Advocacy Update (Q1 2020)

This posting is intended to provide an update in 3 sections:

  1. Activities

  2. Policy issues and brief status report

  3. Political year update

Activities

Public Policy Committee: chaired by Drs. Stephanie Costa and Bill Cotton, has 3 main purposes:

  • Review status of legislation

  • Determine any role or next steps

  • ID if there are any new initiatives to consider

Political Action Committee: has 2 main purposes:

  • Oversee activities and decisions about contributions from our small PAC

  • Oversee our candidate recommendation for endorsement process


Upcoming is the 2020 First Quarter meeting of both the CMA’s Public Policy and PAC Committees:

  • Thursday, March 19 at 6:00 p.m. is the PP meeting.
    The CMA PAC meeting will begin immediately after the conclusion of the Policy meeting.

  • Other meeting dates for the remainder of 2020 are scheduled for:

    June 24 | September 17 | November 12

New this year: CMA “Advocacy Day”

The CMA’s Public Policy Committee will be sponsoring its first ever official Advocacy Day for to talk to legislators about issues of concern to CMA physicians. Open to any topic that a physician might want to address and/or pick up banner on a CMA perspective of evidence-based medicine around bills

  • Monday, March 30 6:00 p.m. Training at CMA offices with State Representative Beth Liston, MD, to help physicians learn about effective interactions with legislators …an educational/background video will be available to help physicians become comfortable with the processes involved.

  • Wednesday, April 1 various times: A day when both the Senate and House are scheduled to be in Session, so legislators will be at the Statehouse. Meetings with individual legislators can be arranged around physicians’ personal availability that day.

More details to follow. Contact Lisa Oyer (Loyer@ColumbusMedicalAssociation.org)

Legislative Update

In January and February, the Ohio General Assembly returned for some limited sessions in advance of the March primary. This year is expected to be a volatile political year with limited session days as the calendar moves towards November.

School funding and specifically challenges with measuring underperforming and its impact on the availability of public dollars to subsidize school choice by parents is dominant issue impacting calendar.

Here is a brief update on selected issues/legislation related to the practice of medicine:


CRNA’s Scope of Practice: HB 224
This bill moved out of the House Health Committee and was passed by the House of Representative by a vote of 94-2 and is getting hearings in Senate. After being stalled for several sessions, this idea moved forward largely as the result of a compromise provision that

  • Provided an option for a supervising physician to opt out of the expanded authority if they believe it is in the best interest of the patient.

  • Also, the bill does not grant authority for CRNA’s to write outpatient prescriptions.

As a result of the compromise, major physician groups were neutral on the bill. The bill beginning to have Senate Health, Human Service and Medicaid Committee hearings.


Price Transparency: SB 97
This issue has been the subject of considerable activity in recent years, including attempts to address the issue in state budget bills, vetoes by the Governor, and lawsuits by major provider groups, include the OHA and OSMA. This year an attempt at a workable system has emerged from the committee process in the Ohio Senate with broad provider support. The bill unanimously passed the Senate and has had its first hearing in the House Health Committee.



Remaining in committee getting hearings; however, with significant challenges:

  • APRN’s independent practice: HB 177. This bill had hearings in the House Health Committee this month; but remains in the committee for further consideration. Some changes were adopted; however, physician groups were not a part of development of any of the changes and strong concerns remain about the impact on patients and functioning of physician-led patient care teams.

  • Psychologist prescriptive authority: HB 323. This bill remains in the House Health Committee after having one hearing that featured proponent testimony. Unresolved issues are many, including level of education/training and lack of a formulary, and a collaboration agreement with physicians.

  • Mental health parity: HB 443. Received an initial sponsor presentation to the House Health Committee. The bill intends to align Ohio statutes with federal law for the levels of required services.

  • Surprise billing: SB 198 and HB 388. These bills remain in committee in their respective chambers. There is general agreement on removing patients from the middle of a surprise billing situation and eliminate balance billing, however no agreement:

    • SB 198 is generally supported by providers, including major physician groups.

    • HB 388 is generally support by payers.

At the core of the differences is the payment dispute determination via SB 198’s mandatory arbitration provisions vs HB 388’s approach of benchmark pricing.



Other issues in various bills are listed below. Contact Malcolm Porter (malcolmjporter@aol.com) for more information.

  • First responder PTSD

  • Gun regulations

  • Adverse pediatric impacts resulting from traumatic events

  • Medication switching prohibitions

  • Health education standards

  • Mandatory nurse overtime standards

  • Insulin costs

  • Fireworks

  • Juvenile tanning bed use

  • Conversion therapy


Note about Prior authorization. Thanks to those practices who completed the comprehensive survey regarding the current prior authorization landscape. Results of the survey were compiled at the end of 2019 and analysis is ongoing. Based on the outcomes of the research will determine whether appropriate next steps will be with the Ohio Department of Insurance, additional legislation, or some other activity.

Political Action Committee Summary

At the March meeting, the Political Action Committee will discuss

  • plans for a June PAC fundraiser

  • consider a budget outline for 2020 contributions from the PAC

  • discuss plans for Central Ohio officeholder/candidate interviews for US Congress, Ohio Senate, Ohio House of Representatives. Watch for dates, in middle of the year

Note: This is an opportunity for any physician to attend screenings and ask questions to all members of the Central Ohio legislative delegation and their opponents.

Remember: Ohio’s Primary is March 17th and early voting is now available to any registered voter.

AdvocacyMalcolm Porter