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The Legislature is now in its final two and a half weeks of the Session. Things have been heating up with more bills receiving action in committees and on the floors of the Senate and House. February 27 marks the final date for bills to pass out of their house of origin. Any bills left in their house of origin after this date are considered dead for the duration of the Session. The final day of the Session is Saturday, March 8. |
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Medically At-Risk Driver Bill Passes House Judiciary
HB 4515 - The House Judiciary Committee passed HB 4515, reporting of the medically at-risk driver legislation, on February 18. The purpose of this bill is to promote public safety on the roadways of West Virginia by providing a mechanism by which health care providers may report when an individual they have treated has a condition that renders them incompetent to operate a motor vehicle. This bill is a top priority of the WVSMA. We have collaborated with the DMV to promote this legislation. The bill was on 2nd reading in the House on February 20.
Bill Would Allow Drivers to Use Bioptic Lenses
HB 4139 - Allows drivers to use "Bioptic lenses" to drive under limited conditions. The special lenses are used by persons with certain eye conditions that render them unable to see well enough to operate a vehicle with any other mechanism. It takes extensive special training and equipment for a person to use the bioptic lens to drive a car. The WV Division of Rehabilitation has been training persons from other states to use this equipment, however, DMV regulations specifically prohibit the use of bioptic lenses in West Virginia. The bill was on 3rd reading (passage stage) in the House on February 20.
Vision Screening to be Required at License Renewal
HB 4069 - Requires everyone undergo a vision screening when renewing their driver's license. (This occurs every five years.) The legislation simply requires all persons applying for a driver license renewal to take the vision screening which is required at initial licensing. This bill is endorsed by the WV Academy of Ophthalmology and the WVSMA.
When the Judiciary Committee took up this legislation they passed an amendment to clarify that the vision screening process will not be used for any type of personal biometric identifying information. There was concern that the DMV might use the screening to do a retinal scan for identification. Currently the DMV collects a fingerprint voluntarily and also uses a computer generated matrix from the driver photos to differentiate a person's features from others. The bill specifies the vision screening requirement will become effective January 1, 2009 and it changes the current 30-day notice to renew a license to 90-days to grant persons the extra time in case they need to see their eye care professional. The bill has passed the House and is awaiting action in Senate Judiciary. |
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Regulating All-Terrain Vehicles.
SB 567 - This bill modifies the regulation of all-terrain vehicle act by specifying that ATV's are prohibited from operating on any paved road. Additionally it clarifies that any county commission may enact an ordinance that further regulates (permits or restricts) the operation of ATV's in the county. Under current law only counties which are operating under a countywide comprehensive plan may pass such an ordinance.
In previous years more comprehensive legislation has been attempted that would require the use of helmets and disallow passengers and child drivers of certain sized ATVs. Those efforts have come up short so there is an attempt to just address the issue of getting these non-roadworthy vehicles off the paved roads. The WVSMA supports efforts to restrict the use of ATVs from the roads and to enforce safety requirements. The bill is currently awaiting action in the Senate Finance Committee. |
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Uniform Maternal Risk Screening
HB 4052 - The bill establishes the Uniform Maternal Screening Act and calls for the development of a uniform maternal risk screening tool to serve as an alert to medical care providers in evaluation and assessment of high-risk pregnancies. The screening tool would be developed by an advisory council made up of providers of maternity services and representatives of the Bureau for Public Health. The data derived from the screening would also be reviewed through a statistical matrix to measure incidents of high-risk and at-risk pregnancies for planning purposes by public health officials. Strong confidentiality language was amended into the bill by request of the WVSMA and other supporters of the legislation specifying the tool shall be confidential and shall not be released or disclosed to anyone including any state or federal agency for any reason other than data analysis of high-risk and at-risk pregnancies for planning purposes by public health officials.
This bill passed the full House on February 5. It is now in the Senate Health Committee with a second reference to the Senate Judiciary Committee.
