2015 Legislative Agenda and Update Sean Graham Associate Director of Policy & Political Affairs.

2015 Legislative Agenda and UpdateSean GrahamAssociate Director of Policy & Political Affairs

Outreach and Advocacy

Outreach and Advocacy Program• Our Mission

Make the WSMA Legislative and Regulatory Affairs department the “go to” resource for information and advocacy for state and federal legislative and regulatory activities.

• Our Goal Offer tiered legislative advocacy services to

specialty and county societies and large physician groups.

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Overview

• 2015 Legislative Session Long Session

• 105 days• Primary duty – operating budget (also capital, transpo)

April 24, 2015: Last day of regular session • (April 26th)

Three Special Sessions • Sine die on July 10 after 176 days of session

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Overview

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• 2015 Session by the Numbers 176 days of session 2497 bills introduced 290 bills in health care committees 363 bills passed by Legislature 10 bills partially or completely vetoed 14.5% of bills introduced passed into law

Overview

2015 Legislative Session• Theme song?

Hotel California?... Send in the Clowns?... What a long, strange trip it’s been

• Legislative Priorities Budget Policy

• Why does this matter? Advocacy is crucial Legislation? It’s the long game that matters

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Overview

Policy – Top 5 takeaways from session• Telemedicine, SB 5175 (Becker)

Reimbursement for services delivered via telemedicine

Narrow definition Long-term goal to expand coverage

• All-payer claims database, SB 5084, (Becker) Claims data from commercial, Medicaid, PEBB Many concepts left up to rule-making

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Overview

Policy – Top 5 takeaways - Bad bills defeated• Surgical techs, SB 5049 (Angel)

Restricted surg-tech from performing functions unless registered with state

• Naturopath prescribing power, SB 5185 (Becker) Allow naturopaths to prescribe Schedule II-V drugs Unsuccessful sunrise review in 2014

• Dentistry scope of practice, SB 5621 (King) “Adjacent and association structures…” Concerns with botox

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Overview

Policy – Top 5 takeaways – Historic bills• WSU medical school established, HB 1559 (Riccelli)

Washington State University to establish its own medical school. WSMA was neutral on this billBroader issue of graduate medical education (i.e. medical residencies)

• Medical marijuana reformed, SB 5052 (Rivers) Multi-year w/ admin simplification focus Registry, standard of care, HP Account

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State Budget

• Budget – the sticking points McCleary

• ~$2.2 billion more (~$1 billion in 2013-2015) Revenue

• House Democrats propose $1.5B – Includes B&O tax increase from 1.5% to 1.8%

Psychiatric Boarding• ~$30 million – 145 psych beds

Class size initiative?• ~$1.4 billion in additional spending in the next two-year

budget cycle9

Revenue

• Final budget $38.2B two-year state spending plan

• $1.3B new K-12 spending • College tuition decreases• $98M to address mental health, psych boarding

Revenue• $452M in tax exemptions repealed/modified

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Legislative Priorities - Budget

WSMA Budget Priorities – 2015-2017• Fair reimbursement for Medicaid primary care

WSMA ask – $100M Final budget – $0

• Residencies/Graduate medical education – Washington Family Medicine Residency Network WSMA ask – $16M Budget as passed – $24.4M

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Legislative Priorities - Budget

• Loan repayment assistance for medical professionals WSMA ask – $8M Budget as passed – $9.6M

• Opportunity Scholarship for STEM, health care professionals Final budget – $41M

• Public Health Fully funded

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Legislative Priorities - Policy

Community/Public Health Mandatory reporting of breast density information

to patients. SB 5040 (O’Ban)• WSMA Opposed, Defeated

Increasing legal age for smoking and use of vapor products, HB 1458 (Orwall): • WSMA Supported, Defeated

