Snow-shmo

So far this session the legislature seems to be channeling the wise words of the ancient Greek tragedian Sophocles, “Without labor, nothing prospers.” Though there were plenty of excuses to take off with Presidents Day and the snowstorm, legislators forged ahead with another full week. Both chambers again found a steady pace balancing time for committees and floor activity. The Senate even worked into the evening all week. Though the week was not without some drama on the floor of the Senate, it was nothing in comparison to past sessions. We are three weeks from the halfway marker of Spring Break. So far, the House has passed four bills while the Senate has passed twelve. That is almost half of the total number of bills passed last session, excluding the budget. It is almost like we are in the twilight zone because of how well things are functioning. We shall see how long it will last.

Cleared the Hurdle

The Senate Families, Seniors and Health Committee took action on SB 83, the child protection bill with a sprinkle of scope of practice expansion we’ve spent countless hours trying to stop. We are delighted to convey we have been successful in our efforts! The committee approved a senate committee substitute for SB 83 stripping the SAFE CARE Providers section from the bill. You may remember this section sought to allow these APRNs and PAs to practice without collaboration with a physician if performing SAFE CARE exams. This is a tough issue to oppose because “who opposes SAFE CARE,” right?! But we know this is just another way for the APRNs to try and whittle away at the collaborative agreement, to the point that eventually they can (and rightfully so) say, “we can practice independently in most other situations, why not just give us complete independent practice?” We can take a collective sigh of relief for now on this issue, but we are certain it is far from over. We remain on guard.

Prior Auth Progress

It was a big day on Tuesday in the Senate Insurance Committee as they held a public hearing on SB 230. This bill, like its house companion HB 618, would reform the onerous processes of prior authorization. These bills establish a gold-carding process, exempting physicians with a 90% approval rate of previous prior auth requests from going through prior auth. An expert witness, David Barbe, MD, former President of the AMA, and World Medical Association. During his testimony Dr. Barbe shared a consensus statement on improving prior authorization from 2018 signed by: the American Medical Association, America’s Health Insurance Plans, American Hospital Association, Blue Cross and Blue Shield Association, the American Group Management Association, and the American Pharmacy Association. The first recommendation being selective application of PA, exactly what our bills aim to do! The hearing was very positive with most members making favorable statements about the need for this reform. They want their constituents to have access to the care they need. We will be pushing for a vote on SB 230 in committee as soon as possible. We expect a vote on HB 618 on Monday in the House Insurance Committee.

Ah, Ah, Ah, Ah Staying Alive

All the bills related to cardiac emergency responses in schools (HB 232, SB 155 &166) were heard in House and Senate on Tuesday. These bills require schools to create and implement a cardiac emergency response plan. A Cardiac Emergency Response Plan (CERP) is a written document that establishes specific steps to reduce death from cardiac arrest in school settings. It can be stand-alone guidelines or merged with a school’s existing medical emergency response plans. It should be posted at key locations throughout the school and practiced regularly.

The American Heart Association (AHA) wants all students and educators to learn First Aid, CPR and AED to create the next Generation of Heartsavers® prepared to act in an emergency, putting more qualified lifesavers in our schools and communities. About 9 in 10 cardiac arrest victims who receive a shock from an AED in the first minute live. During cardiac arrest, CPR can double or triple a person’s chance of survival. We were happy to share some love on these bills in committee.

More Tort Reform!

On Tuesday, the Senate Committee on General Laws heard SB 238, relating to expert witness testimony. Not to be outdone the House Judiciary Committee also heard the house companion bill, HB 263. These important tort reform measures would bring state law more in line with the federal standards for expert testimony. Improving our expert witness laws will help fight against frivolous medical lawsuits. It is critical that we preserve the integrity of expert witness testimony in our Missouri courts. Not surprisingly, the trial attorneys and circuit judges opposed the bill.

The House passed HB 68, the reform of the Statute of Limitations for personal injury claims.  House Bill 68 changes the period for filing a personal injury suit from 5 years to 2 years. Missouri is an outlier in our nation with only three other states with a longer period to file a lawsuit for personal injury than 5 years and over forty-three states with 3 years or less as the time to file suit. The amended statute of limitations applies to claims that come from negligent acts like auto accidents and premises liability, such as slip and falls, but also include a host of employer related claims like negligent entrustment. For those who own property or utilize employees, this bill is of high interest to your operations.

Prepare for Advocacy Day STAT!

There is no time to delay. Physician Advocacy Day is Tuesday, March 4. Please make plans to join us in our largest advocacy effort of the year. If you have not already done so, please register here. Our agenda is replete with activities for our fun filled and successful advocacy day. In addition to a hearty breakfast and lunch, you will have the opportunity to hear from Senate Pro Tem Senator Cindy O’Laughlin, meet Speaker of the House Jon Patterson, MD and shake hands with your very own legislators while you advocate for your profession and your patients. Your presence is essential. This is our day to show the General Assembly that physicians and med students are actively engaged in policies affecting healthcare in our state. Help us keep the reputation of While Coat Day alive and well respected.

A special note regarding MAOPS member participation: We currently have over half of the attendees for this event compared to MSMA. However, both organizations are down in participation compared to the last two years. Please encourage your colleagues to attend. We must step up our game as a profession, or we risk being relegated to “insignificant,” in the eyes of legislators. If you have not registered yet, please do. If you have, try and recruit a couple of colleagues to come to town with you.