Creating Maternal Mortality Review Team
SB 234 - This bill creates a Maternal Mortality Review Team to be established under the office of the Chief Medical Examiner. The Team would be a multidisciplinary team created to review the deaths of women who die during pregnancy, at the time of birth or within one year of the birth of a child. The bill establishes a list of 20 plus team members all representing different stakeholders with expertise in this area. The Team is directed to draft rules for establishment, formation and conduct of the team including developing protocols for review of maternal mortalities. Through their review of maternal deaths, the Team is to establish trends, patterns and risk factors and provide statistical analysis regarding the causes of maternal fatalities in West Virginia. The Team is directed to submit an annual report of their findings to the Governor and Legislature. The legislation contains strong confidentiality language clarifying that the proceedings of the Team are confidential and that the members may not be questioned in any civil or criminal proceeding regarding the information presented or opinions formed from their work. The bill has passed the full Senate and is now in the House Health Committee. The bill has a second reference to the Judiciary Committee. |
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Governor Manchin introduced SB 278/HB 4129 to establish a special license for healthcare professionals who are retired and who want to volunteer their services in free clinics and renders them immune from civil liability. Currently, physicians already have a retired volunteer license which allows them to volunteer without the need for liability insurance coverage. The bill takes this concept and provides such volunteer licenses to physician assistants, dentists, dental hygienists, pharmacists, pharmacy technicians, registered nurses, optometrists, physical therapists, psychologists, and occupational therapists. Each licensing board will be able to determine the number of hours to require for continuing education and will have their normal licensing purview over each volunteer. There must be a written agreement between the retired medical professional and the clinic and each clinic must carry a minimum of liability coverage of not less than $1 million per occurrence. This bill was on 2nd reading on the House floor on February 20. |
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The Hospital Association, in collaboration with the WV Chapter of the American College of Emergency Physicians, is promoting SB 590 which adds healthcare workers to the list of protected persons from acts of violence. The bill includes healthcare workers as a named protected group along side police officers and other public safety workers. Senator Hunter amended the bill to also include child protective service workers and social workers. The bill was on 2nd reading (amendment stage) in the Senate on February 20. |
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A few bills have been introduced which aim to cut into the lucrative and pervasive business of prescription drug diversion. With recent attention being drawn to southern West Virginia counties where prescription drug abuse is reportedly "running rampant," state police, sheriffs and others are looking for ways to curb this problem.
On the House side, HB 4142 was introduced by the State Police and supported by the Board of Pharmacy which would require all "Pain Management Physicians" to query the Board of Pharmacy prescription monitoring database on each patient that they prescribe a schedule II, III or IV drug. A problem with the bill is that the definition of pain management physician was defined as "any physician whose practice is made up by the majority of patients receiving Schedule II through Schedule IV controlled substances." The WVSMA raised concerns about the bill and suggested that there are other ways to combat the problem. Though the intent is good, the net effect of the bill would be to cast too large a net.
On the Senate side the Health Committee has two pieces of legislation (SB 468 and SB 306) that would add Sheriffs, or their designee, parole officers and corrections officers to the list of approved persons having access to the Board of Pharmacy's prescription monitoring database. All persons who are dispensed schedule II, III, and IV drugs in West Virginia are reported to this database. Personally identifiable data is specifically sent in addition to the prescriber's information. Information can be pulled out per prescriber or individual patient.
Delegate Don Perdue, Chairman of the House Health Committee held two stakeholder meetings to attempt to come to agreement on the legislation. A meeting held on Friday, February 8 resulted in agreement on the passage of a Resolution which would initiate a legislative study of the problems and come back next year with recommendations for potentially agreed upon legislation. |
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The Board of Medicine has a hefty legislative agenda this Session with three bills and three rules they are driving through the legislature. The following is an update on the legislation:
Relating to physician assistants and updating language to conform to national changes.
HB 4144 - The bill updates the requirements for physician assistant licensure. It clarifies that an applicant for a PA license may practice under a temporary license until the applicant successfully passes the National Commission on Certification of Physician Assistants' certifying examination. Additionally it clarifies that a supervising physician of a PA must have a full unrestricted license.
Creating felony offense of unauthorized practice of certain health care professions.
SB 290 - This legislation establishes the offense of the unlawful practice of medicine. Currently, it is a misdemeanor to practice medicine without a license. This bill clarifies that if a physician practices medicine on an expired, lapsed or terminated license for a period of time up to 3 months they are guilty of a misdemeanor. Practicing is written to mean "intentionally practices, or holds himself or herself out as qualified to practice, or uses any title, word or abbreviation to indicate to or induce others to believe he or she is licensed to practice." It further clarifies that those who do not fall into this specific category (beyond the three month reprieve) are guilty of a felony and that anyone who practices without a license who causes serious bodily injury to a patient is guilty of a felony.
