Legislative Wrap-Up: 2009 Session Draws to an End

On Saturday, April 11, the Legislature completed their Session and in a bit of a diversion from the usual process they recessed for what is expected to be about six weeks. Instead of moving right into working on the budget the week following the Session, the Legislature has given themselves until June 6 to finalize their work. The federal stimulus dollars are expected to be worked out by that point and better year-end tax revenue estimates will be gathered. The Governor has issued his revised budget, chopping nearly 5 percent out, totaling $200 million. The Finance Committees have a lot to work out over the coming weeks.

This year the Legislature was busy as usual handling the many bills that were introduced by Members. The House introduced 1340 bills while the Senate handled 773 of their own. Additionally, the two houses together introduced 352 resolutions. Of all these bills that were introduced, 227 ultimately passed and at print time, most are still awaiting the Governor’s signature.

For most involved, this year was a seemingly strange year with a much slower pace being set. There was much talk in the final days that there were so few bills left to be handled by both houses that they could get their work done early in the afternoon on Saturday and not stick around until the traditional midnight hour. That however, didn’t happen. The Legislature is quite skilled in making themselves busy at the appropriate times!

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2009 the Year for Healthcare Reform?

Thought by many to be the year for healthcare reform, this Session turned out to be a tough one for virtually all the Roadmap to Health bills. Though the Legislature invested over $100,000 in the Roadmap effort, and over 400 people and organizations statewide donated their time and expertise to the project, in the end it wasn’t enough to push even some of the watered down initiatives through this year.

Of the seven initiatives recommended by the Roadmap project, only three passed.

The tobacco tax increase (SB 420/HB 2746) was “DOA” with the Governor insisting that he didn’t want to increase any taxes this year. Alternately, the small business tax credit bill (SB 413/HB 2744) never got any traction due to tight budget concerns.

The fight over SB 419, the menu labeling legislation, got very “heavy” toward the end with the crescendo being the delivery of hordes of Tudor’s biscuits and Krispy Kreme doughnuts to the House Government Organization Committee in protest by Delegate (previously Senator) Mike Ross. The media coverage of this spectacle put West Virginia, a state with one of the highest obesity rates, in the national spotlight once again for the embarrassing antics of our Legislature. As the committee members gorged themselves on high calorie foods, they killed the bill that would have required restaurants to post food calorie contents on their menus.

Many hoped that the bill creating a temporary health information technology (HIT) reinvestment fee would pass (HB 2747) since it did move from the House to the Senate and through the Senate Banking and Insurance Committee. However, when it hit the Senate Finance Committee, that’s where it stayed. Insurers, like Mountain State Blue Cross Blue Shield raised concerns with the fact they were being looked upon to fund HIT in the state. Questions over the plan for spending the money and uncertainty on how much of the federal stimulus dollars would impact the need for this assessment ultimately sealed the deal against the passage of this bill.

On a brighter note, the bill which was the linchpin of the whole Roadmap project did pass. The provisions of SB 412/HB 2838 which would have established the Governor’s Office of Health Enhancement and Lifestyle Planning (GO HELP) were amended into SB 414 which establishes medical home pilot projects.

GO HELP is given broad powers to garner the forces of all state agencies to work collaboratively toward reform initiatives. The provisions granting this office ultimate contracting authority over the agencies (PEIA, DHHR, etc.) were weakened in order to allow the bill to survive. The big question in everyone’s minds at this point is who will be the director of the office or the “Healthcare Reform Czar” as the position has affectionately been nick-named. The success of this office will be determined mostly by whomever the Governor appoints to lead this effort.

The bill grants broad powers and duties to the Director of GO HELP including negotiating pharmacy benefit contracts, and most importantly, advising the Governor and the Legislature on all healthcare strategy. This would include a 5 year strategic plan on health care reform. The bill also established an advisory council to the office which puts into code the make up of the executive committee of the Roadmap, on which the WVSMA has a seat. Fights over representation on this council nearly derailed the bill in the Legislature’s final hours. Representatives of the state’s two largest Education unions sparred over a seat on the council to the point where they were both removed from the council in a last minute conference committee report.

