Though the House returns in special session June 12 and the Senate may return later this month, most of the health-related legislative issues are finished for 2023.
It was a session full of back and forth on scope of practice and the health information exchange. Some positive moves were made and we kept a significant amount of negative legislation from moving.
Here is a rundown of the fate of some of the bills the OAFP was fighting, involved in or tracking.
After discussions throughout most of session, SB458, which would have provided independent practice to APRNs and nurse midwives, was not heard on the House floor when the House Republican caucus could not agree how the bill should look. The OAFP and other physician groups continued to stress the need for supervision standards and that giving APRNs independent practice would not increase access to care in rural areas. The bill remains dormant and could return next session.
Health Information Exchange – The legislature included $30 million for grants to help providers with costs of joining the HIE. Some organizations have questioned the constitutionality of requiring providers to join the system but the HIE will still go into effect July 1. Some providers, especially those in smaller practices, have been asking for exemptions. To find out more about exemptions, you can click this link. The OSMA also has created an FAQ as has the OHCA. The main page and link to join are here. We haven’t seen information yet about how to apply for grants.
Prior authorization – our request bills for creation of a gold card prior authorization system didn’t move since we noticed that our Texas counterparts were having issues with the measure they passed there. We will visit with them over the interim to see if there is a way to improve our legislation and will continue to visit with the health care authority to explore the possibility of adding Medicaid to the system.
Medicaid managed care – Legislators made no significant adjustments to managed care. The Oklahoma Health Care Authority announced June 8 that Aetna Better Health of Oklahoma, Humana Healthy Horizons of Oklahoma and Oklahoma Complete Health, a subsidiary of Centene, were selected as contractors. Contracts are through June 30, 2025, with options to renew. Implementation has been delayed until April 2024 rather than October 2023.
Mental health – measures proposed by the Health Minds Policy Initiative, and supported by provider groups, designed to improve access to mental health services, passed. The measures include SB442, which requires insurers to provide accurate directories of providers, SB254, which requires insurers to charge no more for out-of-network care than they would for in-network care when the patient is unable to find in-network services in a timely manner and SB444, which requires coverage for benefits delivered through certain collaborative care models involving primary care and other physicians.
All measures that proposed changes to the medical board are dormant. One of those, SB303, would have removed the requirement that appointees be taken from a list provided by the Oklahoma State Medical Association and instead stated that the governor, speaker of the House and pro tempore of the Senate may, rather than shall, select from physician and physician assistant organizations. It also stated that appointees may be removed without cause. Other bills that are also dormant, would have allowed more people, such as medical school faculty, to serve on the boards.
Safety – Two measures, HB2154 and HB2172, are designed to improve safety for medical professionals and staff. HB2154 extends protections of assault and battery against health care professionals to all health care facility personnel. HB2172 adds medical care provider to the list of persons it is a crime to threaten, intimidate or harass by use of an electronic communication device by knowingly publishing, posting or making available personally identifiable information.
Other measures of note:
SB931 – the measure that would have expanded duties of pharmacists was not heard in the House Public Health Committee after heavy opposition.
HB1709 – which would have increased the number of SoonerCare patients an APRN can see to 2,500 was not heard in Senate committee.
The legislature passed SJR22 for administrative rules which disapproved Oklahoma Medical Board rules regarding prescribing for physician assistants. Thus, the practice will remain with current medical board rules which do not allow prescriptive authority off site.
All bills dealing with Immunizations are dormant as are other bills that seemed to have support from anti-vaccination groups though they weren’t related to immunizations. Those included SB165, which would have prohibited cities from fluoridating water, and HB2181, which dealt with head lice regulations at schools.
HB2853 – which would have required PBMs and insurance companies to pass on to patients any negotiated savings on medicines, made it through the House but is dormant in the Senate.
HB1890 – which would have allowed patients to file suit to determine if a provider was out of compliance with transparency statutes and prohibit providers from taking collective action while a lawsuit is pending, is dormant.
HB1956 – The measure would instruct the Oklahoma Tax Commission to garnish wages rather than notifying a delinquent taxpayer that their state license will not be renewed until the taxpayer comes into compliance.
SB1094 – Updates the current medical power of attorney statute allowing parties to sign in front of a notary or two witnesses.
HB1657 – This measure requires the Oklahoma Health Care Authority to streamline the process for Medicaid provider enrollment and credentialing for any fee-for-service and managed care systems.
HB2747 would have created the Office of Alzheimer's Disease and Related Dementia Resource Coordination within the State Department of Health and required the State Department of Health to publish an Alzheimer’s Disease and Related Dementia State Plan and update it every four years. The governor vetoed this measure stating that the federal government, through the National Institutes of Health, is addressing this.