Updating physician and podiatrist licensing requirements.
SB 317 - This bill updates the licensure requirements for physicians licensed under the Board of Medicine. It extends the acceptable time to pass all three steps of the United States medical licensing examination (USMLE) from 7 to 10 years. Additionally it clarifies that if any person fails to pass any of the three steps in three attempts must come before the Board to determine if further education evaluation and training is needed. It also updates the podiatric licensure requirements. The bill was amended to allow for the Board to issue a restricted license to foreign medical graduates who don't meet all the criteria for licensure but who have exceptional education or training and practice credentials that are substantially equivalent to the requirements of licensure. The Board is directed to propose rules that establish and regulate the restricted license.
Board of Medicine, continuing education for physicians and podiatrists.
HB 4202/ SB 429 - This rule modifies the continuing education requirements for physicians by requiring that at least 30 of the 50 hours received are related to the physician's area or areas of specialty. It also clarifies that if a physician fails to renew their license (pay the licensure fee) their license would "expire" instead of being "suspended" as it currently is considered.
Collaborative pharmacy practice rule.
HB 4261/SB 430 - This rule was drafted per the passage of legislation that passed in the 2006 Legislative Session establishing a collaborative pharmacy practice, similar to a collaborative relationship with the physicians and nurses. The Board of Medicine, Board of Pharmacy and Board of Osteopathy were charged with collaborating on the development of this rule.
Radiologist assistant licensure rule.
HB 4262/SB 431 - This rule was developed per the legislation that passed last year which established the Radiologist Assistants licensure and placed them under the Board of Medicine. RA's will function as a physician assistant to a Radiologist. |
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The following are summaries of other healthcare bills which are currently moving through the legislature:
Relating to medical qualifications for school bus operators.
HB 4059 - The bill allows current county board of education employees diagnosed with diabetes to continue to operate a school bus if they obtain a special operator license through the interstate waiver program. The bill passed the House and is in the Senate Health Committee.
Providing that only healthy beverages and healthy or nutritional snacks may be sold in the county school system.
HB 4051 - Would allow the State Board of Education to regulate healthy beverages and snacks sold or served during the school day. The Board would follow standards of the National School Beverage Guidelines. This legislation is supported by the WVSMA and other organizations focused on healthy lifestyles. The bill passed out of the House Health Committee and is currently in the House Education Committee.
Creating an Office for Oral Health under the Bureau for Public Health and authorizing a full time director.
HB 4074/SB 235 - The bill would create an Office of Oral Health and provide for a comprehensive oral health initiative. It has passed out of the House Health Committee and is currently in the House Finance Committee. The bill is a result of a legislative interim study from last year which focused on bettering the oral health of West Virginians. The bill establishes an office of Oral Health under the Bureau for Public Health. Both the House and Senate bills have moved out of their first committee and currently reside in the Finance committees of their respective houses.
Adding CPR and First Aid training to the health education curriculum in secondary schools.
HB 4124 - The bill requires CPR and first aid in the health curriculum being taught in public schools. It was amended in the House Health Committee to clarify that students would not be certified in CPR, but would be taught the basics. The bill was on 3rd reading in the House on February 20.
Relating to definitions under the Medical Professional Liability Act.
HB 4445 - This bill amends the definition of "health care provider" under the medical professional liability act (MPLA). It adds pharmacists and pharmacies to the list. This legislation is being pursued by the pharmacists in response to a recent Supreme Court ruling that determined that pharmacists are not covered under the MPLA and thus aren't granted the protections of the caps on damages and other aspects of the medical liability reforms gained in 2001 and 2003.
Relating to registered nurses required in operating rooms.
HB 4474 - This bill requires a registered nurse to be present as a circulating nurse in all operating rooms during operative procedures. The WVSMA had a question about what is considered an operating room since it was not defined in the bill. At the request of the WVSMA, the House Judiciary Committee amended the bill to clarify that private physician offices are not covered by this law.
Relating to the reimbursement of costs for newborn screenings
HB 4513 - The bill requires insurance coverage for the state mandated newborn screenings that must be done on all infants born in West Virginia. Last year the legislature passed a bill increasing the number of mandated screenings.
Authorizing physician assistants to conduct mental health hygiene process examinations.