The office is charged with coordinating four types of pilot projects on medical homes: Chronic Care Model, Individual Medical Home, Community-Centered Medical Home, and Medical Homes for the Uninsured. The bill defines a medical home as being physician-led, however, an amendment by the House Health Committee added an addendum to the definition clarifying that in the instance that the Centers for Medicare and Medicaid Services declares a nurse practitioner as the leader of the team, then West Virginia shall implement the change. This was done upon the request of DHHR officials who suggested Medicaid’s pilots currently in the works may need the leeway to have a nurse practitioner at the helm. There is, however, language later in the bill which clarifies that the medical home pilots are “based upon the individual practices of physicians”.

The last component of the Reform initiative was legislation requiring the Insurance Commissioner to contract with a Credentialing Verification Organization (CVO) for the purpose of streamlining the credentialing process for providers (HB 2885 link to bill tracking, final bill not available yet). There was a lot of positioning among players in this arena over this bill. Initially the bill allowed up to three CVO contracts to be established then the House Health Committee amended it to specify that there just be a single CVO in the state. As the bill wound its way through the halls of the capitol and over to the Senate, changes were made to merely have the Insurance Commissioner study this issue and come back next year with legislation to establish a process for such an entity(s). The current advisory council to the Insurance Commissioner and DHHR which is responsible for establishing the Uniform Credentialing Form was charged with this task. The WVSMA took the opportunity to codify a specific representative of the Association on the council, as did the Hospital Association.

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MPLA Threatened with Attacks on Caps

As a bill to clarify pharmacists and pharmacies as health care providers under the Medical Professional Liability Act (MPLA) moved through the legislative process, trial lawyers saw their opportunity to begin meddling with the nationally acclaimed protections for healthcare providers. SB 379 was innocuous as originally drafted. It merely added “pharmacist” and “pharmacy” to the definition of healthcare provider, an effort needed after the WV Supreme Court in a case several years ago determined that the two were not intended to be included in the definition.

Trouble started when the Senate Judiciary Committee took up a committee substitute for the bill which only added pharmacists and not the pharmacies which would be in the same malpractice suits. Additionally, the committee had before them an amendment that would have clarified that pharmaceutical medical device suits are not under the protections of the MPLA. Senator Jenkins successfully amended the bill to put it back in its original state.

When the bill arrived at the House Judiciary Committee at least five amendments had already been drafted by committee members (or more precisely for the members by the trial lawyers) who were anxiously awaiting the bill’s turn in this committee. Those amendments addressed issues such as removing the caps on trauma care, raising the caps on noneconomic damages, and modifying the collateral source offsets. The pharmacist association and pharmacy representatives, still hopeful for their opportunity to get protections under the MPLA, encouraged Committee Chairwoman Carrie Webster to run the bill despite this news, suggesting that if it got out of hand the bill could be stopped elsewhere. However, the WVSMA, Hospital Association, Mutual Insurance Company, and others with more level heads advised the Chairwoman to not run the bill.

This was a serious scare to the hard fought protections of the MPLA that the WVSMA, West Virginia physicians, and others worked so hard to obtain in 2001 and 2003. It was also enlightening as to the exact areas of attack that the opponents of reform will use. Physicians—be on notice—this was just a trial balloon. From what was seen this year at the capitol, a concerted attack on the medical liability reform is imminent.

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CON Reform Accomplished

The Legislature has made the most significant revisions to Certificate of Need (CON) law that this state has seen in some time. The Legislature carried on an extensive review of CON laws in WV and other states over the summer interim period, resulting in the drafting and passage of SB 321 this Session. This review stems from the differing opinions of the WVSMA, Hospital Association and the Health Care Authority on the efficacy of the CON laws in WV. With agreements having been worked out between the three parties, this bill, which had been so controversial during the legislative interims, moved through the process relatively smoothly until the final days.

At nearly the very last minute, as the bill was on second reading on the House floor, lobbyists for Wheeling Hospital attempted to amend the bill to avert their need for obtaining a CON on a project currently underway. The amendment would have exempted from CON review certain joint projects of hospitals and universities. Unsure about the ultimate implications of the language, stakeholders urged the House to reject the offering of any amendments. The bill then moved through smoothly. The Health Care Authority vowed to work with Wheeling Hospital to advise them of ways to structure their project in order to move forward without any wrinkles.

