OHA Advocacy Network

Advocacy Report • Friday, June 15, 2007

State Budget Passes Senate

The Ohio Senate Wednesday passed its version of the biennial budget. Rumors of House concurrence on the budget continue to circulate, however a House/Senate conference committee is likely. Conferees and a committee schedule will be released if and when the House fails to concur on the Senate version of the bill.

Both House and Senate versions of the 2008-09 state budget provide all hospitals with a 3.3 percent Medicaid update starting Jan. 1, 2008, and a 2.9 percent update in 2009. They both also expand Medicaid eligibility, providing health care benefits to pregnant women earning up to 200 percent of the federal poverty line, covering an additional 3,800 women who currently lack coverage and children in families earning up to 300 percent of the federal poverty line, covering an additional 26,000 children who currently lack coverage. OHA worked with both the House and Senate to secure supplemental Medicaid payments for trauma centers, rural obstetrics and critical access hospitals, however these provisions were not include in either version of the budget.

OHA also received word that funding was secured in the Senate version for the Ohio Department of Health to create a Web site to post hospital quality data, which hospitals are now required to report as a result of the passage of HB 197. (Bridget Gargan, bridgetg@ohanet.org)

Committee Vote on SB 120 Next Week

The Senate Health, Human Services and Aging Committee is scheduled to vote on Senate Bill 120, legislation requiring all hospitals to operate 24/7 emergency departments, on Wednesday, June 20. Thanks to Ohio hospitals strong grassroots efforts, OHA believes the bill will successfully pass out of the committee.

OHA advocacy efforts now turn to seeking a floor vote in the Senate before the legislature adjourns for summer recess. Since OHA has not received a commitment for a floor vote it is imperative that hospitals contact their senator asking for support of SB 120. If the bill does not receive a floor vote before summer recess there will not be a vote until September. Earlier this week, OHA sent an Advocacy Alert asking hospital and health system CEOs to contact their state senator by June 19, asking them to support SB 120.

Additionally, Premier Health Partners President & CEO Tom Breitenbach, OhioHealth President & CEO David Blom, OHA Senior VP Reed Fraley and OHA VP of State Issues Bridget Gargan met with Gov. Ted Strickland last week to discuss the limited-service hospital issue. Gov. Strickland voiced concerns about the proliferation of new facilities and was supportive of the pending SB 120, requiring that hospitals operate 24/7 EDs. (Reed Fraley, reedf@ohanet.org and Bridget Gargan, bridgetg@ohanet.org)

Work Continues on Physician Credentialing, Managed Care Contracting Bill

The Ohio State Medical Association continues to advocate for passage of legislation, to simplify the physician credentialing process used by health plans and provide relief from burdensome and, in some cases, unfair contracting practices used by some insurers.

House Bill 125, sponsored by Rep. Matt Huffman (R-Lima), includes numerous provisions around physician credentialing and contracting issues, including the following requirements:

Ų a standard credentialing form for credentialing providers and specifies that the form will be the one used by the Council for Affordable Quality Healthcare (CAQH);

Ų procedures for amending a health care contract;

Ų termination of a contract may be initiated by either party without cause by giving a 90-day notice; and

Ų an arbitration mechanism that is binding on both parties when disputes arise.

The legislation does not currently apply to hospitals, but OHA is working with the OSMA, the bill’s sponsor and other interested parties to include hospitals in certain provisions, including:

Ų Prohibiting most favored nation clauses in contracts;

Ų Prohibiting confidentiality clauses in contracts;

Ų Requiring more rigorous time frames from insurers to complete the credentialing process;

Ų Prohibiting a third party payer from selling, renting, or giving its provider network information to any other person;

Ų Requiring a third-party payer to include with a health care contract a summary disclosure form that discloses the compensation or payment terms and claims processes;

Ų Requiring a third-party payer to make available electronically or by an internet portal specified eligibility and coverage information concerning enrollees. (Jeff Klingler, jeffk@ohanet.org)

Rep. Budish Outlines Health Plan for OHA Finance Committee

Rep. Armond Budish (D-Beachwood) presented his Healthy Ohio Plan for Everyone (HOPE) plan to the OHA Finance Committee on Thursday. As envisioned, the plan would establish a mechanism to fund health care coverage for an estimated 1.3 million uninsured Ohioans with a combination of annual hospital assessments, new state revenue, taxes on employers and federal matching funds. The proposal also includes the diversion of current hospital HCAP payments to fund the HOPE plan. Based partly on the efforts in other states to develop wide-ranging health care for the uninsured, the plan would add coverage to 400,000 new managed Medicaid enrollees, 100,000 younger adults age 18-29 under their parent's employer-based health care plans, and an estimated 800,000 individuals under a commercial "negotiated pool buy-in."