SB 481 - The bill would add physician assistants to the list of persons qualified to perform mental hygiene exams for determination of involuntary hospitalization. Currently, in addition to physicians, the following are authorized to perform the exams: psychologists, independent clinical social workers, and advanced nurse practitioner with psychiatric certification. The committee passed an amendment which clarified that the physician assistants would be permitted to do the exams only after they have been authorized by an order of the circuit court. The same requirement exists for the social workers and nurse practitioners. The bill has passed the Senate and is in the House Health Committee.
Allowing optometrists to prescribe drug-dispensing vision correction devices.
SB 615 - The bill will allow optometrists to prescribe and dispense a new type of contact lenses that contains medication. The new contacts are not yet FDA approved. There is concern that this bill may provide the opportunity for optometrists to expand their scope of practice to include prescribing drugs they are currently restricted from prescribing to patients. The bill is currently in the Senate Health Committee.
Creating Healthy Lifestyles Restaurant Calorie Posting Program
SB 632 - This bill establishes the "Healthy West Virginia Program" and directs the Office of Health Lifestyles to establish a Healthy Lifestyles Restaurant Calorie Posting Program. The program is to allow voluntary participation by covered food service establishments. The "covered food establishments" are defined as food establishments doing business in West Virginia and nationally which have substantially similar menu items in standardized serving portions. The purpose of this bill is to initiate the Healthy Lifestyles Restaurant Calorie Posting Program, to encourage restaurants to voluntarily participate in this program and to provide that any restaurant participating in and advancing this program will be issued a universally recognized logo, suitable for public display by the business, and will benefit from the marketing of this program through all state agencies. |
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The following are summaries of other employer/employee relations and business related bills which are currently moving through the legislature:
Proposing amendment to Constitution designated Inventory Exemption Amendment.
SJR 5/HJR 101 - These Resolutions, which have been introduced by request of the Governor, would amend the State Constitution to authorize the Legislature to exempt from personal property taxes personal property inventory in the form of raw materials, goods in process and finished goods employed exclusively in or resulting exclusively from manufacturing. If adopted, this constitutional amendment would go before the voters.
Requesting the Joint Committee on Government and Finance to study the establishment of a court of chancery within the unified judicial system in the State of West Virginia.
HCR 20 - House Speaker Rick Thompson has introduced this resolution calling for a study establishing a Chancery Court in the state. Such a court originated in England and has been adopted in a number of states (most notably Delaware) to handle complex business cases.
Relating to nonpartisan election of Supreme Court justices and circuit court judges.
SB 218 - This bill would require, beginning in 2010, non-partisan elections of state Supreme Court justices and circuit court judges.
SB 475 - Would require nonpartisan election of Supreme Court justices.
Increasing monetary limit to file circuit court suit.
SB 238 - This bill increases the jurisdictional limit for filing suits in circuit court from $300 to $2,500. The bill would be helpful to small businesses because they will be able to resolve many matters in magistrate court instead of having to go to the circuit court.
Extending the deadline for submission of the written plan for participation in the pilot program for increased powers for municipal self government.
SB 333/ HB 4060 - These bills would revise the municipal home rule pilot program and extend the deadlines for submission and consideration of pilot home rule plans. The pilot program was passed by the Legislature in 2007. Of interest on this topic is that the City of Charleston is looking into establishing a provider tax on hospitals as part of their home rule pilot program. The WVSMA is concerned about any efforts to create new provider taxes. This year it might be on hospitals, next year it could be on physicians.
Requiring consumers' notification of information security breach.
SB 340 - This bill would establish requirements for notification to consumers when electronic data containing personally identifiable information is compromised. The bill places the Attorney General in charge of enforcing the law and creates monitory penalties. The WVSMA has been engaged in discussions on this bill along with other stakeholder groups representing the business community which all have had concerns about the impact of this legislation. Of particular concern to the WVSMA is how this bill might create a second tier of regulation for healthcare entities already covered under HIPAA.
Eliminating Business Franchise Tax.
SB 465 - The bill would phase out the business franchise tax. The Senate Finance committee amended the bill to phase out the tax in 2015 rather than 2013.
Creating limited sales tax holiday for certain Energy Star appliance purchases.
SB 474/HB 4305 - These bills, which have been introduced by request of the Governor, propose a limited sales tax exemption for non-business purchases of Energy Star qualified appliances and other energy-saving products.
Including sole proprietor in insurance policies "small employer" definition.