The following are the provisions of the final bill:

• Increase the capital expenditure and major medical equipment thresholds from $2 million to $2.7 million;
• Eliminate CON reviewability of such non-health related projects as electronic health records, telephone systems, parking garages, cafeterias, etc., up to a certain dollar level, based on hospital size;
• Modify the fee structure for filing a certificate of need application by implementing a cap through rules;
• Eliminate lithotripsy from CON review;
• Allow hospitals near state borders to expand across state lines (into contiguous counties only) without West Virginia CON regulatory review. 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;
• 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 any in-state behavioral health service selected by DHHR providers seeking to stem the referral of children to out-of-state programs.

The legislative interim subcommittee will likely be reestablished next year and has plans to examine the following issues: Refining of the definition of “affected person” status for purposes of certificate of need.  Related to that would be an requiring that an “affected person” demonstrate good cause for requesting a public hearing pursuant to a certificate of need application; Gaining insight and detail into the accountability and compliance of the Health Care Authority with statutory and regulatory timeframes for certificate of need; The possibility of licensing ambulatory health care facilities; and, Exempting state hospitals from certificate of need review if the service which the state hospital wishes to provide will not be in direct competition with private facilities in the area.

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Tax Commission Clarifies Physician Provider Tax

Upon the request of the Tax Commission, the Legislature has passed SB 724 modifying the definition of “physician services” under the existing physician provider tax law. The bill was proposed to negate the impact of the current tax appeals of some eleven hospitals. These hospitals are arguing that they have been paying the provider taxes incorrectly on hospital employed physician services since the tax’s inception in 1993. Evidently they believe they should have paid the “physician rate” on a broader set of services provided by such physicians in their hospitals instead of the “hospital rate”. (The physician rate is currently .4% having been sequentially reduced from 2% starting in 2001 and is set to sunset at 0% on June 30, 2010. The Hospital rate is 2.5% and is not set to sunset) In order to avert an approximate $300 million payback to these hospitals, (if they are successful in the appeal), the Tax Commission chose to push legislation to narrowly define the physician tax to be just those services provided by that employed physician. Non-employed physician services would also continue to be taxed at the physician rate.

Importantly, the bill does not appear to negatively affect the payment of or rate of the physician provider taxes by physicians. It does not alter the current phase-out of the provider tax on physicians. The WVSMA will continue to watch this very closely as it is implemented.

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Osteopathic Licensure Requirements Updated

Osteopathic students will now have more options available to them to fulfill the requirements of the one year rotating internship with the passage of SB 526.  Current law requires osteopathic licensure applicants in West Virginia to have completed a one year program approved by the AOA.  There were exceptions to this rule, but students would have to petition the board only after completion of the program to find out if their program met all of the requirements of licensure.  Some found after they had completed an ACGME program (whether it was one, three, or five years) that all of the requirements for the one year rotating internship were not fulfilled under the program so they were being required to take an additional one year residency approved by the AOA to be licensed in state.

This law change will recognize both AOA programs and ACGME programs.  In order to retain the philosophy of osteopathy, those physicians who complete an ACGME program would also be required to complete 40 hours of CME in OMM/OMT (osteopathic manipulation theory and practice) prior to licensure.

The bill also extends the time that a physician may practice in state without being fully licensed as they are training.  Currently the osteopathic board allows physicians to complete their first year of residency under an educational permit.  Now those residents will be allowed to continue training under the educational permit throughout the duration of their residency, so long as they are in an approved program.

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Board of Medicine and Other Boards Achieve Rules Changes

The Board of Medicine had a heavy legislative agenda this year, with three rules and a statute change. Two of the three rules passed in the healthcare rules bundle bill HB 2819. Those rules were the regulation of the extraordinary circumstances medical license rule and the rule making modifications to the licensure of physician assistants. A third rule, defining the use of laser as the practice of medicine, died after optometrists, nurses and others complained that the rule went beyond the purview of the Board of Medicine.

