March 14, 2016 VOLUME 28, ISSUE 9
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March 14, 2016 VOLUME 28, ISSUE 9 Welcome to the 9th issue of award-winning Health Care Highlights for 2016. This year marks the 28th year of our unique health care publication. Our newsletter reaches more than 5,000 health professionals and health policymakers. In this issue, we provide an EXECUTIVE SUMMARY of key health-related enactments during the 60-day session. Hooray, it's over! The second regular session of the 82nd Legislature ended at midnight Saturday. Lawmakers return this week to work only on the state fiscal year 2017 budget during the three-day extended session authorized by Gov. Earl Ray Tomblin. Several important decisions will be made regarding funding of many health programs, and we will report the outcome on the Budget Bill to you next week. During this year’s regular session, lawmakers introduced 1,180 bills in the House of Delegates and 700 bills in the state Senate. Of the 1,880 total bills introduced this session, about 291 were health care-related bills (15.4%). The Legislature enacted a total of 276 bills (15%) during the session. We profile in this issue the 51 (17.5%) health care bills that passed. Many already have been signed into law by Gov. Earl Ray Tomblin; others await his approval. Now that the regular legislative session has ended, the Governor has 15 days following the receipt of a bill to veto, sign or allow it to become law without his signature. On the other hand, there were 240 health-related bills that did not pass. In addition, the Legislature considered 14 resolutions requesting health-related interim studies. These do not require passage by the Legislature or approval by the Governor. They simply “request” that the Legislature create interim study committees. The Legislature may decide to study any topic during the interim period between now and next January, even if there has not been a resolution proposed or adopted. Decisions on interim study topics will be made by the Joint Committee on Government and Finance in April or May. See inside this issue for a preview of the resolutions. We are glad to have you in our subscriber communications network! Subscription information and rates for non- subscribers are available by calling 304-344-8466 or by e-mail to [email protected]. Please respect the publication’s privacy rights as other use of the newsletter’s material is protected by copyright and requires written permission from the publisher. Health Care Highlights is published weekly during the regular legislative session and monthly during the interim periods between legislative sessions by the firm Government Relations Specialists, LLC. 1 | P a g e Health Care Highlights Volume 28, Issue 9 March 14, 2016 Governor Issues Proclamation to Extend Session for Budget Bill Gov. Earl Ray Tomblin on Wednesday issued a proclamation, as required by the state Constitution, to extend the 2016 legislative session for three additional days until Tuesday (March 15) to allow for further consideration of the budget bill (SB 269). The proclamation specifies the Legislature shall only consider the budget bill during the extended session. If the Legislature is unable to complete budget work by then, the Governor could extend the session for a few more days, or call for a special session at a later date, to be determined (which is the best guess at the Capitol.0 Budget conferees named by the House of Delegates include Finance Committee chair Eric Nelson and Delegates Bill Anderson, Eric Householder, Carol Miller and David Perry. Budget conferees named by the Senate include Finance Committee chair Mike Hall and Sens. Robert Plymale, Roman Prezioso, Dave Sypolt and Chris Walters. Amended APRN Bill Removes Schedule II Drugs A Senate floor amendment to HB 4334, which expands the scope of practice for advanced practice registered nurses (APRNs), removes prescriptive authority for Schedule II controlled substances such as oxycontin and morphine. It allows APRNS to apply for independent practice after three years of collaboration with a physician, establishes a 13-member Joint Advisory Council on Limited Prescriptive Authority, and allows APRNs to sign death certificates following training, along with certain other health-related documents. The Senate passed a similarly amended version of the bill on Thursday on a 34-0 vote. The House had passed the measure on Feb. 27 on a 72-20 vote, with eight members not voting. The bill now goes to Gov. Earl Ray Tomblin. “I think the bill could have been a little stronger, for both sides,” Sen. Tom Takubo said Thursday. “This has absolutely nothing to do with individuals; it has everything to do with experience.” Sen. Ron Stollings called the amended bill “an artful compromise” that “will help strengthen the entire health care delivery system in West Virginia.” Missing from the final version is any requirement for independent APRNs to practice in rural, medically underserved areas. A House floor amendment Saturday evening established the Advisory Council as gubernatorial