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House Committee Sends Message on CON
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The House Ways and Means Revenue Policy Subcommittee met this week to consider H.3250, a bill to reform the state's Certificate of Need (CON) program. The panel is chaired by Rep. Brian White (R-Anderson) who was joined by Reps. Bingham (Lexington), Herbkersman (Beaufort), and Pitts (R-Laurens) to consider the legislation. Rep. Murrell Smith (R-Sumter), Chairman of the House CON Ad Hoc Committee, also participated in the hearing to report on his committee's work, as did Rep. Jim Merrill (R-Berkeley), who supports elimination of the CON program.
Rep. Smith gave a brief summary of recent activities involving the CON program, from the work of the DHEC CON Review Panel appointed in 2012, to the controversial gubernatorial veto that led the Supreme Court to order that the program be restored last year. Smith reported that his committee hosted a series of meetings last fall where they heard from hospitals, nursing homes, physicians and other members of the state's health care industry to understand the perspective of all of the affected parties. He commended SCHA and other stakeholders for working to bring the state's health care community to a consensus on such a difficult issue.
Rep. Smith said that his committee used the recommendations of the DHEC CON Review Panel as a baseline for their legislation and shared some of the major changes offered by the bill. SCHA continues to support many elements of H.3250; including raising the economic threshold for capital expenditures, raising or eliminating the threshold for medical equipment and other initiatives to streamline the CON review process. After providing a basic overview of the bill, the attention then turned to the people in the audience. "The days of CON preventing competition is over," said Smith. He said that if stakeholders could not work together to make the CON process less cumbersome, he would join other legislators that want to eliminate the program. Representatives Bingham, White, and Herbkersman all agreed and echoed Smith's sentiment.
Committee members agreed to move the bill forward with the intention of offering an amendment in full committee that would serve as a compromise for all stakeholders. Ways and Means Chairman Brian White ended the hearing with a stern warning for all the interest groups working on the issue: "The days of protecting turf need to end. If we don't work it out, it will disappear." The bill will now move to the full Ways and Means Committee where a compromise amendment is expected to be offered. |
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House Nullification Bill Likely Dead
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This week members of a House LCI subcommittee likely put an end to legislation aimed at nullifying the Affordable Care Act (ACA) in South Carolina. Chairman Mike Gambrell (R-Anderson) was joined by fellow subcommittee members Terry Alexander (D-Florence), David Mack (D-Charleston), Todd Atwater (R-Lexington), Mike Sottille (R-Charleston) and Dan Hamilton (R-Greenville) to consider H.3020, also known as the Anti-Commandeering Act.
As written, the bill would prohibit the state from establishing a state health exchange or expanding the Medicaid program and criminalize the act of aiding in the implementation of the ACA by public officials or certain state employees. The testimony on H.3020 mostly consisted of South Carolina citizens who opposed Obamacare and considered it an overreach by the federal government. Jim Ritchie with the SC Alliance of Health Plans (SCAHP) spoke against the bill, arguing that H.3020 would allow for the dismissal of state employees who aided in helping citizens access health insurance through the ACA, but did not address county employees. Ritchie went on to say that the SCAHP did support increased regulations on navigators working to connect citizens to coverage on the federal health exchange.
After receiving testimony, Chairman Gambrell shared some of his major concerns with the bill. "This is a job loss bill," he said. Gambrell declared that he was against the ACA, but that H.3020 does not do what it is designed to do and he would not want to bind a legislator to a future budget decision based on the proposed bill. He also worried about the legal ramifications of the bill, saying he didn't want to "tie the state up in a lawsuit that is indefensible." With that, the committee voted to table the bill by a vote of 5-1, with Rep. Hamilton voting in opposition of the motion. H.3020 is likely done for this session, but there's still a chance for similar legislation to be introduced in the senate. |
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Interim DHHS Director on the Hot Seat
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It was a big week for interim DHHS Director Christian Soura as he made his first budget presentation before the House and went before the Senate Medical Affairs committee for confirmation.
In his budget presentation before the Ways and Means Healthcare Budget Subcommittee, Soura provided a summary of the 2014 fiscal year, an update on current spending and an overview of the 2016 executive budget. He reported that the agency finished 2014 below their initial estimate of Medicaid enrollees by over 100,000 beneficiaries, which he attributed to delays in ACA mandates and technical problems with the federal Health Insurance Marketplace (healthcare.gov). He admitted that the agency did not see the effects of the "woodwork effect" or "welcome mat" as initially predicted. The agency also set aside 3% ($206M) for reserves.
As for 2015, the agency is on par with its initial estimates, having spent 55% of their annual appropriation through 58% of the year. Soura updated the committee on the progress of the Healthy Outcomes Plans (HOP), reporting over 10,600 participants and recognizing that all hospitals were participating in the initiative in some form. He also updated committee members on the Hospital Transformation Plan, reporting that no applications had been received and that significant resources may remain for use in 2016.
Soura's next stop this week was before the Senate Medical Affairs Committee for his confirmation as the new DHHS director. While some members alerted Soura to their concerns with the new dual eligible program, Healthy Connections Prime, Senate Democrats seized on the opportunity to question Soura about his position on Medicaid expansion and potential alternative plans. Soura shared that he had worked for Democratic administrations in Pennsylvania, and that he considered himself more of an adviser to the Governor rather than a policy maker. "My resume shows that I've never been worried about partisanship," said Soura. He went on to say that he was watching Medicaid expansion alternatives in other GOP-controlled states, but that he was still concerned about the cost to the state. He presented the HOP Program and Healthy Connections Checkup as initiatives that could help reach the hundreds of thousands of individuals who fall in the coverage gap created by refusing Medicaid expansion. Ultimately, the Senate Medical Affairs committee unanimously approved Soura as the new Director of DHHS and his confirmation will now head to the Senate floor for consideration. |
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Chamber Actions
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- H.3114 (Nanney) - Prohibits abortions at twenty or more weeks and provides penalties - Adjourned Debate to Feb. 11
- S.136 (Cleary) - Includes oral surgeons and dentists in the definition of "emergency medical providers" - Received second reading
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Intros of Interest
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- Document 4551 - Proposed regulations to establish the online CON application - referred to House 3M
- H.3508 (G.M. Smith) - Updates the scope of practice for advance practice registered nurses (APRN's) - referred to House 3M
- H.3511 (Sandifer) - Provides a tax deduction for health care professionals for providing services at a free clinic - referred to Ways and Means
- S.413 (Cleary) - Allows pharmacists to administer certain vaccines without a written order or prescription from a practitioner - referred to Medical Affairs
- H.3488 (Long) - Authorizes certain refills of topical ophthalmic products by practitioners and pharmacists under certain circumstances - referred to House 3M
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February 6, 2015
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