This rules bundle obtained the rules of multiple different health related boards.  The Board of Nurses rule on prescriptive authority was included.  This rule was heavily negotiated by the Board of Nurses, WVSMA and the Board of Medicine.  The rule expands some of the medications that a nurse may prescribe.  Additionally, included in this bundle were the rules put forth by the Board of Pharmacy, including the rule establishing licensure requirements for the charitable clinic pharmacies. This rule was also hotly debated prior to session as the free clinics were unhappy that they were to be regulated by the Board of Pharmacy. The final version of this rule as it went through the session was basically agreed to by all parties.

The Board of Medicine had another bill which passed, HB 2801, clarifying that it is an autonomous board and its employees are exempt from the classified service of the Division of Personnel. This bill was necessary to clear up a question about the oversight by the DHHR of the Board and to pull the employees out from under the hiring restraints of civil service. The bill hit a bump in the road in the last days as Senator Stollings amended the provisions of SB 634 into the bill as it awaited passage on the Senate floor. That bill exempted physicians who volunteer at children’s camps from liability. The House would not accept the amendment and instead of forcing the bill into conference committee where it likely would have died, the Senate recalled the bill and removed the amendment.

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Maternal Risk Screening to be Uniform

A bill, SB 307, has passed which requires the Bureau for Public Health to establish an advisory council on maternal risk assessment. The nine member advisory council to the Office of Maternal, Child and Family Health is to develop a uniform maternal risk screening tool to identify women at risk for preterm birth or other high risk conditions.

This tool is to be utilized by all providers of maternity care so that referral for needed services and data collection may be made. Importantly, the bill includes strong confidentiality language for the information garnered from the screening. The language specifically states that the uniform maternal screening 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 was specifically included to protect the confidential information shared between the patient and their physician when discussing high risk behavior such as illegal drug use. The hope is that with such strong protections from law enforcement the patient might be more forthcoming with information which would enable the physician to provide appropriate care and treatment referrals.

This bill was proposed by the Perinatal Partnership of which the WVSMA is a member.

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Behavioral Health Funding Bill Stirring Opposition

A bill designed to increase funding to behavioral health agencies, SB 672, is facing growing opposition from the DHHR and others as it awaits the Governor’s signature. The bill, which passed relatively smoothly, places into state law about 29 specific billing codes of the agencies and directs Medicaid to increase the reimbursement of those codes proportionately across the board. The increased funding would come from a new line item in the budget that is expected to be funded at $1.5 million this year. Medicaid is strongly opposing this legislation and lobbying the Governor to veto. This tactic is an unusual one, to put specific billing codes into state law. It has raised concern among other providers that it is bad public policy. The WVSMA has also weighed in on advising the Governor that this approach is misguided.

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Optometric Scope Expansion Halted

A well organized coalition of physician associations and others halted a dangerous scope of practice expansion by the optometrists. HB 2978 would have allowed optometrists, to perform surgery, order laboratory or diagnostic tests, and to prescribe, administer and dispense any medications that the Board of Optometry desires. The WV Academy of Ophthalmology implemented a well planned out strategy to combat this bill and the WVSMA assisted in their effort. Specifically, the bill would have removed patient protections from current law, standards by legislative rules for education, training for optometrists to prescribe limited drugs, limits on prescriptions to certain drugs, etc.

The bill would have allowed optometrists to administer drugs including needle injections into and around the eye, the dispensing of drugs, to perform anything they have been “trained” to do.

Since the bill failed, the House passed HCR 46 directing the Legislature to study the need for a scope of practice expansion by the optometrists.

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Insurers Required to Cover Dental Anesthesia

The Legislature has passed SB 326 mandating dental anesthesia coverage for certain patients. The bill includes general anesthesia for dental procedures and associated outpatient hospital or ambulatory facility charges in conjunction with dental care if the patient is:

• Seven years of age or younger, or is developmentally disabled OR is an individual for whom a successful result cannot be expected from dental care provided under local anesthesia because of a physical, intellectual or other medically compromising condition of the enrollee or insured; and for whom a superior result can be expected from dental care provided under general anesthesia; or
• A child who is twelve years of age or younger with documented phobias, or with documented mental illness; and with dental needs of such magnitude that treatment should not be delayed or deferred; for whom lack of treatment can be expected to result in infection, loss of teeth or other increased oral or dental morbidity; for whom a successful result cannot be expected from dental care provided under local anesthesia because of such condition; and for whom a superior result can be expected from dental care provided under general anesthesia.

