2016 Legislative Session Update WSMA Legislative and Regulatory

2016 Legislative Session Update WSMA Legislative and Regulatory Affairs

2016 Legislative session context • Two-year “biennial” legislative cycle o Supplemental budget year • Election year • Short session o 60 day regular session • Special session o 14 days in o Special sessions six out of last seven years 2

2016 Legislative session context Bills introduced • 1392 Bills in Health Care Committees • 200 Bills passed by Legislature • Total: 297 Questions remain • Bills “Necessary to implement the budget” • Governor vetoes o 27 bills vetoed o SB 6569 – Patient out of pocket costs o SB 5145 – Health technology clinical committee 3

Budget • State budget outlook o o o • 2015 -- $38. 2 B two year state spending plan $1. 3 B new K-12 spending College tuition decreases $98 M to address mental health, psych boarding Mc. Cleary decision What’s different in 2016? o o Mc. Cleary funding – up to $4. 5 B more by 2017 -2019 Revenue forecasts § November caseload forecast - $400 M in increased caseload costs q $190 M from increased Medicaid enrollee costs § February revenue forecast down $78 M GF 2015 -17 4

2016 Budget • WSMA 2016 asks • Protect WSMA priority investments from 2015 o Student loan repayment- $9. 6 M o GME - $24 M primary care; $8 M psych residencies • • • No taxes directed at physicians Pediatric Medicaid funding, $7 M Mental health student loan repayment, $3 M Vaccine portal/module, $511, 000 (DOH) Maternal mortality review panel $230, 000 (DOH) 5

Budget breakdown – Senate vs. House Senate budget proposal House budget proposal • Pediatric primary care reimbursement - $0 • Vaccine module - $511 K • Health professional student loan repayment for mental health - $0 (avoided $1 M cut) • Health professions account – $500 K sweep (no physician fee increase) • Tax increases on physicians – none • • • Pediatric primary care reimbursement - $0 Vaccine module - $511 K Health professional student loan repayment for mental health - $1 M Health professions account – no sweep Tax increases on physicians – none 6

Top 5 takeaways from session 1. Credentialing 2. Telemedicine 2. 0 3. MA medication retrieval 4. Maternal mortality review panel 5. Bad bills defeated 7

Bad Bills Defeated 8

Bad bills defeated • Balance billing prohibition in emergency settings, HB 2447 (Cody) o Highly technical and political o WSMA opposed o Dead • “ Associate physicians, ” HB 2343 (Cody) o Alternative pathway for med school grads who do not match a residency o Dead • Naturopath opioid prescribing (Schedule II-V), SB 2304 (De. Bolt) o Inappropriate scope expansion o Dead • Mandatory reporting of breast density to patients, SB 6416 (Rolfes) 9

Healthy Doctors, Health Patients (HDHP) 10

2016 HDHP • Credentialing, HB 2335 (Cody) o Standardize turn-around time and process to credential providers o Passed House 97 -0; Senate 48 -0 • Medical Assistant medication retrieval, HB 2350 (Cody) o PQAC overreach o Allowing MAs to retrieve medication while under appropriate supervision o Passed House 95 -2; Senate 42 -6 • Benefit managers, HB 2445 (Robinson) – OIC legislation o Grant regulatory authority over BM/third party administrators o Dead • Pharmacy Benefit Managers, 5 ESSB 5857 (Parlette) o Registration and regulation of PBMs o Substitute includes requirement that OIC look at IRO process to settle disputes between pharmacies and insurance carriers o Passed Senate 49 -0; House 94 -3 11

Workforce & Practice of Medicine 12

2016 Workforce & Practice of Medicine • Interstate licensure compact, HB 2452 (Riccelli) MQAC/DOH o Securing and stabilizing workforce o Advancing practice and payment of telemed (2015) o Dead • Telemedicine 2. 0, SB 6519 (Becker) o “In-home” reimbursement o Telehealth collaborative (TBD) o Passed Senate 49 -0; House 91 -6 • Prescription Monitoring Program access, HB 2730 (Peterson) o “Bulk” access to the PMP for hospitals, groups of prescribers o Passed House 80 -16; Senate 47 -1 13

Liability & Business Practice 14

2016 Liability & Business Practice • Medicaid fraud Qui Tam, SB 6156 (Rivers) o Support pushing out the sunset on Qui Tam provisions to 2023. o Act would expire in 2016 and allows private parties to pursue private causes of action against medical providers. o Passed Senate 48 -0; House 96 -1 • Blinded provider compensation agreements, HB 2332 (Kirby) o Keeps compensation arrangements filed with the OIC exempt from public disclosure o Passed House 97 -0; Senate 47 -0 • Prohibiting /restricting non-competition (solicitation) clauses o o WSMA monitored these bills, but does not have policy on non-compete clauses HB 2406 (Manweller) – restricts non-competes for low-wage workers HB 2931 (Stanford) – voids non-competes that are “unreasonable” DEAD 15

Public & Community Health 16

2016 Public & Community Health • MMR committee, SB 6534 (O’Ban) o Creates panel to conduct reviews of maternal death factors in WA o Passed Senate 47 -0; House 95 -0 • Age of individuals which sale of tobacco and vapor products may be made, HB 2313 (Orwall) o Raises the legal age to purchase tobacco and vapor products from 18 to 21 o NTIB • Concerning vapor products – Two bills o SB 6328 (Dammeier) o HB 1645 (Pollet) o NTIB 17

2016 Public & Community Health • Pharmacist ‘prescribing’, HB 2681 (Stambaugh) o Amended down “awareness” bill promoting pharmacists' ability to dispense contraception under CDTA. o Passed House 92 -4; Senate 46 -3 • Reducing distracted driving incidents, HB 2574 (Farrell) o Focuses on wireless communication device-related activities, such as holding the device in-hand or reading or manually entering data o NTIB • Increase oil transportation safety, HB 2575 (Farrell) o Updating a 2006 report to state emergency response commission regarding a statewide response to chemical, biological, radiological, nuclear and explosive materials. o NTIB 18

2016 Election – WAMPAC, State Races • 2016 campaigns o Impact on 2015 session o Campaigns o Presidential o Congressional o Statewide elected o State Senate o State House of Representatives o Judicial o Vote tracker / Diamond club o Candidate interviews / fundraisers 19

Thank You Kathryn Kolan, J. D. kak@wsma. org Sean Graham sean@wsma. org