July 2013 63rd Legislative Assembly Recap July 2013 1 July 2013 North Dakota Medical Association In this Issue The mission of the North Dakota Medical Association is to promote the health and well-being of the citizens of North Dakota and to provide leadership to the medical community. Submissions ND Physician welcomes submission of guest columns, articles, photography and art. NDMA reserves the right to edit or reject submissions. All contributions will be returned upon request. Advertising NDMA accepts one-quarter, one-half and full- page ads. Contact our office for advertising rates. ND Physician is published by the North Dakota Medical Association, 1622 E. Interstate Ave., P.O. Box 1198, Bismarck, N.D. 58502-1198, Phone: 701.223.9475, Fax: 701.223.9476 E-mail: [email protected] Katie Cashman, Editor Copyright 2013 North Dakota Medical Association. 63rd Legislative Assembly Recap ................................... 12 All rights reserved. North Dakota Medical Association Council Officers A. Michael Booth, M.D., President Steven P. Strinden, M.D., Vice President Debra A. Geier, M.D., Secretary-Treasurer Fadel E. Nammour, M.D., Speaker of the House Kimberly T. Krohn, M.D., Immediate Past President Robert W. Beattie, M.D., AMA Delegate Shari L. Orser, M.D., AMA Alternate Delegate Councilors Joseph E. Adducci, M.D. Misty K. Anderson, D.O. Stephanie K. Dahl, M.D. Catherine E. Houle, M.D. Timothy J. Luithle, M.D . Steven R. Mattson, M.D. Fadel E. Nammour, M.D. Mark W. Rodacker, M.D. Signing of SB 2323 ....................................................... 20 Sarah L. Schatz, M.D. Shelly A. Seifert, M.D. Randolph E. Szlabick, M.D. Physician Advocate .............. 3 NDMA Awards ..................... 7 Rory D. Trottier, M.D. Harjinder K. Virdee, M.D. Dennis E. Wolf, M.D. NDMA in Action ................... 5 ND Health Info Network .........8 Commission and Pac Chairs Parag Kumar, M.D., Socio-Economics Fadel E. Nammour, M.D., Legislation and A New Era ......................... 6 2013 Legislative Summary ... 12 Governmental Relations Shari L. Orser, M.D., Medical Services and Public Relations Rolf R. Paulson, M.D., Ethics Advertise in our next issue! Keith D. Rau, M.D., Medical Education Thomas I. Strinden, M.D., NDMA PAC NDMA accepts one-quarter, one-half and full-page ads. Contact NDMA at: 701.223.9475 • [email protected] Staff Courtney M. Koebele, Executive Director Advertise Katie Cashman, Communications Director Leann K. Benson, Chief Operating Officer On the cover Annette Weigel, Administrative Assistant Governor Jack Dalrymple speaking during the State of the State address, delivered in the House Legislative Chamber on January 8, 2013. Photograph provided by Garry Redmann, North Dakota Department of Transportation 2 ND Physician Physician Advocate Perspectives of the Sixty-Third Legislative Assembly of North Dakota from our President: Lessons Learned nother legislature has come The biggest problem facing the Aand gone in Bismarck. This was legislature was dealing with an my 12th go-round as a member underdeveloped infrastructure in oil of the NDMA and this time it country. Flooding had also struck the was my privilege to serve you as western part of our state during the your president. The real work, of past biennium, devastating Minot and course, was done by our executive remaining a perennial headache in the director, Courtney Koebele, and Red River Valley. Fortunately, with the A. Michael Booth, M.D. our communications director, Katie large reserves built by tax collections Cashman. As always, Leann Benson that wildly exceeded projections, this of a program to facilitate credit checks and Annette Weigel kept the office in legislature had plenty of funding to on patients. order and the rest of us on schedule. deal with these problems. With the approval of the expansion of Medicaid under the Affordable Care Fortunately, with the large reserves built by tax collections Act, there should be a real benefit that wildly exceeded projections, this Legislature had plenty to most of our practices. There were of funding to deal with these problems. It did just that and also some interesting nuances in the still managed to cut income taxes and provide more property manner in which this expansion was tax relief. passed, which, if extended to the rest of North Dakota’s Medicaid program, could lead to some substantial administrative improvements overall. Many of our physician members It did just that and still managed to Lesson learned: decisions are easier invested a considerable amount of cut income taxes and provide more when your uncle is paying the time, as well. There were too many property tax relief. You can read about Medicaid bill. to mention, but I would like to give it in the newspapers. Lesson learned: a special thanks to Stephanie Dahl, life is good when you have lots of cash Michael Gonzales, Gaylord Kavlie, in your treasury. Shelly Killen, Kim Krohn, Doug Our medical school has Litchfield, Michael Moore, Shari Orser, For medicine, the