 The bill does clarify that prior authorization may be required and that insurers may limit coverage to only that provided by a fully accredited specialist in pediatric dentistry, a fully accredited specialist in oral and maxillofacial surgery, or a dentist to whom hospital privileges have been granted.

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Bill Placing Duty to Report Colleagues Misdoings Fails

A bill, HB 2403, which came out of an interim study to revamp some regulations of Chapter 30 boards containing some troubling provisions failed to pass out of the Senate Government Organization Committee. (Chapter 30 Boards are all the professional licensure boards including the Boards of Medicine, Osteopathy, Nursing and all other healthcare related licenses as well as lawyers, architects, engineers etc.) The bill contained language making it a “duty” of any licensee to report other licensees for violating the practice act. A very simple explanation of the far reaching implications of this language would be --when a licensee is disciplined by the board, the board now may have reason to then discipline any of that licensee’s partners/colleagues for their failure to report suspected (not confirmed) breaches of the standard of care. The bill also modified certain requirements for persons serving on state licensing boards, restricting an individual to serve on both their state association board and on their licensure board.

The WVSMA raised concern over this language and asked the Senate committee to not run the bill.

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Other Healthcare Bills and Resolutions That Passed

The following is a listing of all healthcare related bills that passed the Legislature this Session. Most are still awaiting the Governor’s action. To read the bills or for any additional information visit the legislative website at www.legis.state.wv.us.

SB 322 – Exempting certain life insurance policies from Medicaid assignment.

This bill exempts the first $25,000 of a death benefit of a life insurance policy from assignment under the provisions of the law.

SB 339 – Exempting certain licensed medical professionals from county hiring prohibition.

The bill updates the law prohibiting the hiring of certain county officials who are married. The bill clarifies that it is not unlawful to employ a spouse of any elected county official by that county official, provided that the elected county official may not directly supervise the spouse employee, or set the salary of the spouse employee. It clarifies that the provisions of this law only apply to spouse employees who were neither married to nor engaged to the elected county official at the time of their initial hiring.

SB 408 – Relating to model health plan for uninsurable individuals.

The bill permits the Insurance Commissioner to waive the waiting period for eligibility for coverage under the state’s high risk health insurance plan and to use surpluses in the program to subsidize premiums of certain low income persons.

SB 431 – Providing in-state medical providers notice of small group health benefit plan.

The bill removes the sunset date for the small-group insurance program and reassign the responsibility for providing notice to in-state medical providers and receiving provider elections to opt out of the program from the Public Employee Insurance Agency to the West Virginia Health Care Authority.

SB 456 – Creating Reduced Cigarette Ignition Propensity Standard and Fire Prevention Act

The bill establishes a fire safety standard for cigarettes sold in the state and sets a reduced cigarette ignition propensity performance test and standard. The bill requires compliance certification by manufacturers and certain packaging markings. The bill authorizes the State Fire Marshall, law-enforcement agencies and their authorized representatives to enforce its requirements. The bill establishes penalties and creates a special fund for those penalties.

SB 464 - Authorizing Public Employees Insurance Agency charge fee for paper transactions.

The bill is to permits PEIA to promulgate a rule to charge fees to employers who transact business with the agency by paper when more efficient and less expensive electronic transactions are available.

SB 470 – Regulating all-terrain vehicles on Hatfield McCoy Trail.

This bill modifies the law on the Hatfield-McCoy trail system. The bill adds “utility-terrain vehicles” to the vehicles that may operate on the trail system and defines them as “any motor vehicle with four or more low-pressure tires designed for off-highway use, having bench or bucket seating for each occupant and a steering wheel for control”. The bill requires occupants of these vehicles to wear helmets, as well as those of ATVs and motorcycles. It clarifies that outfitters can not rent an ATV to any person under age 16 and who does not have a driver’s license and places additional requirements on such outfitters.

SB 481 - Requiring employers provide certain documentation to Public Employees Insurance Agency.

The bill requires that employers participating in the PEIA plans provide, all reasonable documentation (sufficient to verify actual full-time employment of the employer's employees who participate in the PEIA plans) required for the Director of the agency to operate the plans, including certain employment records.

