Agency reform bills take center stage during week four of legislative session

Posted on: 3/1/19

In week four of the legislative session, “agency reform” bills took center stage as five bills promoted by the Senate Republicans were amended to eliminate state agency boards. Each bill was voted from the Senate Rules Committee on 11-2 votes along party lines. Gov. Kevin Stitt advocated for this change. The bills would grant direct appointment authority, with Senate confirmation, for the directors of five state agencies, including the Oklahoma Health Care Authority (SB 456), the Department of Mental Health & Substance Abuse Services (SB 459), Department of Transportation, Department of Corrections and the Office of Juvenile Affairs.

Similar bills were passed from House committee that make agency heads and boards of the same agencies a mixture of gubernatorial and legislative appointees. The bills dealing with the health agencies include HB 2481, Health Care Authority, and HB 2483, Mental Health & Substance Abuse Services.

OHA opposes direct appointment of state agency directors by the governor and changing the agency boards to advisory status only. Because the agency directors have traditionally been appointed by and report to their respective boards, discussion and decisions regarding agency programs, operations and finances, including discussion about budget cuts, are communicated during each open board meeting. While some agencies’ board member appointments are based solely on congressional districts, the health agency board members are required to have experience and/or education appropriate for serving in these positions.

Accepting federal funds: A Senate bill (SB 605) to accept federal funds to cover the uninsured passed from the Senate Committee on Retirement and Insurance last week 9-0. This is the first time a measure has been considered in a committee of the Legislature since the Affordable Care Act was enacted by Congress in 2010. The bill was also assigned to the Senate Committee on Appropriations and did not receive a hearing prior to the Feb. 28 committee deadline.  

While SB 605 did not advance, the topic is very much under discussion by legislators. Because of the type of legislation, the subject may be considered later in the legislative session with appropriations and budget bills.   

Guns – property rights: Governor signs the first bill of his term. OHA, working with a coalition of businesses, successfully amended HB 2597, the “permit-less carry” bill, which was signed into law this week. The amendment supported by the OHA preserves current protections that allow private property owners to prohibit firearms from being carried onto property. The bill permits Oklahomans age 21 and older to carry a firearm without a permit. Further the bill prohibits felons and those with domestic violence convictions or who have been adjudicated as having a mental illness from carrying a firearm.

Following is the status of legislation of interest:

Status of bills supported by OHA that passed committee – to floor for action: HB 1089, SHOPP, extends the sunset date from Dec. 31, 2020 to Dec. 31, 2025;  SB 704, provides protection for living organ donors under the Oklahoma Living Organ Donor Fairness Act, by providing fairness in treatment by life insurance carriers; HB 2288, removes loopholes in the Oklahoma Clean Indoor Air Act; HB 2285/SB 1031, updates the duties of the Hospital Advisory Council; HB 2351, creates the Interstate Medical Licensure Compact, which provides a framework and process for multi-state medical licenses of physicians; HB 2460, removes smokers as a protected class in employment law; HB 2612, creates the Oklahoma Medical Marijuana and Patient Protection Act; HB 2631, increases workers’ compensation fee schedule by 3 percent for physicians and hospitals; SB 86, expands definitions of medical care providers related to aggravated assault and battery with a firearm beyond emergency care providers; and, SB 848, addresses the opioid epidemic while advocating for physicians to determine patient care in post-surgical situations in the prescribing of opioids.

Status of bills supported by OHA that passed committee and passed on the floor: SB 575, modifies the statute for parental consent for the treatment of minors to allow for written consent for a telemedicine encounter, thereby removing a barrier for implementation of school-based telemedicine by requiring the parent to be present during the visit.

Status of bills supported by OHA held in committee: HB 1225, Prompt Pay, initiates a statutory change for commercial carriers to pay providers promptly for clean claims by changing the current 30 days request for additional information to 15 days after receiving a claim. The bill will be held until next session to work out a conflict with Health Choice.

Status of bills opposed by OHA that failed in committee: HB 2417 and SB 218, Right to Shop, requires health plans to establish a program in which enrollees are directly incentivized to shop before and after their out-of-pocket limit has been met therefore encouraging health care consumers to make decisions based on a potential for monetary gain, the application of which is an incentive to out-of-network providers; SB 68, authorizes free-standing emergency room licensure for facilities that do not meet federal requirements for designation as an emergency room, are not eligible for reimbursement by Medicare and Medicaid, and are not affiliated with an existing licensed Oklahoma hospital system or facility; and, SB 955, creates licensure of radiologic technologists, changing the established practice of X-rays taken by an assistant or technologist working under the license and direction of a physician to requiring four separate licenses and six separate permits to X-ray separate portions of the body. State licensure is simply a needless duplication and added expense and would require several different licenses, primarily for people who are already certified by other professional entities. Note: the same language was inserted in HB 2041 without notice and passed from the House Public Health Committee.

Status of scope of practice bills: SB 801, changes the current requirement that a certified registered nurse anesthetist work under the supervision of a medical doctor, osteopathic physician or dentist to working “in collaboration with” a physician. SB 801 passed from committee and will go to the Senate floor for consideration. SB 839, which allows prescriptive authority for certified nurse practitioners who have obtained a waiver of supervision from the State Board of Nursing, was withdrawn from consideration by the bill’s author. The bill is dormant; however, the subject may be amended into another bill as a floor amendment.

Deadlines: Bills introduced for this legislative session must receive a hearing in the committee of the house of introduction and be voted out of committee before they go to the floor in the house of introduction for action. The committee deadline was Thursday, Feb. 28. March 14 is the deadline for bills and resolutions to be reported from the floor of the house of introduction (third reading) to the opposite house. House bills go the Senate and Senate bills go to the House for consideration.

For a tracking list providing more information about legislation in this report, click here. For more information about specific legislation, please email Shelly Bush, education & government relations assistant, [email protected]. (Lynne White)