Legislative Update as of June 1, 2019

THE FIRST SESSION OF THE 57TH LEGISLATURE

Governor Stitt completed his consideration of the more than 530 bills and joint resolutions sent to him by lawmakers during the 2019 regular session Wednesday. In the course of the session, Stitt signed 515 of the 535 bills sent to him, issued one line-item veto, vetoed 16 bills completely, allowed two bills to become law without his signature and signed two joint resolutions.

The 535 measures sent to Stitt were considerably more than those placed on former Gov. Mary Fallin's desk in any of her eight years in office. Lawmakers sent 462 measures to her desk in 2014, the most during any session of her tenure. On average, Fallin received 411 measures annually from the Legislature and signed 395 of them, just over 96.0 percent. Stitt signed 96.3 percent of the bills put before him during the 2019 legislative session.

Lawmakers pre-filed a record 2,815 bills and joint resolutions prior to the start of the First Session of the 57th Legislature. By the time lawmakers finished their work May 23, that number had grown to 2,899, including bills filed to implement the fiscal year 2020 budget, some additional joint resolutions and two other bills filed late by Senate President Pro Tempore Greg Treat, R-Oklahoma City, and Rep. Charles McCall, R-Atoka.

Lawmakers adjourned on May 23.

OOA TRACKS 313 BILLS

The OOA tracked 313 of the 2,899 bills that were filed this session. The following is an update on the most pressing issues the OOA tracked.

SB 100 by Sen. David – SB 100 allows for optometrists to rent space near or within a retail store for the purposes of practicing optometry. The measure allows retail stores to rent to optometrists and specifies the conditions of renting property. Specifically stating that the practice of optometry must be separate from other occupants and accessible by the public. Further, no lease may contain provisions allowing a reduction of rent based on revenue of the optometrist. The measure provides requirements for assessment mechanisms used to conduct eye examinations, such as requiring that a patient has had an in-person examination within the last 24 months for a visual aid glasses prescription. The measure also provides requirements for visual glasses and contact lens prescriptions, including requiring contact lens prescriptions to be valid for a minimum of 12 months. This bill was signed by the Governor on May 21, 2019 and goes into effect on November 1, 2019.

SB 497 by Sen. Standridge – SB 497 requires insurers to provide reimbursements to pharmacists for providing medical services related to managing drug therapy, administering immunizations, and administering therapeutic injections. Additionally, insurers must reimburse pharmacists if the health benefit policy, contract, or agreement of the individual provides for payment or reimbursement of the service. This bill passed the Senate and was assigned to the House Insurance Committee. In the committee, two amendments were submitted with one requiring payment being sent directing to providers if the patient “signed as assignment of benefits agreement”. The bill is dead.

SB 509 by Sen. Rader/ HB 2638 – These bills are step therapy reform bills. Step therapy, often called “fail first,” is a process that requires patients to try and fail one or more medications chosen by their insurer before they can access the optimal treatment recommended and prescribed by their healthcare provider. Step therapy protocols can interfere with the patient-provider relationship and limit a healthcare provider’s ability to tailor care to an individual patient’s needs. These bills will address step therapy protocols required by health plans in connection with prescription drug access and protect patients. HB 2638 has passed out of the Senate Health and Human Services Committee but was not heard on the Senate floor. SB 509 was signed by the Governor on April 16, 2019 and goes into effect on November 1, 2019. 

SB 801/SB 890 by Sen. Smalley – SB 801 would modify the authority of Certified Registered Nurse Anesthetists to administer anesthesia and in collaboration with a medical doctor, osteopathic physician, pediatric physician, or dentist as opposed to under their supervision. SB 801 died on the Senate floor but the language from this bill was submitted as a committee substitute in SB 890 in the House Public Health Committee. The substituted language passed the committee 7-3 and is now headed to the House floor. An action alert was sent on April 9th for members to contact their Representatives. The OOA opposes this bill.

SB 839 by Sen. Smalley – SB 839 creates a path to independent practice for APRNs by creating a “Waiver of Supervision”. Sen. Smalley removed himself as the author of this bill so it died. The OOA hopes to work alongside our health care partners to develop a solution with the APRNs.

SB 848 by Sen. Rader – Clean-up bill for SB1446. It modifies certain provisions of the Uniform Controlled Dangerous Substances Act. This bill requires all osteopathic physicians to obtain one hour of education in pain management or one hour of education in opioid use or addiction each year preceding an application for renewal of a license, unless the licensee has demonstrated to the satisfaction of the Board that the licensee does not currently hold a valid federal Drug Enforcement Administration registration number. This bill was signed by the Governor on May 21, 2019 and goes into effect immediately. All osteopathic physicians must complete their one hour of Proper Prescribing by June 20, 2019, and every year following. The course must be approved by the State Board of Osteopathic Examiners.