SB 552 – Relating to affordable health insurance plan proposals.

This bill extends the time for the pilot program for affordable health insurance plans. The Health Care Authority was charged several years ago with developing a plan for physician practices and clinics to develop such pilots.

SB 632 – Requiring insurers share certain information with Bureau for Medical Services.

This bill requires insurers and providers to provide information upon request to Medicaid regarding claims that might have been paid by Medicaid to determine the period that the service recipients, their spouse or dependents may be or may have been covered by the health insurer.

SB 687 – Relating to Comprehensive Behavioral Health Commission.

This bill reestablishes the Behavioral Health Commission and extends it to June 30, 2011.

SB 767 - Relating to Certain Medicaid Program Contracts.

Legislation pulling Medicaid out from under the Division of Personnel contracting regulations passed on the final day. This bill allows Medicaid to establish their own procedures and requirements for competitive bidding and the awarding of contracts. This includes allowing them to establish the basis for awarding the contract, whether it be lowest bid, best value, sole source, or any other basis the secretary of DHHR chooses. This applies to all contracts that Medicaid enters into for professional health care, managed care, actuarial and health care-related monitoring, quality review/utilization, claims processing, and independent professional consultant contracts for the Medicaid program.

HB 2360 – Insuring that tobacco products are not sold in any packaging other than the original.

This bill makes it illegal for retailers to sell single cigarettes. This is mainly seen as addressing underage smoking since it is youth who mainly are purchasing single cigarettes.

HB 2423 – Relating to the Board of Medical Imaging and Radiation Therapy Technology.

This bill updates some definitions and the powers and duties of the board. Additionally it modifies provisions for licensure as a radiologic technologist, medical imaging and radiation therapy technology, the scope of practice for nuclear medicine technologists, and the requirements for an MRI technologist license. This bill was vetoed on 4/22/09 on technical error on the bill title. It is expected to be taken up and passed with corrections when the Legislature reconvenes in late May.

2504 – Silver Alert Plan.

This bill establishes an alert system for missing cognitively impaired persons. The bill directs the Secretary of the Department of Military Affairs and Public Safety to establish “Silver Alert”, a program authorizing the broadcast media, upon notice from the State Police, to broadcast an alert to inform the public of a missing cognitively impaired person. The program is a voluntary, cooperative effort between state law-enforcement and the broadcast media.

HB 2660 – Expanding the definition of limited health care service.

The bill adds dental, vision, pharmaceutical and podiatric services to those services that may be offered by prepaid limited health service organizations.

HB 2788 – Protecting incapacitated adults from abuse or neglect by a caregiver.

The bill modifies the terms abuse, neglect, and serious bodily injury as used under the code relating to abuse or neglect of an incapacitated adult. The bill adds penalties of misdemeanor and felony for various actions and establishes penalties for intentional misappropriation of funds of an incapacitated adult.

HB 2819 – Authorizing miscellaneous agencies and boards to promulgate legislative rules.

This bill contains rules from multiple agencies. It includes two rules from the Board of Medicine: extraordinary circumstances license and the physician’s assistant rule, the Board of Nurses Limited Prescription Authority rule, WV Board of Physical Therapy rules, WV Board of Architects rules, WV Board of Dentistry rules, and WV Board of Pharmacists. In total there are 24 rules included in this one bundled bill.

HB 2884 – Long Term Care Partnership Program.

The bill requires Medicaid to establish a long-term care partnership program in West Virginia in order to provide for the financing of long-term care through a combination of private insurance and Medicaid in accordance with federal requirements on qualified state long-term care insurance partnerships. It requires Medicaid to file a state plan amendment to accomplish this. The purpose of this program is to reduce Medicaid costs for long-term care by encouraging the purchase of private long-term care insurance policies that are covered under the “qualified state long-term care insurance partnerships.”

HB 2916 – Relating to Emergency Medical Services Act.

Modifies the fees for EMS certification and recertification and requires all applicants to undergo a national criminal background test and fingerprinting.

HB 3047 –Clarifying that the Director of the Public Employees Insurance Agency is authorized to enter into capitated provider arrangements for provision of primary health care services.

