AMS Physicians Achieve Remarkable Legislative Successes

Once again, physicians stood up for their patients and profession, going 8-0 in the most recent legislative session. The Arkansas Medical Society went undefeated in the legislative session, passing all eight supported bills and defeating all 13 bills the Society opposed.

AMS Legislation that became law:

• Prior Authorization for Terminally Ill (SB 316/Act 992) – prohibits a PA denial of pain medication for a terminally ill patient.
• Graduate Registered Physician Act (HB 1162/Act 929) – provides for non-matching medical school grads to work under the continuous on-site supervision of a board-eligible physician, under Arkansas State Medical Board (ASMB)-approved protocol and licensure.
• APRN and PA Hydrocodone Combination Products (HB 1136/Act 529) – bill allows APRNs and PAs to prescribe HCPs (which were rescheduled to Schedule II on October 6, 2014) if authorized in collaborative practice agreement, or by supervising physician.
• Credentialing (SB 934/Act 1232) – requires (among MANY other things to be detailed later) insurer decisions be made in 60 calendar days (down from 90); require insurer to treat applicant physician as a participating physician for payment purposes from date of submission of completed application, once application approved; and penalizes insurers $1,000 a day for each day exceeding 60 days.
• Combating Prescription Drug Abuse Act (SB 717/Act 1208) – allows Department of Health to develop algorithms to determine if a patient being prescribed opioids within a 30-day period by more than 3 physicians; allow prescriber to delegate access to the database; require opioid prescribing guidelines for emergency departments; and provides immunity for good faith reporting of suspected drug diversion.
• Limiting physicians’ financial penalties (SB 701/Act 902) – when determining gain-sharing or risk-sharing in alternative payment systems, insurer shall not attribute any cost variations to physicians resulting from negotiations between insurer and other entity outside of physician’s practice.
• Prior Authorization Transparency Act (SB 318/Act 1106) – will (among other things) provide transparency in insurance company requirements and restrictions, with 60 day written notice (at least) regarding any new requirements or restrictions; prohibits retrospective denial for 45 days after an authorization; requires that only an Arkansas licensed physician can make recommendations or decisions regarding PAs or nonmedical review requests; and provides that if an insurer fails to comply with any of the Act provisions, any requested services are deemed authorized or approved.
• Telemedicine Act (SB 133/Act 887) – require insurers to cover services for real-time two-way electronic audio-visual communications of a physician licensed by ASMB, and reimburse, the same as if services were provided in person.

 AMS Opposed (bills failed after committee debate):

• CRNA Independence (SB 78).
• APRN Independence and Allowed Prescribing of Full Schedule II (HB 1160).
• APRN Full Schedule II Prescribing (HB 1165).
• APRN Payment Parity (HB 1926).
• Telemedicine without a prior professional relationship (face-to-face initial visit) and allowing the use of telephone only (SB 845 and HB 1747).
• Weakening licensing boards’ regulatory authority (HB 1158).
• Weakening fluoride use by allowing local control (HB 1355).

 AMS Opposed (bills failed with NO committee debate):

• Lowering the rate on Soft Drink Tax (SB 725).
• “Transparency” bill (SB 959) which is similar to much already in federal Sunshine Act.
• Weakening the Medicaid Fairness Act (SB 829).
• Allowing chiropractors direct access to Medicaid patients (HB 1736).
• Allowing opticians to prescribe contacts (SB 457).

 AMS Amended to Fix Problems:

• APRN collaborative practice language amended to clarify that collaboration should occur with a practicing physician with similar training to APRN (HB 1609/Act 824).
• Non-compete language amended to clarify that physicians and other licensed healthcare professionals would not be impacted (SB 998/Act 921).
• Venue language amended that would have inadvertently, but detrimentally impacted 2003 Tort Reform language pertaining to multiple defendants (HB 1252/Act 830).