SB 890 by Sen. Smalley – SB 890 modifies the authority of Certified Registered Nurse Anesthetists to administer anesthesia and controlled substances. It requires a hospital or other medical facility to select either the traditional supervised practice model or collaborative practice model for Certified Registered Nurse Anesthetists and to disclose such model upon request of the patient. It requires a Certified Registered Nurse Anesthetist or their employer to carry specified medical professional liability insurance policy coverage of at least $1 million with an aggregate limit of at least $3 million if they fall under the traditional supervised practice model. It provides for liability. This bill died before being heard on the House floor.

SB 917 by Sen. McCortney – SB 917 includes Advanced Practice Registered Nurses as licensed practitioners authorized to prescribe dangerous drugs within the scope of practice of such practitioner. The act adds Oklahoma licensed Clinical Nurse Specialists, Certified Nurse Practitioners and Certified Nurse-Midwifes as those licensed to prescribe under the supervision of an Oklahoma licensed physician, along with Certified Nurse Practitioners who have received a waiver of supervision from the State Board of Medical Licensure and Supervision. The act only allows pharmacists to dispense prescriptions for controlled dangerous substances prescribed by an Advanced Practice Registered Nurse licensed and located in Oklahoma. This bill died before being heard in committee.

SB 955 by Sen. Scott – SB 955 creates the Radiologic Technologist Licensure Act and makes the State Board of Medical Licensure and Supervision to be the licensing board. The bill sets requirements and fees for the license and requires practitioners be licensed by Jan. 1, 2021. This bill died in Senate Committee.

SB 1019 by Sen. Hicks – SB 1019 allows pharmacists to dispense devices or medications to a patient without a prescription in order to prevent the death of, or serious harm to the health of, the patient if:

  • There is a current record of a prescription for the medication or device in the name of the patient requesting it;
  • The prescription has expired and a refill requires authorization;
  • Records indicate that the patient has been on consistent medication therapy;
  • The amount of the medication or device dispensed is for a reasonable amount of time; and
  • The medication or device, excluding controlled dangerous substances, is listed on the inclusionary formulary to be developed by the State Board of Pharmacy.

The measure also provides that a pharmacist who, in good faith, dispenses a medication or device to a patient pursuant to these provisions is immune to civil liability and not subject to criminal prosecution. This bill was signed by the Governor on April 23, 2019 and goes into effect on November 1, 2019.

SB 1043 by Sen. Rader – SB 1043 stipulates that the OSUMA must spend $1.5 million for medical school certification and $1 million to enhance physician recruitment. Additionally, the OSUMA shall use up to $28,927,141.00 for duties including the Oklahoma State University Dean's GME Program. The OSUMA must use this allocation to reimburse the Oklahoma Health Care Authority an amount equal to the proportionate share of Oklahoma State University Center for Health Sciences' Dean's GME program disallowance. Twenty million dollars of the allocation shall be used to construct a new building which will also serve as the Tulsa location for the Board of Medicolegal Investigations. The CEO of the OSUMA may request an early transfer of funds to support cash flow. This bill was signed by the Governor on May 28, 2019 and goes into effect immediately.

SB 1044 by Sen. Rader – SB 1044 sets the provider rates to Sooner-Care related providers to 5.0 percent. This bill was signed by the Governor on May 29, 2019 and goes into effect on July 1, 2019.

SB 1078 by Sen. Rader – SB 1078 provides an income tax credit for a portion of compensation to qualifying doctors practicing in rural areas of the state. It requires the credit to be available for tax years 2021 through 2025. This bill died in Appropriations.

HB 1027 by Rep. McEntire – HB 1027 was stripped of its original language regarding CRNAs in committee and substituted for SB 955’s language, Sen. Scott’s bill regarding the Radiology Tech Licensure Act. This bill is now sponsored by Rep. Lewis Moore. The substituted language passed out of committee but was not heard on the House floor and is now dead.

HB 1155 by Rep. Worthen – HB 1155 provides that if a practitioner believes after one year of continuous treatment that the patient is in compliance with the pain-management agreement and it is in the best interests of the patient, the practitioner is authorized to set the review of the treatment plan at four- or six-month intervals and issue prescriptions for the patient as necessary. This bill was signed by Gov. Stitt on April 25,, 2019 and goes into effect on November 1, 2019.

HB 1445 by Rep. Gann – HB 1445 recreates the State Board of Osteopathic Examiners until July 1, 2024. This bill was signed by Gov. Stitt on May 23, 2019.

