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May 2007
Note: Questions relating to state legislative activity or any of the items noted in ACS Cross Country may be directed to Mindy Baker, State Affairs Associate, at mbaker@facs.org.
Trauma and Injury Prevention Issues Focus of Two State Legislatures
It was a productive year for the trauma community in the Indiana General Assembly, which adjourned on April 29. Two bills of interest were passed and sent to the governor. One of them, HB 1378, repeals the statute permitting insurers to deny payment for trauma and emergency services if the injured patient was harmed due to alcohol or other drug intoxication. The second, HB 1237, amends the requirement for seatbelt usage from occupants of the front seat to all occupants in a motor vehicle equipped with safety restraints. HB 1378 was signed by the governor on April 27, and HB 1237 passed both conference committees on 4/29.
Meanwhile, the Tennessee legislature is considering SB 1511/HB 1283. This bill would allow people 21 years old and older to legally ride their motorcycle without a helmet. The bill recently passed the House Transportation Committee with a 9-8 vote and is now set to be heard by the House Finance Budget Subcommittee. Early indications are that the committee will vote down the bill.
(Please post any comments you may have about this issue on the ACS Advocacy Bulletin Board located on the web portal.)
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Kentucky First to Pass "Emergency Volunteer Health Practitioners Act"
Kentucky was the first state to pass model legislation to “permit volunteer health practitioners to provide services in Kentucky during an emergency declaration.” The legislation was developed by the National Conference of Commissioners on Uniform State Laws (NCCUSL), a 116-year-old not-for-profit organization founded to provide “states with non-partisan, well-conceived and well-drafted legislation that brings clarity and stability to critical areas of state statutory law.”
According to NCCUSL, “This act allows state governments during a declared emergency to give reciprocity to other states’ licensees on emergency services providers so that covered individuals may provide services without meeting the disaster state’s licensing requirements... [and] calls for the creation of a registration system which out-of-state practitioners may use either before or during a disaster. The system may coincide with existing federal/state systems. Upon registration, practitioners are expressly allowed to contribute their professional skills to existing organized disaster efforts. The effect of the act should be to ease the utilization of out-of-state practitioners when a state needs them the most.”
In an article in the Lexington-Herald Leader, Kentucky lawyer Stephen Cawood, (and Kentucky’s representative to NCCUSL) discussed how NCCUSL normally requires three or more years to draft model legislation, but due to recent events in the Gulf Coast, the procedure was accelerated and the act was adopted within a year.
This legislation has been introduced in California, Mississippi, Colorado (where it has been sent to the Governor), Tennessee, Oregon, and Maine.
For a copy of the Model Act, visit: http://www.law.upenn.edu/bll/ulc/uiehsa/2006act_final.htm
(Please post any comments you may have about this issue on the ACS Advocacy Bulletin Board located on the web portal.)
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Scope Battles Rage Across the Country
Scope-of-practice issues are a perennial battle in many states, with non-physicians repeatedly trying to expand their scope. In response, physician organizations in several states have created coalitions to help combat the onslaught.
As mentioned in the April 13 edition of ACS NewsScope, New Mexico Gov. Bill Richardson (D) dealt a blow to patient safety in his state when he signed S.B. 367 into law. This legislation allows optometrists to provide services generally performed by surgeons, even though they have not undergone the appropriate surgical education and clinical training. More specifically, the law permits optometrists to use scalpels to remove simple lesions of the eyelid or on the skin surrounding the eye and to perform anterior punctures. The College, the American Academy of Ophthalmology, and others urged the governor to veto the bill, pointing out that a simple lesion could, in fact, be a precancerous growth, a sebaceous cell carcinoma, or lymphoma.
At the other end of the country, the New York Chapter of the ACS is currently engaged in two scope battles. The first, as contained in AB 3168/SB 1443, would expand the scope of podiatry to include conditions of the ankle and all soft tissue structures below the knee anatomically affecting the foot and ankle. The Senate bill was heard in committee on May 2, and the New York Chapter testified in opposition to the bill, which was ultimately held in that committee.
Click here to read the NY Chapter’s position paper on SB 1443 (110K PDF)
The state of New York is also facing legislation that would allow single-degree (non-MD/DO) oral and maxillofacial surgeons to perform elective cosmetic surgery. The Medical Society of the State of New York, the New York Chapter of the ACS, and other state organization are working with the AMA’s Scope of Practice Partnership to defeat this legislation. This particular issue has popped up in other states over the past few years, with the American College of Surgeons and other national surgical societies engaging their members to work for defeat of these proposals.
(Please post any comments you may have about this issue on the ACS Advocacy Bulletin Board located on the web portal.)
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AMA Update: Organized Medicine Secures Major Legislative Victories on Contracting/ Payment Issues
According to the AMA’s Advocacy Resource Center’s Managed Care Update:
Colorado has become the first state in the nation to pass legislation requiring health insurers to use a standard managed care contract when negotiating with health care providers. Colorado Gov. Bill Ritter has signed into law a bill to make the language in payer-provider contracts more transparent. Colorado S.B. 79 is very similar to last year’s bill (S.B. 198), which addressed many of the most egregious payment practices facing physicians. It requires use of a standard form contract that includes the disclosure of payment and compensation terms (including fee schedules, methodology used to calculate fee schedules, internal processing and edits used, and so on.), and it sets forth a number of contract requirements regarding termination for cause by either party, contract amendments, utilization review, categories of coverage, rental network PPOs, binding arbitration, and physicians’ rights to a private cause of action.
Arkansas has also passed a noteworthy bill addressing the issue of the unregulated secondary discount market. Incorporating key principles from the AMA's model legislation, Arkansas H.B. 2627 prohibits selling, leasing, assigning, conveying, or granting access to a physician panel or its associated rates unless authorized in an agreement between the contracting agent and provider. It also requires the subscriber identification card to clearly state the network responsible for provider claims arising under the card, and makes the provider network contractual discount or alternative rate only enforceable for that network.
(reprinted with permission from Janet Rosenblad, Legislative Attorney, AMA Advocacy Resource Center)
(Please post any comments you may have about this issue on the ACS Advocacy Bulletin Board located on the web portal.)
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Past Issues of ACS Cross Country:
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ACS State Affairs
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Division of Advocacy and Health Policy
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Jon H. Sutton
Manager, State Affairs
Chicago Headquarters
312-202-5358
jsutton@facs.org |
Mindy Baker
State Affairs Associate
Chicago Headquarters
312-202-5363
mbaker@facs.org |
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Revised May 16, 2007
Advocacy and Health Policy
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by the American College of Surgeons, Chicago, IL 60611-3211
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