appointments. The Board of Examiners for Registered Professional Nurses, the WV Board of Medicine, the WV Board of Osteopathic Medicine and the state Board of Pharmacy will make selections to the Advisory Council for official appointment by the Governor. The APRN Advisory Council will consist of 13 members, including: Six APRNs with at least three years of full-time practice experience, and consisting of at least one certified nurse practitioner, one certified nurse-midwife, and one certified nurse anesthetist; Two licensed allopathic physicians who are in a collaborative relationship with APRNs; Two licensed osteopathic physicians who are in a collaborative relationships with APRNs; One licensed pharmacist; One consumer representative; and, One representative from a school of public health or institution of higher education. The council will choose its own chair and will meet at least biannually. It is charged with reviewing applications for APRNs to prescribe limited drugs without a collaborative agreement, and reviewing and advising on complaints against APRNs, among others duties. The introduced version of the bill (which did not pass) would have expanded APRN prescriptive authority to include no more than a 72-hour supply of Schedule II drugs, up to a 30-day supply of Schedule III drugs and up to a 30-day supply of Attention Deficit Disorder medications. The bill also removed collaborative relationships with physicians as a continuing requirement of practice, but retaining the collaborative relationship requirement for a two-year period as a prerequisite to qualify for prescriptive authority, and permitted the signature of an APRN to have the same force and effect as that of a physician insofar as patient care documentation is concerned. 2 | P a g e Health Care Highlights Volume 28, Issue 9 March 14, 2016 Telemedicine Bill Sails Through Legislature A bill which permits, defines and establishes licensing requirements for physicians and podiatrists to utilize telemedicine technologies passed both the Senate and House of Delegates unanimously en route to Gov. Earl Ray Tomblin’s desk. The bill, HB 4463, also limits prescribing controlled substances by requiring a physical encounter and original prescriptions for Schedule II medications. The legislation bill contains consumer protections and follows national standards in clarifying that the practice of medicine takes place where the patient is located. That means a provider must be licensed in West Virginia to treat West Virginia patients. Under amendments adopted by the House Committee on Health and Human Resources, the physician is required to inform the patient of his or her physical location and to provide contact information. Advances in broadband technology, coupled with telemedicine, are expected to expand access to care for a variety of medical specialties into rural areas of the state. The Interstate Medical Licensure Compact, which currently supports medical licensure portability between 12 states, will also aid in expansion of telemedicine. Early Eye Drop Rx Bill Passes Unanimously The Early Eye Drop Prescription Refill Bill (HB 4038), which allow patients to request a refill on their prescription after at least 70% of the predicted days of use, or on day 21 of a 30-day prescription, passed both House of Delegates (Jan. 26) and the Senate (on Friday) by unanimous vote en route to Gov. Earl Ray Tomblin. If signed by the Governor, West Virginia will join 18 other states (including surrounding states Maryland and Kentucky) in adopting the legislation. States where early eye drop prescription refills already are allowed include: Alaska, Connecticut, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Missouri, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Utah, Washington and Wyoming. Five other states have bills under consideration, including Louisiana, Massachusetts, Nebraska, North Carolina and South Carolina. The goal of the legislation, an interim bill recommended by the Joint Committee on Health, is to prevent gaps in care that could result in a regression in the treatment of serious eye conditions such as glaucoma and other degenerative eye diseases. The legislation assures the continuation of quality patient care for those who suffer from these conditions and are required to use daily eye medication. The medications are essential for the preservation of sight, but often, prescription eye drops run out well before the refill date. The West Virginia Academy of Eye Physicians & Surgeons (ophthalmologists) strongly supported this legislation, which is modeled after a bill introduced late in the 2015 session. The legislation also has been supported by the West Virginia Association of Optometric Physicians, the West Virginia Academy of Family Physicians, the American Academy of Ophthalmology and the American Glaucoma Society. In addition, the U.S. Centers for Medicare & Medicaid Services issued a policy memorandum or “guidance” in support of the concept in June 2010. Air Ambulance, UPL Bills Await Signature An air ambulance bill (HB 4315) spotlighted by Gov.