Weekly Legislative Update: May 27, 2022


REGULAR SESSION ENDS/SPECIAL SESSIONS CALLED

The 58th Session of the Oklahoma Legislature has come to a close. Irrespective of Medicaid privatization through the incorporation of insurance based managed care, the medical community and physician profession had a tremendously strong session.

A significant issue needing to be addressed this session was replacing “medical power of attorney” language back into the statute. The language was mistakenly repealed last year. This was accomplished with the passage of SB 1596 (Howard/Stinson).

Some other highlights of this session include:
  • No distinctive “scope of practice” measures were passed
  • Stopped measure allowing PA oversight from unlimited number of physicians
  • Defeated legislation allowing PT’s to provide unsupervised diagnosis and treatment
  • Stopped measure allowing pharmacists to conduct screening tests without physician authorization
  • Defeated legislation allowing chiropractors to inject drugs, serums or vaccines
  • Stopped all anti-vaccination measures
  • Stopped measure allowing contagious children to attend school
  • Defeated effort to eliminate OSMA input and vetting of prospective members to the Medical Licensure Board
  • Created statutory Chief Medical Officer (CMO) position at OSDH
  • Passed insurance coverage requirement for breast diagnostic exams
  • Supported measure to allow Licensure Boards to provide temporary licenses to health care practitioners/providers upon an emergency declaration

With regards to Medicaid reform, SB 1337 (McCortney/McEntire), designed to “privatize” Medicaid by incorporating managed care insurance administration, was signed into law this week. The measure provides that the Oklahoma Health Care Authority (OHCA) shall award no less than three statewide Medicaid “capitated contracts” for “contracting entities” and/or “Accountable Care Organizations” (i.e. provider networks). These will cover the Medicaid expansion population; pregnant women, children, newborns and parents & caretaker relatives. Contracts will become effective no later than October 1, 2023.

Due to OSMA’s coalition building, diligence and discussions with the bill’s authors, several pro-physician provisions were included in the final measure. Those items include:
  • An “anti-discriminatory” provision requiring plans to offer contracts to independent practitioners not affiliated with a hospital network
  • Clean claims to be paid within fourteen (14) days
  • Plans shall meet all established prior authorization requirements
  • Standardized drug formulary for all plans
  • Physicians and providers may contract with multiple plans
  • After the fourth year of the initial contracting period, each plan shall spend a minimum of eleven percent (11%) of its total health care expenses on primary care services

The companion bill, SB 1396 (McCortney/Wallace) providing the funding mechanism through the Supplemental Hospital Offset Payment Program (SHOPP), was also signed by the Governor. OSMA was neutral on that measure.

In additional news from the Capitol, the legislature initiated a “Special Session” last week designed to help the Governor prioritize the $1.8 billion in federal “American Rescue Plan Act” (ARPA) stimulus funds. The Special Session is currently ongoing and is expected to continue in the late summer or early fall.

In response to the $9.8 billion budget sent to his desk, the Governor, in turn, line-item vetoed a handful of budget items and called his own “Special Session” to be convened on June 13, the middle of primary campaign season. He expressed his disappointment that the budget did not include an elimination of the state’s grocery tax (which was seriously considered by the legislature this year) or a significant reduction in the state income tax. All the Governor’s budget vetoes were overridden.

LEGISLATIVE ISSUES IMPORTANT TO OSMA

MEDICAID MANAGED CARE

SB 1337 (McCortney/McEntire) – Language drafted by the Oklahoma Health Care Authority (OHCA) allows for the creation of capitated Medicaid health insurance plans was filed this week. Sen. McCortney and Rep. McEntire continue to work with OSMA on language favorable to the state’s Medicaid patient population as well as physicians and other medical providers (Conference Committee Report Adopted; Passed Senate; Passed House; Signed by Governor) OSMA OPPOSES

