Legislative Update: Spring 2012

While not nearly as stressful as the 2011 legislative session during which we successfully passed two bills, the 2012 session has certainly had its issues, with the budget overwhelmingly at center stage. Healthcare, because of its high cost to the state has seen a lot of activity.

HB 2319 (companion bill SB 6178) “Implementing the affordable care act”was probably the single most important piece of legislation to pass this session. (WANP Position: Supported; Result: Passed with partial veto by Governor of section of the bill requiring the operations of the Exchange to be suspended in the event that it is no longer self-sustaining was vetoed. Effective date: 3/23/2012.)

This is a very long and somewhat complicated piece of legislation that defines how parts of the federal legislation commonly known as “Obamacare” are implemented on the state level. A fair bit of my time was devoted to reading and trying to predict how this legislation would affect naturopathic practice—so far, so good. The WANP will be working on this bill over the rest of this year to include NDs in the recommendations of the Exchange Board; specifically, in the process for designating the “essential health benefits” that must be offered both inside and outside of the Exchange; the creation of a process for identifying state-mandated benefits; and requiring the state to apply for a wellness program demonstration project.

Between now and the beginning of the next legislative session in 2013 the WANP has two primary goals:
1) Gain inclusion of naturopathic physicians for Medicaid coverage in Washington State.
2) Address the discriminatory reimbursement practice of the insurance industry as it relates to reimbursement for naturopathic doctors.

SB 6440: “Providing health care purchasing options for individuals and small employers.” (WANP Position: Opposed. Result: Passed the Senate 41-7; died in House Rules committee.)

This bill was of primary concern as it would have allowed the Insurance Commissioner to enter into reciprocal agreements to allow health insurance policies to be sold across state lines. This could have resulted in the elimination of Every Category of Provider (ECOP) statute that mandates inclusion of NDs in all state-regulated health plans.

The following list of bills were relevant to Washington NDs this year. In addition to this ‘short list’, the WANP Governmental Affairs committee and our lobbyist, Terry Kohl, annually review an extensive list of proposed legislation to make sure that ND interests are represented and our scope of practice maintained.

SB 6394: “Requiring transparency for patients regarding training and qualifications of health care professionals.” (WANP Position: Opposed; Result: Dead, never heard.)
This bill was introduced by medical doctors who are concerned that other professions get to use the term “doctor”. It really didn’t add anything new as far as “transparency” or public safety and so was dropped.

SB5234: “Creating a statewide program for the collection, transportation, and disposal of unwanted medicines.” (WANP Position: Supported. Result: Dead)
Similar legislation nearly passed in 2011, but was defeated in 2012 with opposition from the pharmaceutical industry. This was a common sense approach to increasing public and environmental safety and I’m very sorry that it didn’t get more support.

HB 2366: “Requiring certain health professionals to complete education in suicide assessment, treatment, and management.” (WANP Position: concerns. Result: amended, passed, signed by Governor; Effective date 6/7/2012)
This bill was a bit controversial not due to its content, but rather because it required six hours of “training in suicide assessment, treatment, and management” for all health care providers every six years. In the end, the requirement was eliminated for all but a small group of non-medical providers.

SB 6051: “Concerning the donation and redistribution of unused prescription drugs.”
(WANP Position: supported. Result: never passed out of committee.)

SB 6237: “Creating a career pathway for medical assistants.” (WANP Position: Supported. Result: Passed. Effective date 6/7/2012.)
This bill creates a new profession called a ‘medical assistant’ that includes NDs as a health care professional that may delegate tasks that are within ND’s scope of practice. (The ‘health care assistant’ credential will be eliminate July 1, 2016).

SB 6265: “Addressing the medical use of cannabis.” (WANP Position: Supported. Result: Died on the Senate floor.)
This bill corrects the Governor’s veto provisions of the 2011 medical cannabis legislation that provided for arrest protection for patients who voluntarily register with the Department of Health (DOH) and the licensing of producers, processors and dispensaries.

