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The Legislature wrapped up their second week of session on Friday. Over 1000 bills have already been introduced with many of them focusing on healthcare related topics.
CLICK HERE for a full listing of health care related bills introduced as of Friday, February 20. This document has embeded links to the actual bill text. |
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After of a year of negotiating, a host of meetings and a large number of studies, the Legislature appears close to making the first significant changes in the state’s certificate of need laws in years reducing regulation on physicians and hospitals. The proposal includes a controversial provision permitting West Virginia hospitals near state borders to expand across state lines without West Virginia regulatory review. A six-member select Legislative committee on CON co-chaired by Senator Dan Foster and Delegate Harold Michael recommended legislation that would also:
- Increase the capital expenditure and major medical equipment thresholds from $2 million to $2.7 million and modify the fee structure for filing a certificate of need application;
- Eliminate lithotripsy from CON review;
- Modify and cap the CON filing fee;
- Eliminate CON reviewability of such non-health related projects as electronic health records, telephone systems, parking garages, cafeterias, etc., up to a certain level, based on hospital size;
- Eliminate CON review in certain instances for ambulatory care facilities operated by a hospital in the same county as the hospital if there is no objection by an affected party after notice has been made in the community;
- Exclude state psychiatric hospitals from CON review if the hospital is creating forensic beds, as well as in-state behavioral health providers seeking to stem the referral of children to out-of-state programs.
- The “border state issue” remained unresolved until a last-minute compromise was worked out between legislators, the West Virginia Health Care Authority and the West Virginia Hospital Association. The Health Care Authority originally opposed giving up jurisdiction over border state projects, fearing hospitals might invest in large out-of-state facilities that would fail, and then try to make up lost revenue through rate increases on West Virginia patients. The compromise prohibits that. Under an amendment offered by Senator Evan Jenkins, hospitals may not use the financial condition of any out-of-state facility as the basis for requesting a rate adjustment on West Virginia patients.
The subcommittee is asking the Legislature to continue the study on CON for another year, with plans to examine:
- Modifying the statutory moratorium on nursing home beds;
- Cross-border competition and its impact on West Virginia laws;
- The definition of “affected person” (one who can officially object to a CON proposal);
- Regulatory timeframes in the CON process;
- The possibility of licensing ambulatory health facilities ; and,
- Eliminating dialysis from CON review.
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Following nearly a year long effort to develop a healthcare reform plan, the Legislative Interim Select Committee D on Health last week approved the introduction of bills. The legislation came out of a comprehensive process, named the "Roadmap to Health" headed by consultant Ken Thorpe, PhD from Emory University. The legislation is yet to be introduced, but a summary of the bills follows:
- Establish the Governor's Office on Health Enhancement and Lifestyle Planning "GO HELP". The office would have broad authority and oversee the implementation of the other recommendations of the project. The GO HELP office director, would report directly to the governor and would oversee coordination of state entities for the purpose of redesigning health system delivery services. The director’s major challenge would be the development of a five-year strategic plan and overseeing the following components of the health care reform;
- Provide a tax credit to employers with fewer than 25 employees of up to 50% of the cost of private health insurance benefits, within certain limits. The total amount that may be used in any taxable year may not exceed $25,000. The program would exist for three years and is aimed at encouraging employers to enter the insurance market. It was clarified that it will allow businesses that currently provide health insurance to also benefit from this tax credit;
- Require restaurants that operate more than 15 establishments to post calorie content on their menus, menu boards and drive-through boards. The program is modeled after one in New York City;
- Increase the tax on cigarettes from fifty-five cents to $1.20, the current national average and on other tobacco products from the current 7% to 14% of their wholesale price. Essentially, this is a doubling of tobacco taxes for cigarettes and other forms of tobacco. Half of the revenue generated will go into a special account to fund the GO HELP office and the other half into the state General Revenue Fund;
- Impose a temporary fee of 0.199% of all health care claims paid on health insurers to help jump-start health information technology systems such as electronic medical records. The fee, beginning in October, would be paid into the West Virginia Health Information Network Account. The program will be administered by the West Virginia Insurance Commission; and,
- Establish of a Central Verification Organization "CVO" for credentialing of healthcare providers. The legislation allows creation of up to three CVO's in West Virginia.