Rep. Budish noted that, while the plan needs work, it represents an opportunity to address a public health crisis that will not go away and likely become worse if not dealt with now. The committee responded with several questions and concerns about the high, upfront financial contribution required of the hospital industry with no apparent counterpart required from insurers. The committee also questioned whether the plan could inadvertently cause employers to drop group coverage and push potentially huge numbers of currently insured Ohioans onto the HOPE plan.

Budish pledged to work with OHA and the Finance Committee as the plan is developed further and invited committee members and the OHA membership at large to contact his office with comments and questions. (Bridget Gargan, bridgetg@ohanet.org)

In Other Legislative Action…

APN Prescriptive Authority – Legislation providing authority to advance practice nurses to prescribe schedule II controlled substances was introduced at the end of May. HB 253, sponsored by Rep. Scott Oelslager (R-North Canton), was referred to House Health Committee this week.

Shaken Baby Syndrome – SB 144, sponsored by Sen. Steve Stivers (R-Columbus), was referred to the House Health Committee this week. The OHA-supported legislation would require the Ohio Department of Health director to convene a group of experts to assist the department in developing education materials on Shaken Baby Syndrome. The department will provide the materials on its Web site enabling child birth educators, pediatricians and obstetricians, hospitals and child care centers to educate expecting or new parents.

Joint Township Hospitals – This week, the House State Government & Elections Committee passed legislation allowing Ohio’s four joint township hospitals to hold an executive session to discuss trade secrets. HB 194, sponsored by Rep. Jim Zehringer (R-Ft. Recovery), will now move to the full House for consideration.

Grieving Parents Act – Legislation addressing notices, death certificates and disposal of fetal tissues in circumstances where fetal death has occurred prior to 20 weeks gestation was introduced last month and is now pending in Senate Health, Human Services & Aging Committee. SB 175, sponsored by Sen. Kevin Coughlin, would require hospitals to provide a woman who presents herself at a hospital as a result of a fetal death, or potential fetal death, the right to apply for a fetal death certificate and information on hospitals procedures for disposing of the product of human conception that has suffered a fetal death prior to twenty weeks of gestation. OHA supports the concept of the bill, but has concerns with some ambiguities in the legislation and is processing the legislation with its Maternity Licensure Task Force.

Federally Qualified Health Centers – The House Health Committee this week accepted a substitute version of HB 164, legislation sponsored by Rep. Ross McGregor (R-Springfield) that would permit the Ohio Department of Health (ODH) to pilot the construction of at least two Federally Qualified Health Centers (FQHC) (one urban, one rural) inside of or adjacent to hospital emergency rooms. The FQHCs would serve patients that present themselves at the ER in need of non-emergency care. It also permits ODH to enter into an agreement with the state’s primary care association to promote the establishment of new FQHCs and FQHC Look-Alikes. The sub bill deletes language eliminating the $20,000 limitation in current law on how much ODH may reimburse a free clinic or FQHC look-alike for medical liability insurance premiums.

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Direct questions on OHA’s advocacy agenda to:

Bridget Gargan, Vice President, State Policy & Advocacy (bridgetg@ohanet.org)

Jeff Klingler, Director, State Policy & Advocacy (jeffk@ohanet.org)

Jean Scholz, RN, Director, Health Policy (jeans@ohanet.org)

Rick Sites, General Counsel (ricks@ohanet.org)

Stacey Conrad, Specialist, State Policy & Advocacy (staceyc@ohanet.org)

Jonathan Archey, Manager, Federal Relations (jonathana@ohanet.org)

Laura Landis, Executive Assistant, State Policy & Advocacy (laural@ohanet.org)