OHA Advocacy Network

Advocacy Report • Friday, March 14, 2008

Before leaving for spring recess, the Ohio General Assembly took action on a couple of health care issues this week. Legislators will return to Columbus the first week of April for two months of legislative action before recessing for the summer to campaign.

OHA, ONA, OONE Supported Nurse Staffing Bill Clears House

By a 91 to 1 vote, the Ohio House of Representatives Wednesday passed House Bill 346, legislation regarding hospital nurse staffing plans that is supported by OHA, the Ohio Nurses Association (ONA) and the Ohio Organization for Nurse Executives (OONE). In preparation for Wednesday’s vote, OONE members accepted a challenge from OHA to write letters to their state representatives urging a “yes” vote on the bill. OONE members did an outstanding job by writing 221 letters, contacting 82 of 99 House members.

The bill requires that hospitals create a nursing care committee that includes nurses representing all types of nursing services offered by the hospital. The committee will develop recommendations for a nurse staffing plan that is consistent with current private or governmental accreditation standards. Hospitals would be required to significantly consider the recommendations when establishing staffing plans, and they must provide the nursing staff with a copy of the staffing plan, free of charge, and provide a copy to others who request it for a nominal fee.

OHA will continue to push for enactment of the “common sense” nurse staffing legislation, sponsored by Rep. Jim Hughes (R-Columbus), as the bill now moves to the Ohio Senate for consideration. OHA met with Sen. Sue Morano (D-Lorain) on Monday to discuss the legislation as she is registered nurse that serves on Senate Health, Human Services & Aging Committee. Morano indicated that the bill is “a step in the right direction” by giving direct care nurses a voice in the staffing development process. She also indicated a desire to strengthen the role of hospital nursing care committees so they may evaluate the staffing plan after it is implemented and address and resolve comments or concerns raised by direct care nurses. To learn more about the nurse staffing issue visit OHA’s state health care issues Web site. (Jeff Klingler, jeffk@ohanet.org; Jean Scholz, jeans@ohanet.org)

Hearings Continue on State Health Care Reform Bill

Members of the House Healthcare Access and Affordability Committee heard testimony this week on a proposal to extend a $1,000 tax credit against health insurance premiums for the self-employed. The proposal is part of an omnibus health care reform bill, House Bill 456, sponsored by Rep. Jim Raussen (R-Springdale ). Ty Pine with the National Federation of Independent Business testified that “the number one concern of small business owners, above government regulations, paperwork requirements and even taxes, is the cost of health insurance.” Pine spoke in support of the $1,000 tax credit against health insurance premiums for the self-employed saying it “would go a long way in creating a level playing field and enhancing access to affordable health insurance.” The committee also heard support from Jeff Davis, owner of Scioto Landscaping, who shared his struggles as small-business owner in providing health insurance for his employees.

OHA supports this provision in principle. Currently, the self-employed can deduct the cost of health insurance. The maximum tax savings (assuming a $12,000 premium and maximum tax rate of 7%) is $840.00. This provision increases the subsidy, which is positive. However, OHA has not seen an estimate of the cost, so as not to put additional pressure on the state budget, as well as assurances that this will reduce the number of uninsured.

The committee will meet March 26 or 27 to hear proponent testimony on the provisions of HB 456 concerning Health Information Technology. OHA will share information on the exact day and time when it becomes available.

Additional OHA positions on other HB 456 provisions can be found in the OHA analysis of the legislation. (Bridget Gargan, bridgetg@ohanet.org)

House, Senate Pass Provider Credentialing, Contracting Legislation
The Ohio House and Senate passed House Bill 125, the Health Care Simplification Act, sponsored by sponsored by Rep. Matt Huffman (R - Lima). OHA supports the bill, which includes a two-year moratorium on the use of most favored nation clauses in hospital provider agreements with health plans and creates a committee to study the effects of most favored nation clauses on the availability, accessibility and affordability of health insurance. The legislation also makes several reforms to the managed care contracting process and requires health plans to provide a summary disclosure form for each contract. Health plans must also use a standard credentialing application form when credentialing physicians and adhere to streamlined credentialing time frames. The bill now heads to the governor.

OHA is drafting a detailed analysis of the legislation, and will make it available to members in the coming weeks. (Jeff Klingler, jeffk@ohanet.org; Mary Gallagher, maryg@ohanet.org)

OHA is Seeking Medicaid Managed Care Data from Hospitals

In a request sent to CFOs and other hospital financial staff, OHA recently asked hospital CFOs to complete a simple, monthly online survey on Medicaid managed care plan (MCP) performance through its new Medicaid Managed Care Plan (MCP) accounts receivable (AR) report system. The survey will assist OHA in its advocacy efforts and help OHA quickly respond to bill processing issues with MCPs. Hospitals are asked to complete the survey about accounts receivable for inpatient and outpatient cases at the first of each month, reporting data from the month immediately preceding. Using survey data, OHA expects to have the first report available to members on or about May 15. The survey is housed on OHA’s Medicaid managed care Web page, along with definitions and directions.

On a related note, NAMI Ohio, Ohio’s leading mental health advocacy organization, is monitoring the impact of the Strickland Administration’s newly implemented policy that will enable Medicaid Managed Care Plans (MCPs) to place limitations on access to atypical antipsychotic medications for the Aged, Blind and Disabled population. The policy was recently amended to exempt psychiatrists who participate in the provider panels of MCPs or are working within a Community Mental Health Center.

Despite this recent change, NAMI Ohio continues to be concerned about how this policy may impact access to mental health medications. NAMI has asked OHA to seek feedback from hospitals on whether or not the new policy is creating an impediment to providing services to mentally ill patients in a hospital setting. NAMI is asking for specific incidents to gauge the impact of the policy. NAMI Ohio also intends to try to work with the MCP after it has denied the prior authorization request to encourage the plan to reverse its decision.

Please forward information to NAMI Ohio, Betsy Johnson, and Associate Executive Director NAMI at betsy@amiohio.org.

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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, Manager, State Policy & Advocacy (staceyc@ohanet.org)

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

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