2017 Legislative Update AAHAM May 16 2017 Elisabeth

2017 Legislative Update AAHAM May 16, 2017 Elisabeth Hurst, JD www. nebraskahospitals. org

2016 Legislative Session 60 days Of 445 bills introduced, 86 flagged as bills of interest to the NHA Budget Shortfall Taxes Corrections School Funding Transitional Health Insurance 2

2016 Legislative Session Passed Legislation • • • LB 721 – Surgical First Assistant Practice Act LB 817 – Direct Primary Care Agreement Act LB 911 – Behavioral Health Blue Print/Statewide Assessment 3

2016 Legislative Session Appropriations: NE Perinatal Quality Improvement Collaborative 2% Medicaid provider rate increase 2% CHIP provider rate increase Additional 0. 25% provider rate increase for behavioral health, nursing facilities, assisting living and ICF-DD providers Coverage for Hepatitis C medication & other FDA approved therapies Restoration of behavioral health aid previously reduced in 2013 for an average increase of 4. 8% per year Health Aid Program: $6. 4 million 4

2016 Legislative Session Defeated Legislation LB 900 – Repeal of the Helmet Law • Effectively Defeated • LB 1032 – Transitional Health Insurance Plan 5

2017 Legislative Session 90 days Of 667 bills, 122 flagged as bills of interest to the NHA Budget Shortfall ($1. 1 billion gap between projected revenues and spending for the two-year budget period ending June 30, 2019) Biennial Budget Taxes Corrections Health and Human Services 6

Opportunities & Unknowns Political landscape 18 new senators 11 Republicans 7 Democrats New Speaker, New HHS Committee Chair Whole New Committee Composition 7

Opportunities & Unknowns Political landscape 32 Republicans 15 Democrats One Independent, One Libertarian 34 Senators started the session with less than two years experience (70% of the legislature) 8

HHS Committee • • Chair: Senator Merv Riepe (Ralston) Steve Erdman (Bayard) Mark Kolterman (Seward) Sara Howard (Omaha) Matt Williams (Gothenburg) Sue Crawford (Bellevue) Lou Ann Linehan (Elkhorn) 9

Appropriations Committee • • • Chair: Senator John Stinner (Scottsbluff) Robert Clements (Elmwood) Robert Hilkemann (Omaha) John Kuehn (Heartwell) Kate Bolz (Lincoln) Mike Mc. Donnell (Omaha) Dan Watermeier (Syracuse) Anna Wishart (Lincoln) Tony Vargas (Omaha) 10

2017 Legislative Session’s BIG ISSUES 90 day session turned into 60 day session Rules of the Legislature Referencing of Bills Day 33, 2 bills signed into law (28 in 2015) Day 51, 14 bills signed into law (83 in 2015) Bills still advancing 11

NHA’s Priorities 2017 Priorities Behavioral Health Telehealth Medicaid Program Transformation Credentialing of Health Care Professionals 12

2017 Legislative Session Bills of Interest Supported Legislation LB 61 – Interstate Medical Licensure Compact (HHS: Jan. 19) LB 255 – Dialysis Tech registry (HHS: Jan. 26) LB 285 – HIV prenatal testing (HHS: Jan. 26) LB 166 – Raymond Ruling/Hospital Pharmacy (HHS: Jan. 27) LB 442 – MCO Oversight committee (Executive Board: Feb. 1) LB 283 – LPN licensure (HHS: Feb. 3) LB 323 – Palliative Care Council (HHS: Feb. 3) 13

2017 Legislative Session Bills of Interest Supported Legislation LB 73 – T-21 smoking age increase (General Affairs: Feb. 13) LB 92 – Telehealth coverage (Banking: Feb. 13) LB 88 – Credentialing of military spouses (HHS: Feb. 15) LB 342 – Nurse Compact clean-up (HHS: Feb. 15) LB 242 – BH provider recruitment (Approp. : Feb. 27) LB 441 – Medicaid Expansion (HHS: March 8) 14

2017 Legislative Session Bills of Interest Supported Legislation LB 513 – PPS base rate increase (Approp. : March 13) LB 205 – DD Providers appropriation (Approp. : Mar. 14) LB 206 – DD Providers rate increase (Approp. : Mar. 14) LB 438 – Cigarette tax increase (Revenue: March 17) LB 223 – PDMP clinicians (HHS: March 23) 15

2017 Legislative Session Bills of Interest Opposed/Neutral Legislation • OPPOSITION LB 368 – Helmet Law Repeal (Judiciary: Feb. 6) LB 609 - Outpatient workers’ compensation schedule (B & L: March 6) LB 327 – Biennial Budget (Approp. : March 13) LB 59 – Abortion notice on website (HHS: March 22) • NEUTRAL LB 195 – Mammography notification (HHS: Jan. 20) 16

2017 Legislative Session Preliminary Biennial Budget LB 327 – Biennial Budget (Appropriations: March 13) • $8. 2 million/year reduction in Medicaid Program § 3% PPS Medicaid reimbursement rate cut § 3% cut in Medicaid reimbursement for DME § 1% Medicaid rate increase for nursing facilities & home health § 1% Medicaid rate increase for DD providers § 1% Medicaid rate increase for BH providers contracted with BH Regions 17

2017 Legislative Session Bills of Interest Priority Legislation Support LB 61 – Interstate Medical Licensure Compact (HHS: Jan. 19) LB 92 – Telehealth coverage (Banking: Feb. 13) LB 513 – PPS base rate increase (Approp. : March 13) Oppose LB 327 – Biennial Budget (Approp. : March 13) LB 368 – Helmet Law Repeal (T & T: Feb. 6) 18

Discussion, Questions and Recommendations 19