This bill will allow PEIA to move forward on a medical home pilot project they have in the works with a clinic. They will be allowed to establish an enhanced payment to the providers for agreeing to provide their participants with additional levels of services.

HB 3083 – Permitting blood donations by persons age sixteen with parental consent.

This bill clarifies that any person seventeen years of age or older may donate blood without the permission or authorization of a parent or guardian and any person sixteen years of age may donate blood with the permission or authorization of a parent or legal guardian.

HB 3195 - Establishing a funding mechanism for state aid for local health departments.

This bill redefines the funding mechanism for the local health departments to ensure that no counties will lose funding next year. Due to a flawed funding system, nearly half the local health departments are set to lose funding next year.

HB 3240 – Giving the Commissioner of Motor Vehicles authority to approve all-terrain vehicle rider safety awareness courses.

The bill allows the commissioner of the DMV to authorize a state institution of higher education, which is the operator, owner, trainer or promoter of an all-terrain vehicle rider safety awareness course approved by the commissioner, to issue the certificates of completion on behalf of the commissioner. It also grants immunity to the institutions for injuries resulting from the training.

HB 3288 – Relating to mental health parity.

The bill updates the mental health parity law already in effect by clarifying that for those insurers providing a group health plan with an average of more than fifty employees on business days during the preceding calendar year, may not apply cost containment measures as provided in this law unless the insurer can demonstrate that the application of this law results in an increase of two percent of the actual total costs of coverage for the plan year involved with respect to medical-surgical benefits and mental health benefits under the plan.

HB 3336 – Continuing early intervention services to families with developmentally delayed infants and toddlers but eliminating the cost-free provision.

This bill allows the Birth-to-Three program to charge families on a sliding fee scale and to bill third party payers for the services of the program. Previously the services were fully free to participants. This change was needed due to a reduction in funding.

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Resolutions that Passed

The following are resolutions passed by at least one house.  The Joint Committee on Government and Finance makes the final determinations on what issue the Legislature will study during the interim.

SCR 50 – Requesting Joint Committee on Government and Finance study reciprocal hospice care service agreements with border states.

SCR 67 – Requiring Joint Committee on Government and Finance  study asbestos trust disclosure issues.

SCR 75 – Requesting Joint Committee on Government and Finance study drug diversion and unintentional pharmaceutical overdoses.

SCR 76 – Requesting Joint Committee on Government and Finance study available health care initiatives.

HCR 46 – Requesting the Committee on Government and Finance to conduct a study on expanding the scope of practice for optometrists.

This study resolution was passed following the failure of the bill that would have allowed the Board of Optometry to expand the scope of practice for optometrists.

HCR 53 – Requesting the Joint Committee on Government and Finance to conduct a study on identifying good perinatal health education models or developing models in West Virginia.

This resolution will have the Department of Education perform this study and report jointly to the Legislative Oversight Commissions on Health and Human Resources Accountability and Education Accountability.

HCR 58 – Requesting the Joint Committee on Government and Finance to conduct a study on Substance Abuse and Public Assistance.

HCR 87 – Requesting the Joint Committee on Government and Finance to conduct a study on the disposal of pharmaceuticals and other hazardous materials.

HCR 89 – Requesting the Joint Committee on Government and Finance to conduct a study on the status of oral health in West Virginia’s rural communities.

HCR 91 – Requesting the Joint Committee on Government and Finance to conduct a study on establishing a program to permit medicine aides who are certified to administer certain drugs.

HCR 92 – Requesting the Joint Committee on Government and Finance to conduct a study on requiring the establishment of school-based health centers in new school constructions.

HCR 99 – Requesting the Joint Committee on Government and Finance to conduct a study on adequate and appropriate responses to the mental health needs of students.

HCR 104 – Requesting the Joint Committee on Government and Finance to conduct a study relating to whether a dependent child of an insurance policyholder should have the same insurance coverage for contraceptive health services as the policyholder.

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Bills of Interest that Died

The following is a sampling of healthcare related bills that failed to pass this Session. To read the bills or for any additional information, visit the legislative website at www.legis.state.wv.us.

SB 333 – Basing school nurse ratio on total net enrollment.