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Community/Public Health Establishing marketing and product standards for

vapor products, SB 5477 (Dammeier)• WSMA Supported, Defeated

Increasing access to opioid antagonists to prevent opioid-related overdose deaths, HB 1671 (Walkinshaw) • WSMA Support, Passed

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• Community/Public Health Good Samaritans free testing, SB 5494/HB 1353

• WSMA Supported, Defeated Reducing distracted driving, SB 5656 (Rivers)

• WSMA Support, Defeated Removing personal and philosophical exemptions

for vaccine use, HB 2009 (Robinson)• WSMA Support, Defeated• Likely to be revisited by legislature• Interim planning already underway

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• Mental/Behavioral Health Primary care psychiatric consultation services –

SB 5947 (Becker)• UW Psych Program (Budget $4M in each of next two

biennia – Safety Net Assessment)

Transport of patients to facilities other than hospitals, HB 1721 (Robinson)• Workgroup to establish standards• WSMA Supported, Passed

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• Administrative Simplification Substitution of biosimilar drugs, SB 5935

(Parlette)• WSMA Supported, Passed

Radiology benefit managers, HB 1183 (Harris)• WSMA Supported, Passed• OIC continued work to address benefit managers

Repealing the Prescription Monitoring Program, HB 2192 (Taylor)• WSMA Opposed, Defeated

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• Payment Reform/Coverage Network adequacy and Medicaid non-

participating providers, HB 1652 (Cody)• “Good faith” negotiations• WSMA Support, Passed

Independent Review Organizations, HB 1956 (Moeller)• WSMA Support, Defeated

Prescription Drug Assistance Foundation, HB 2021 (Riccelli)• WSMA Supported, Passed

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• Payment Reform/Coverage Grace Period, SB 5430/HB 1626 (Becker, Schmick)

• Two different approaches attempted• WSMA Supported, Defeated• Commitment from Sen. Becker to address in interim

Medicaid “look-back” and Exchange grace periods, SB 6089 (Hill)• Exchange transparency, oversight• Medicaid look-back

– Exchange enrollee behind on premiums? Determine eligibility for Medicaid

– Reimburse through Medicaid retroactively for claims

• WSMA Supported, Passed19


• DOH/MQAC/HCA/State Agencies Demographic information collection, SB 5772

(Conway)• WSMA Supported, Defeated (amended into HB 1485, as

passed) Education-based remediation plans for

physicians (and other providers), HB 1135 (Cody)• WSMA Supported (opposed after amendment),

Defeated Regarding requirements of allopathic physician

licensure/”Foreign trained” licensure, HB 1874 (Tharinger)• WSMA Supported, Defeated

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• DOH/MQAC/HCA/State Agencies Bree Collaborative subject to the Open Public

Meetings Act, SB 5144, (Dammeier)• WSMA Supported, Passed

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Legislative priorities - Policy

• Liability Reform Reauthorizing the Medicaid fraud false claims act

(Qui Tam) – SB 5287/HB 1067• WSMA Opposed, Defeated

Expanding beneficiaries for wrongful birth and wrongful life suits, SB 5747 (Padden)• WSMA Opposed, Defeated

Crisis standards of Care during emergency• Liability protection during emergency• Anticipated but not addressed this year• Likely to be revisited by legislature

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• Practice of Medicine Patient medication coordination, SB 5441

(Rivers)• WSMA Support, Passed

Refill eye drop prescriptions, SB 5268 (Parlette)• WSMA Support, Passed

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• Practice of Medicine Non-compete agreements - HB 1173, 1926, 1577

• Prohibitions on non-competes for physicians, HB 1173• Others with focus on low-income individuals, broader

non-compete issue• WSMA HOD took no stance• Will be revisited by legislature

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• Questions? • Other issues of interest?

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For more informationLegislative Affairs

Sean GrahamAssoc. Director of Policy and Political [email protected]

Thank you!

www.WSMA.org26

2015 Legislative Agenda and Update Sean Graham Associate Director of Policy & Political Affairs.

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