SB 6298 and companion HB2637: “Concerning labeling of foods that contain genetically engineered material.” (WANP Position: Supported. Result: Heard but not passed out of committee.)
This bill requires labeling for genetically engineered raw agricultural commodities and genetically engineered ingredients offered for retail sale.

SB 6346 and companion HB 2438: “Harmonizing state requirements regarding discrimination against health care providers with federal requirements.” (WANP Position: Supported. Result: SB 6346 died on Senate floor.)
This bill puts federal law into state law which is similar to ‘every category of provider (ECOP) but is not every willing provider. Because of the expected doctor shortage in primary care, it is in the best interest of the public to be able to choose their own practitioner.

SB 6412: “Assisting persons seeking individual health benefit plan coverage when their prior carrier has terminated individual coverage.” (WANP Position: Supported. Result: Passed. Effective date 3/23/2012.)
This bill exempts certain persons whose individual coverage was discontinued by July 1, 2012, from the standard health questionnaire and requires a person’s prior coverage in a plan that was discontinued by July 1, 2012, to be credited against any pre-existing waiting period in the person’s new coverage.

SB 6429: “Promoting state employee wellness and productivity.” (WANP Position: Supported. Result: Died in Rules committee.)
This bill requires the state health care authority to expand and maintain the state employee health and wellness program.

HB 2306: “Authorizing the presentation of claims for payment for pathology services to direct patient-provider primary care practices.” (WANP Position: Neutral. Result: passed. Effective date 6/7/2012.)

HB 2316: “Regarding the disclosure of health care information.” (WANP Position: Supported. Result: Died in House Rules committee.)
This bill maintains heightened standards of privacy for patient information and records related to mental health services and information related to sexually transmitted disease while consolidating those provisions in the Uniform Health Care Information Act.

HB 2318: “Concerning shared decision making.” (WANP Position: Supported. Result: Passed. Effective date 6/7/2012.)
This bill establishes alternative methods of certifying patient decision aids for purposes of establishing prima facie evidence of informed consent by allowing a patient decision aid to address any medical condition or procedure, including abortion;; and allowing the state health care authority to charge a fee to a certification applicant to defray the costs of the assessment and certification of the patient decision aid.

HB 2571: “Concerning waste, fraud, and abuse detection, prevention, and recovery solutions to improve program integrity for medical services programs.” (WANP Position: Neutral. Result: Passed. Effective date 8/1/2012.)
This bill Implements solutions to create efficiency and cost savings through a shift from a retrospective “pay and chase” model to a prospective prepayment model and invests in the most cost-effective technologies or strategies that yield the highest return on investment.

HB 2762: “Concerning tax expenditure reform to provide transparency and accountability in fiscal matters.” (WANP Position: Opposed. Result: Died on House floor)
This bill would have eliminated ND tax exemptions if it had passed in the 2012 session.  The WANP strongly opposed this bill in the 2012 session and will continue to oppose any legislation that repeals any tax exemptions relevant to NDs.

For the exceedingly curious (or crazy) amongst you, the full content of these bills and any others you might be interested in may be found at: http://apps.leg.wa.gov/billinfo/. This site allows you to search by bill number and get your fill of legislative lingo.

Between now and the beginning of the next legislative session in 2013 the WANP has two primary goals:
1) Gain inclusion of naturopathic physicians for Medicaid coverage in Washington State.
2) Address the discriminatory reimbursement practice of the insurance industry as it relates to reimbursement for naturopathic doctors.

This agenda might seem oxymoronic in that Medicaid doesn’t reimburse any better than the worst reimbursement from any of the carriers. However, participation in many of the health care reforms may be predicated on participation in Medicaid. We need to be at the table even if we don’t all eat of every particular dish.

Much of the work of the WANP is monitoring legislation – and the majority of it is invisible. This might give some doctors the impression the WANP isn’t doing anything for them. Our ability to practice as broadly as we do in Washington is dependent on state law, and it is imperative that legislation is monitored regularly for changes that could negatively impact your ability to make a living. This is what the WANP Governmental Affairs committee does. By supporting the WANP, you support this essential work. If you have more interest, please consider joining the Govermental Affairs committee. We’re all in this together.

Comments are closed.