main concerns were come of age, in no small Steve Strinden, and Charlie Volk for maintaining our Medicaid rebase that part through its ability to their efforts. Also, a special thanks to we had received four years ago and engage in strategies that those who served as Doctors of the providing some relief from the bad make its mission truly a Day, including the UND residents. debt problems that have been dogging community-based effort You really put a caring, human face on physicians and hospitals, in the that emphasizes team- our profession! western part of the state in particular. building rather than the We were treated well: physicians did increasingly obsolete North Dakota entered this session receive a Medicaid payment update riding the crest of an unprecedented identical to that received by other ivory-tower model. wave of cash, thanks to the rapid providers. This, in part, seemed to development of the Bakken oil field. be due to the fact that our legislators By the end of the session, new have begun to recognize that our One of the most important issues projections suggested that the addition increasingly integrated clinic systems for NDMA, and one that will likely of the Three Forks reserves will mean that those updates are going become a signature act of this make this growth even stronger than for much more than just physician’s Legislature, was the funding of a expected at the start of the session. salaries. Moreover, where small significant expansion of the UND Happily, our agricultural sector clinics remain, particularly in our School of Medicine and Health has remained strong and our other smaller towns, Medicaid cuts tend to Sciences, and the construction of energy sectors, particularly electrical disproportionately hurt access to care. a new medical school building in generation, have continued to perform The legislature’s approach to bad debt Grand Forks. Dr. Josh Wynne did an well. Unemployment is low. was a little less direct, with the passage outstanding job championing this July 2013 3 Continued from previous page... We also had a number of other successes: mandatory reporting of abuse of the elderly and disabled became law. The ban on bottle rockets survived yet another challenge. We were able to fend off an attempt by the State Board of Pharmacy to create a statewide license for those prescribing scheduled drugs. effort, which our organization solidly amendment were introduced. Had all of these been enacted, they would have backed. Our medical school has come eliminated virtually all elective abortions in North Dakota, except that in of age, in no small part through its situations where the mother’s life was physically threatened and they would ability to engage in strategies that have also shut down in vitro fertilization in this state (Fact: 1 to 2 % of all live make its mission truly a community- births in this country are now the result of in vitro fertilization). The executive based effort that emphasizes team- committee of your NDMA Council, faced with this, met in February to respond. building rather than the increasingly We found that our Ob-Gyn colleagues were being seriously threatened by obsolete ivory-tower model. Lesson this legislation. These bills made no exceptions for rape or incest. They also learned: doing your homework and criminalized the physicians performing the abortion while absolving the woman listening to your stakeholders does of any legal culpability for seeking the abortion in the first place. SB 2305 placed have its rewards. an unprecedented restraint on the practice of medicine in our state by requiring a physician to have local hospital privileges before performing an abortion in We also had a number of other a free-standing facility, a principle that could be used in the future to further successes: mandatory reporting of restrict the operation of other outpatient surgery facilities. After considerable abuse of the elderly and disabled debate, the committee opted to step up and declare our organization in became law. The ban on bottle rockets opposition to these measures. Our position clearly provoked some controversy survived yet another challenge. We but it did have some noticeable impact. Ultimately, we were able to help defeat were able to fend off an attempt SB2302 and SB2303, which would have effectively ended in vitro fertilization in by the State Board of Pharmacy this state. The other measures did pass, and unfortunately, if implemented, will to create a statewide license for still create problems for our Ob-Gyn colleagues, particularly as they attempt to those prescribing scheduled drugs. manage complicated mid-term pregnancies. It is widely anticipated that the four They wanted their funding for laws that were passed and signed will be challenged in court. The constitutional the Prescription Drug Monitoring measure, which would imbed the “personhood” concept in our state’s Program to be independent of a direct constitution, will be on the 2014 general election ballot.