LEGAL REFORM

SB 1596 (Howard/Stinson) – Creates the Oklahoma Health Care Agent Act which establishes standards and procedures for adults and emancipated minors to designate medical power of attorney to an agent should they become medically incapable. The measure restores stricken language from last year which mistakenly repealed provisions dealing with a power of attorney for health care. (Passed Senate; Passed House; Signed by Governor) OSMA SUPPORTS

GENERAL GOVERNMENT

HB 2776 (Pfeiffer/Montgomery) – Creates the Health Care Workforce Development and Finance Act for recruiting & educating the state's health care workforce and directs the Health Care Workforce Training Commission to administer the loan repayment program. (Revises and updates Physician Manpower Training Commission (PMTC) (Passed House; Passed Senate; Sent to Secretary of State without Governor’s signature) OSMA NEUTRAL

HB 3319 (Miller/Haste) – Permits the boards of nursing, osteopathic examiners, and medical licensure and supervision, to grant a health care provider a temporary license when an emergency has been declared by certain entities and provides guidelines for the license (Passed House; Amended and Passed Senate; back to House to consider Senate Amendments; House concurred with Senate Amendments; Signed by Governor) OSMA SUPPORTS

SB 709 (Rosino/Roe) – Provides that the State Commissioner of Health serves at the pleasure of the Governor and is exempt from certain qualifications so long as they hold at least a master's degree and certain related experience. AMENDED TO INCLUDE THE STATUTORY CREATION OF A CHIEF MEDICAL OFFICER (Passed Senate; Passed House as Amended; Senate Passed with House Amendments; Signed by Governor) OSMA SUPPORTS

SB 1322 (Pugh/Martinez) – Permits physician assistants operating under certain practice agreements to sign death certificates and take other related actions; amended to restate when PA’s can prescribe narcotics (Passed Senate; Passed House; Signed by Governor) OSMA OPPOSES

INSURANCE

HB 3504 (Provenzano/Stanley) – Requires all health benefit plans provide coverage for certain breast cancer diagnostic examinations (Passed House; Passed Retirement & Insurance Committee; Title Stricken*; Passed Senate as amended; Back to House to consider Senate amendments; Passed House; Signed by Governor) OSMA SUPPORTS

MENTAL HEALTH

SB 1307 (Coleman/Vancuren) – Requires schools that issue student identification cards to include numbers for the National Suicide Prevention Lifeline and the Crisis Text Line and permits higher education institutions print similar information on student IDs (Passed Senate; Passed House Floor; Signed by Governor) OSMA SUPPORTS

SB 1413 (Montgomery/Sneed) – Directs the Insurance Department to conduct a market conduct examination to analyze certain limitations on mental health parity by health providers. (Passed Senate; Passed House Public Health; Passed House Floor as Amended; House concurred with Senate amendments; Signed by Governor) OSMA SUPPORTS

WOMEN & CHILDREN HEALTH

HB 4327 (Stearman/Daniels) – Permits individuals to bring certain civil actions against any person who performs or assists in the performance of an abortion in any way. (Passed House; Passed Senate Floor as amended; Passed House; Signed by Governor) OSMA OPPOSES**

SB 612 (Dahm/Olsen) – Relates to abortion by imposing a fine or prison sentence on any person purposely performing an abortion except to save the life of the mother (Carry over bill from 2021; Passed Senate; Passed House; Signed by Governor) OSMA OPPOSES**

SB 1100 (Bergstrom/Dills) – Limits the designation of a newborn's gender on birth certificates to only male or female and specifically prohibits nonbinary designations (Passed Senate; Passed House, Signed by Governor) OSMA OPPOSES

SB 1503 (Daniels/Russ) – Creates the Oklahoma Heartbeat Act which disallows abortion if a fetal heartbeat is detected and allows certain individuals to bring civil action against certain persons they know to have performed or undergone an abortion (Passed Senate; Passed House Public Health; Passed House; Signed by Governor) OSMA OPPOSES**

**OSMA understands the moral implications of the abortion issue; however, as long as the practice remains permissible at the federal level, OSMA opposes the criminalization of this legal medical procedure.

*Title Stricken means the language in the measure continues to be in a drafting stage and a work in progress.