EHR and Scope of Practice Bills Move Forward

State Update

BY RONNA WALLACE
MMS LEGISLATIVE CONSULTANT

MMS President Dennis M. Dimitri, M.D., presented testimony on two important bills before the Health Care Financing Committee in late September. One bill would provide additional time for health care providers to comply with the interoperable electronic health record mandate contained in the cost containment bill from 2012, and would delay the current 2017 deadline date to 2022.

“While physicians are much further along on interoperable records than many other professions, 2017 is not achievable for all of us and much less so for other providers. This date was arbitrary and aspirational when established and needs to be recalculated to a more reasonable goal,” Dr. Dimitri told lawmakers.

At that same hearing, Dr. Dimitri voiced the MMS’s opposition to a bill that would require the legislature to refer scope of practice bills to the Health Policy Commission (HPC) for review, evaluation, and recommendation. As currently drafted, the bill would mean that if recommended by the HPC, the legislature would have little discretion and the bill would automatically be placed on the calendar without further legislative review, even if significantly rewritten by the HPC, which the legislation currently allows.

The MMS does not oppose a fair, objective, patient-centered review of scope of practice legislation, but H.993 (An Act Relative to Health Policy Commission Reviews of Scope of Practice Proposals) is written to favor non-physician health care providers and drastically restricts legislative discretion and jurisdiction for virtually all scope of practice bills.

Continuing to top the MMS agenda is opioid abuse reduction and education. Legislation has already passed the Senate and is pending before the House. The MMS supports most of the provisions in the Senate bill, many of which were borne out of discussions between MMS officers and staff and Senate health care leaders. MMS leaders support the concept of “partial fill,” which would allow patients to elect to receive a portion of their total narcotic prescription from the pharmacy — at a lower copayment — with the option to return to the pharmacy to receive the remainder of the prescription if necessary. The MMS feels strongly that this initiative would significantly reduce the amount of unused drugs sitting in the medicine cabinet for those patients that choose to take advantage of this option.

Another provision supported by the MMS included in the Senate bill is a drug stewardship program. Similar to a partial fill program, the drug stewardship program targets safe storage and disposal by requiring the pharmaceutical industry to put forth programs intended to reduce the amount of unused drugs in the home. Programs would supplement current police station drop-off programs and could include mail order, drop-off day events, and additional drop-off locations in more welcoming or convenient locations.

Lastly, the Senate is proposing language to require the Prescription Monitoring Program to “push” information to physicians on where they stand in the bell curve of prescribing, compared to their colleagues in similar specialties and practice settings. Prescribers who exceed mean or medians within their category would be sent notice of their percentile ranking. The MMS supports this concept of informed prescribing patterns after modifications were made to strengthen liability protections for physicians. The information would be confidential and sent only to the practitioner. The information would not be public record, not subject to disclosure, not admissible as evidence in a civil or criminal proceeding, and would not be the sole basis for investigation by a licensure board.

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