HB 2194 by Rep. Randleman – HB 2194 expands the definition of “physician” to include individuals with a doctoral degree who are licensed psychologists. This bill passed out of the House and assigned to the Senate Health and Human Services Committee but has not been heard. The reason for this legislation, we are told, is to ensure psychologists are reimbursed by Medicaid for their services. We have spoken with the author and even voiced our support to get the Medicaid laws changed but to no avail. The OOA opposes this legislation and signed onto a letter voicing that opposition. This bill died as it was not heard in the Senate HHS Committee.

HB 2349 by Rep. Chad Caldwell – HB 2349 allows an Advanced Practice Registered Nurse to apply for a waiver of supervision to be considered by the Oklahoma Board of Medical Licensure and Supervision and establishes guidelines for the waiver. The bill allows the applicant to be designated as an unsupervised advanced practice registered nurse if the waiver is granted. The bill prohibits an unsupervised APRN from having authority of oversight over other nurse practitioners. This bill was never heard in its House committee. The OOA supported this bill and will continue to work alongside our partners and the APRNs in the interim to find a solution.

HB 2368 by Rep. Kannady – officially creates the Oklahoma Commission on Opioid Abuse. The 13-member commission chaired by the Attorney General is to study, evaluate and make recommendations for any changes to state policy, rules or statutes to better combat opioid abuse in Oklahoma.  An amendment put forth in Senate Committee states that the Governor shall appoint a doctor of osteopathy and the President Pro Tempore shall appoint a licensed practicing medical doctor. The OOA successfully worked with Rep. Kannady to ensure the osteopathic voice is represented on this commission. This bill was signed by the Governor on May 16, 2019 and goes into effect immediately.

HB 2288 by Rep. Wright – Creates the “Oklahoma Workplace Clean Air Act” and prohibits smoking in all enclosed public places, recreational areas, places of employment, areas and vehicles owned/operated by the state; and, certain facilities and outdoor public places. These are updates to previous laws regulating smoking cigarettes to include medical marijuana. The OOA supports this bill. This has passed out of House Committee but was not heard on the floor and was held over until next year.

HB 2511 by Rep. McCall – An amendment for HB 2511 passed by the Senate Finance Committee, creates an income tax credit for taxable income from compensation from the practice of medicine or osteopathic medicine by a qualifying doctor in a rural area. A rural area is defined as any municipality that has a population of less than 25,000 and is at least 25 miles from the nearest municipality with a population greater than 25,000. The bill caps the credit at $25,000 per qualifying taxpayer. The bill provides the credit cannot reduce the taxpayer's tax liability to less than zero. The bill permits the credit to be claimed up to five years. The bill caps the credits allowed at $1 million per year. The version of the bill passed by the House proposed a tax exemption. Oklahoma Tax Commission Executive Director Tony Mastin said the switch from an exemption to a credit would reduce the benefit received by qualifying doctors by roughly one-half. To qualify, a doctor must have an Oklahoma medical license, have graduated from a medical school located in Oklahoma and reside in the same county as the rural area where the compensation is earned. This bill passed the Senate Finance Committee with the title stricken and was referred to Appropriations. The OOA supports this bill.

HB 2612 by Rep. Echols – HB 2612, the Medical Marijuana Unity Bill was sent and approved by the Governor on March 14, 2019. Two changes relevant to physicians are they are not requiring recommending physicians to be board certified and physicians can now rescind patients’ licenses by reporting them to the Medical Marijuana Authority. 

HB 2758 by Rep. Wallace – HB 2758 provides legislative intent for the use of $5.5 million in FY2020 appropriations along with $4.5 million in appropriated to the Board of Medicolegal Investigations in HB2765, the general appropriations bills, for the purpose of constructing a new Tulsa facility in conjunction with the Oklahoma State University Center for Health Sciences. This bill was signed by the Governor on May 29, 2019.

HB 2767 by Rep. Wallace – HB 2767 creates the Rate Preservation Fund for the Oklahoma Health Care Authority. It requires the funds be used for the sole purpose of maintaining reimbursement rates to providers when decreases in the states Federal Medical Assistance Percentage (FMAP) would result in reimbursement rate decreases by the authority. This bill was signed by the Governor on May 24, 2019 and goes into effect immediately.

SB 86 by Senators Jech, McEntire, Sanders and HB 1927 by Rep. Roe - This is legislation being presented by the Oklahoma Nurses Association and SSM Health-St. Anthony.  This bill expands Oklahoma’s existing law addressing the assaults of first responders and those specifically working in Hospital Emergency Departments to include all hospital workers that interact with patients.  The OOA supports these bills. SB 86 was signed by the Governor on May 28, 2019 and goes into effect immediately. HB 1927 died in conference.

 

 
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