the New Year. • Scope of Practice - APRN Independent Practice OAR advocates for team-based care with the physician at the head of the care team. For years, the legislature has been asked to act in response to a variety of independent practice proposals for APRNs. This general assembly, the issue of APRN independent practice arose again in HB 177, sponsored by Rep. Tom Brinkman (R-Mt. Lookout). Amid the pandemic, a different version of the bill surfaced, which sought to allow independent practice for both APRNs and physician assistants for the duration of the COVID-19 emergency. After the physician and hospital community expressed objections to this substitute bill, it was pulled from committee and no longer considered. OAR joined with the rest of the House of Medicine to oppose this legislation and will urge legislators to support the physician-led team-based care model in the New Year. Physicians have serious concerns about termination of the standard care arrangement between APRNs and physicians, including those related to patient safety. 2021 Look Ahead Senator Matt Huffman (R-Lima) has been unanimously elected to serve as Senate President for the 134th General Assembly, and further Senate leadership includes Senator Jay Hottinger (R-Newark) as President Pro Tempore, Senator Kirk Schuring (R-Canton) as Majority Floor Leader, and Senator Rob McColley (R- Napoleon) as Majority Whip. Their formal election and swearing-in is scheduled for January 4th, 2021. Key Minority Leadership members in the Ohio Senate will include Senators Kenny Yuko (D-Richmond Heights) as Minority Leader, Cecil Thomas (D-Avondale) as Assistant Minority Leader, Nickie Antonio (D- Lakewood) as Assistant Minority Whip and Tina Maharath (D-Canal Winchester) as Assistant Minority Whip. Speaker of the Ohio House Bob Cupp will continue to serve into the new general assembly as Speaker of the House along with Representatives Tim Ginter (R-Salem) as Speaker Pro Tempore, Bill Seitz (R-Green Township) as Majority Floor Leader, Rick Carfagna (R-Genoa Township) as Assistant Floor Leader, Don Jones (R-Freeport) as Majority Whip and Cindy Abrams (R-Harrison) as Assistant Majority Whip. Their formal election and swearing-in with also be on January 4th, 2021. Key Minority Leadership members in the Ohio House will include Representatives Emilia Sykes (D-Akron) as Minority Leader, Kristin Boggs (D-Columbus) as Assistant Minority Leader, Paula Hicks-Hudson (D- Toledo) as Minority Whip, Richard Brown (D-Canal Winchester) as Assistant Minority Whip, and Phil Robinson (D-Solon) as Caucus Chair. The House Health Committee will most likely continue under the leadership of current Chairman, Representative Scott Lipps (R-Franklin) who has been instrumental in the progress of our legislative initiatives. The Senate Health Committee will lose its current Chairman in term limited Senator Dave Burke (R-Marysville) but with two physicians as Senators now in the Ohio Senate, it is anticipated both will have key positions on the Senate Health Committee next year. Thank you for your continued support of OAR during this challenging year. We wish you a happy and healthy holiday season and look forward to continuing to serve you in the new general assembly. .
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