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Several health-related matters were recommended either as legislation or studies during the busy February interim meeting of the Legislative Oversight Commission on Health and Human Resources Accountability (LOCHHRA). During its final meeting before the official start of the 60-day session, LOCHHRA recommend the following legislation that is soon to be introduced in the Legislature:
- The Commission would support the bill concerning the redefining of pain offered by the End of Life Center. The bill would redefine the word “pain” in West Virginia Code to conform to definitions adopted by the West Virginia boards of Medicine and Osteopathy, the Federation of State Medical Boards and others. The new definition deletes the word “intractable pain” in favor of the term “pain” as it is now considered archaic and may lead to possible misinterpretation. The issue is especially important in treating severe pain in patients at the end of life. This is one of the key policy issues of the WVSMA;
- A bill to enable the Division of Personnel to extend the 90-day period for a temporary employee to be hired to 1,000 hours, or roughly an additional 15 days more. This is a national standard and is intended to help meet staffing shortages at some state hospitals;
- Add $2 million to the state budget of the Autism Center at Marshall University and $500,000 for a training program for those who provide services to persons with autism;
- The Commission endorsed the proposal of the DHHR submitting a family planning waiver to CMS if determined beneficial and cost effective and to expand coverage for pregnant women to 200% of the federal poverty level if resources are freed up by the family planning waiver service;
- That a resolution be introduced to identify one or more “model” counties of good perinatal health education in the schools. The teen population has the worst perinatal birth outcomes in the state so it would be beneficial to look at CDC curriculums and determine which schools have the best programs and report back to LOCHHRA.
- The Commission send a letter of support to the two education committee chairs for funding the Perinatal Project to be continued under the Chancellor of the Higher Education Policy Commission at a cost of $150,000 the first year and $200,000 in each future year;
- The Commission would support any legislation offered by the Behavioral health Commission in their first phase of redesigning the system and support the continuation of the commission for 2 years; and
- The Commission would support the codification of the Partnership for Community Well-Being.
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A set of controversial rules were finally agreed upon by the Rule-Making Review Committee submitted by the WV Board of Pharmacy for pharmacies in the ten free clinics across West Virginia. The rule on Charitable Clinic Pharmacies had so many comments had been submitted, that a box of letters, faxes and e-mails was set before each member of the Rule-Making Review Committee. The rule now allows a health care practitioner to dispense drugs without a pharmacist present in limited circumstances and transportation of prescriptions to a satellite office and providing continuing education for pharmacists who volunteer.
Additionally, the Legislative Rule Making Review Committee approved a rule granting Pharmacists the ability to administer certain adult immunizations, including influenza and pneumonia. This rule derived from legislation that passed last legislative session which was negotiated by the WVSMA and the Board of Pharmacy. |
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The Judiciary Interim Committee adopted a bill to establish standards for newly developing drug court process. The goal is to reduce recidivism, provide cost savings from fewer incarcerations for alcohol and drug convictions. |
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The change by retirees from the PEIA plan to the Coventry Advantra Freedom plan has resulted, on average, in savings to retirees, according to a study by the Performance Evaluation and Research Division (PERD) of the Legislative Auditor’s Office. Lara Stephens, research analyst for PERD, told members of the Select Committee on PEIA, Seniors and Long-Term Care that while aggregate medical out-of-pocket costs increased, average pharmaceutical out-of-pocket costs decreased from FY 2007 to 2008. In a detailed analysis of data, PERD concluded even though there were increases in out-of-pocket medical expenses and a relatively small decrease in pharmaceutical out-of-pocket costs, the increase in out-of-pocket costs does not represent an overall increase when decreases in premiums and out-of-pocket maximums are taken into account. |
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The cumbersome process to implement the rules promulgated by most state agencies has begun. Rules are made by constitutional officers, cabinet secretaries, major departments, divisions within departments, and by boards, commissions and authorities established by law. The rules provide details for the agencies to handle day-to-day operations issues. Because of a Supreme Court decision, all rules must now be adopted by the legislature.
The House Health Committee got started on Monday by passing all the Board of Medicine's rules.