Modifies the requirement for school nurses to be based on one nurse for every 1500 students in the county. Current law requires one nurse for every 1500 students K-7th grade.

SB 426 - Requiring certain medical providers accept Tricare military insurance.

This bill would have required all physicians insured under the Physician Mutual Insurance Company to accept TriCare enrollees. The Senate Military Committee evaluated this issue in depth and heard testimony from the WVSMA, TriCare and the military that clarified physicians are seeing the TriCare enrollees but there are other barriers that keep physicians from contracting with TriCare.

SB 520 – Creating Prescription Record Privacy Act (Data Mining).

This bill was intended to stop pharmaceutical manufacturers from using prescribing data for marketing purposes and to restrain the “undue influence of pharmaceutical representatives on a physician’s prescribing habits”. The bill clarified that no person shall knowingly disclose or use regulated records in this state that include prescription information containing individual identifying information for marketing a prescribed product.

SB 592 – Behavioral health service provider tax.

The bill clarifies the statute taxing behavioral health services at 5%. The original bill aimed to sunset the tax in 2010 when the physician provider tax is to sunset but an amendment removed that provision.

SB 603 – Relating to Bureau for Public Health’s commissioner and state health officer.

This bill would have removed the statutory requirement for the Commissioner for the Bureau for Public Health to be a physician. This is the second year the bill has been introduced by Governor Manchin’s administration. The Governor has failed to appoint a physician to the office since Dr. Henry Taylor stepped down nearly 6 years ago. The WVSMA actively opposed the bill.

SB 634 – Relating to certain physicians volunteer liability.

The bill would have limited the liability of physicians, residents, medical students, and nurses who volunteer at youth camps. The limitation on liability did not apply to acts or omissions constituting gross negligence or willful and wanton conduct.

HB 2415 – Identifying salvia divinorum as a hallucinogen.

This bill initially aimed to make the salvia divinorum plant a Schedule I drug. It was modified to simply make it a misdemeanor to possess a material, compound, mixture or preparation intended for human consumption which contains salvia divinorum, unless the substance was obtained directly from, or pursuant to a valid prescription or order of a practitioner while acting in the courts of his or her professional practice.

HB 2485 - Allowing pharmacy interns to vend pseudoephedrine and other chemical precursors of methamphetamine.

The bill was initially written to clarify that pharmacy interns are allowed to sell pseudoephedrine over the counter as well as the pharmacist and the pharmacy tech. This was a simple clarification of the current law that requires these drugs to be over-the-counter. There was a disagreement between the House and Senate over whether law enforcement should be granted access to the list maintained by the Board of Pharmacy and the bill died on the last night.

HB 2579 - Adopting guidelines to permit pharmacists to prescribe medications.

This bill would have granted the authority to the Board of Pharmacists to issue rules clarifying any drugs that the Board determines are acceptable for pharmacists to prescribe.

HB 2696 - Authorizing certain persons who are emergency medical technician-paramedics to apply to obtain a license to practice registered professional nursing.

The bill would have allowed EMTs with certain training and experience to be licensed as nurses without attending nursing school.

HB 2626 – Requiring licensure of Pharmacy Benefit Managers.

The bill would have required pharmacy benefit managers to be licensed and regulated by the WV Insurance Commission. Such PBMs are entities that perform pharmacy benefit management and include a person or entity acting for another pharmacy benefit manager in a contractual or employment relationship in the performance of pharmacy benefit management services, including mail order pharmacy.

HB 2767 – Changing the membership of the PEIA financial board.

This bill would have modified the PEIA Finance Board to clarify that one member shall represent a political subdivision participating in PEIA.

HB 2780- Emergency Credentialing of Health Care Providers.

This bill would have required the Secretary of the Department of Health and Human Resources to establish a registry of emergency health care providers who are available to provide health care services during an emergency or crisis. The Bureau for Public Health is implementing a program of this type and found that this bill was premature.

HB 2932 - Requiring the approval of board of health rules relating to tobacco use in public or private places.

The bill would have required the approval by the county commission of the clean indoor air regulations issued by the local board of health.

HB 3022 – Creating a Medical Home Pilot Project for Uninsured Adults.

This bill would have directed PEIA to implement a plan that entitles subscribers to obtain medical home services from participating providers.

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