SB 497 - This bill would change the requirements for the state's Small Business Health Insurance Plan to enable sole proprietors to apply for insurance coverage. Currently the law allows only businesses with two or more employees to be eligible for this type of plan.
Providing that all employees have the right to review and copy the contents of their personnel file.
HB 4048 - This bill would allow employees access to their own personnel files by employees under certain circumstances. The bill was significantly amended in the House Judiciary Committee and is awaiting action in the House Finance Committee.
Asbestos Claims Transparency Act.
HB 4049 - Members of the West Virginians for Fairness Coalition are working to develop legislation that would aim to prevent "double-dipping" of asbestos claims. The WVSMA is in support of the Coalition's efforts. There is concern that trial attorneys are filing claims in state courts though their clients may be entitled to receive an award from an asbestos bankruptcy trust, thus to obtain multiple recoveries for the same injury. The coalition's bill would provide for transparency of these claims.
Expanding technology infrastructure to provide broadband internet access throughout the State of West Virginia.
HB 4343 - The purpose of this bill is to expand technology infrastructure by providing broadband Internet access throughout the State and create the Electronic Telecommunication Open Infrastructure Act (ETOPIA).
Healthy Families Act.
HB 4447 - The bill would require employers to provide paid sick leave days. The bill would pertain to employers who have more than 15 workers, and these employers would be mandated to provide up to seven sick days a year (the exact number depends on whether the worker is part-time or full-time). The state Commissioner of Labor will have inspection and enforcement powers. |
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The WVSMA has been working pro-actively to keep physicians up to date and compliant with the new federal tamper resistant prescription pad mandate. We have applied for a grant to financially assist West Virginia physicians to meet the federally mandated tamper resistant prescription requirement. This grant will give physicians a "jump-start" on the new tamper resistant pads by providing approximately 500 physicians with a 6-month supply of tamper resistant pads or paper. These funds, which first must be appropriated by the WV Legislature, came from the settlement money awarded to the State Police through the Perdue Pharma OxyContin lawsuit.
All written prescriptions for Medicaid recipients will soon be required to be written on mandated tamper resistant prescription pads in order to be eligible for reimbursement. This action is required by section 7002(b) of the U.S. Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, which was signed into law on May 25, 2007.
As of April 1, 2008, all prescription pads or printer paper for prescriptions written for Medicaid members are required to have at least one of the features listed below. By October 1, 2008, prescription pads and paper will be required to have all three of the following recognized characteristics:
1. Industry-recognized features designed to prevent unauthorized copying
2. Industry-recognized feature(s) designed to prevent erasure or modification of information written by the prescriber, or
3. Industry-recognized feature(s) designed to prevent use of counterfeit prescription forms
According to this mandate, physicians who use computer generated prescriptions for Medicaid patients will also need to ensure that the paper being used in their printers is compliant and tamper resistant.
The WVMSA has worked diligently with the WV Bureau for Medical Services in order to assist physicians with the federal mandate. We have met to determine the security features that are economical and reasonable to implement. Physicians will soon be receiving correspondence from the Bureau describing the required features.
Over the past few months, the WVSMA has also been actively involved with obtaining price quotes from print vendors for tamper resistant prescription pads. These vendors include both instate and national firms. We have found a company who can supply quantity pricing for both the tamper resistant prescription pads and the tamper resistant printer paper for computer generated prescriptions. The company has also pledged to meet and exceed the requirements set by the WV Bureau for Medical Services for the tamper resistant prescription pads. In addition to providing the tamper resistant paper/pads, all West Virginia pharmacies will be contacted and advised that any prescription written on this vendor's prescription pads or paper will be compliant with state requirements, thereby reducing the number of phone calls and questions from pharmacists who are filling prescriptions for Medicaid patients.
The WVSMA has plans in place to move quickly once the WV State Legislature approves appropriation. As soon as the grant money is available, we will communicate to physicians the process for applying for a complimentary supply of tamper resistant prescription pads or paper.
If you need more information or have additional questions, please contact Barbara Good, WVSMA Physician Practice Advocate, at (304) 925-0342, ext. 11 or via email (Barbara@wvsma.com). |
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February 22, 2008
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KEEP INFORMED!
To stay on top of the actions of the West Virginia Legislature, there are several methods you can utilize: read your local paper, go on-line to the legislative website, and watch your local public television station program The Legislature Today every weekday night at 6:30 p.m.
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