HB 2214 - Definition of Surgery by the WV Board of Medicine
HB 2216 - Regulation of Extraordinary Circumstances Medical License by the WV Board of Medicine
HB 2215 - Medicine, Licensure, Disciplinary and Complaint Procedures by the WV Board of Medicine. The changes mostly affect the physician’s assistant.
The Senate Helath Committee then followed suit and passed a number of rules bills on Thursday.
SB 194 - Licensure of Medical Adult Day Care Centers by DHHR.
SB 196 - Tuberculosis Testing, Control Treatment and Commitment by DHHR
SB 207 – Definition of Surgery by the WV Board of Medicine
SB 220 - Limited Prescriptive Authority for Nurses in Advance Practice by the Board of Examiners for Registered Professional Nurses |
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Stating “an alarming number of veterans are returning home with traumatic brain injuries,” Lisa Silver, Transition Assistance Adviser for the WV National Guard, joined others in calling for increased attention to, and funding for, TBI treatment. During a joint meeting of health and veterans committees of the House, Silver said while there is no accurate count of how many West Virginia veterans suffer from traumatic brain injuries, nationally it is estimated that 80% of injuries among veterans returning from Iraq and Afghanistan are the result of IED explosions. Often employers don’t always understand what’s happening with veterans who return to their jobs because there are delays in diagnosis, she said. Ginger Dearth of the Traumatic Brain and Spinal Cord Injury Rehabilitation Fund said West Virginia’s rate is higher than the national average because of aging, ATV accidents, mining accidents and a large number of persons serving in the military. She called for a dedicated funding stream for treatment through a Traumatic Brain Injury Medicaid Waiver which would increase eligibility criteria to cover those 22-65 years old. Dr. James Petrick, a clinical neurophysiologist from West Virginia University Hospitals, noted there are only five neurophysiologists in West Virginia. |
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A commission studying behavioral care needs and facilities in West Virginia is recommending closer integration between behavioral health and primary care. John Bianconi, Commissioner of the Bureau of Behavioral Health and Behavioral Health Facilities told the House Health Committee his office is placing emphasis on prevention and early intervention with behavioral health patients. A task force of 175 volunteers spent over 2,000 hours coming up with 170 recommendations, he said. Included among them is adding 150 forensic and other behavioral health beds in West Virginia by 2011. |
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A federal court has ruled vaccines aren't to blame for autism, thereby denying claims of thousands of parents who believed childhood vaccines had caused their children to develop autism. The bitterly-fought controversy was ended with a long-awaited decision in which a special federal court concluded there was little, if any, evidence to support the link, calling evidence, "weak, contradictory and unpersuasive." |
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State Insurance Commissioner Jane Cline says one of the reasons West Virginia is working on new health coverage plans is because the needs and finances of young, healthy workers are different from those of older populations. Cline told The Charleston Daily Mail, “What we want to try to do is make available, at the very minimum, your basic preventive care opportunities. . . If we have a package that’s much more affordable, but not full-blown, we may encourage them to buy the policy.” Governor Joe Manchin, in his State of the State address, proposed the establishment of new, affordable benefit packages. Cline says it’s too early to estimate how much the plans will cost or how many might purchase them. The numbers could be affected on how many benefit from a proposed expansion of Medicaid coverage, she told the Daily Mail’s Michelle Saxton. |
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Concerned about high rates of post traumatic stress disorder and increases in mental and physical health problems among veterans returning from deployment, a select committee on veteran’s issues is recommending establishment of a permanent standing interim committee on veterans’ issues. The committee also endorsed legislation to request public and private colleges to develop plans to become more “military or veteran friendly.” The goal is to ease the transition of veterans back into an educational environment.
- The Legislature also will consider creating a Legislative Oversight Committee on Long Term Care.
- West Virginia Mutual Insurance Company has paid off the $24 million start-up loan it received in 2004 from the state. Insurance Commissioner Jane Cline says the Mutual has paid back the entire amount borrowed, plus interest.
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February 23, 2009
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Contacting your Legislators
The West Virginia Legislature has expanded information available through its Internet web-site http://www.legis.state.wv.us/. On the bottom right of the legislature’s homepage is a spot to enter your zip code. All your elected officials will come up and most have an e-mail address. You can access them through this process or leave messages on their office phones or via fax to House of Delegates members-- 304-340-3315 and to State Senators at 304-357-7829.
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