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Congressional Republicans reveal "American Health Care Act"
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After releasing many versions of a policy paper outlining their plan for repealing and replacing the Affordable Care Act, House Republicans unveiled the legislative language for a replacement plan Monday evening. The plan, drafted by the House Ways and Means Committee and the House Energy and Commerce Committee, provides a better understanding of how the details may work.
The legislation, dubbed the "American Health Care Act," has not been scored by the Congressional Budget Office (CBO), so exact numbers for fiscal impact and coverage are only speculation now. However, it appears the bill would result in a significant increase in the number of uninsured individuals through Medicaid cuts, lower financial assistance, and the repeal of individual and employer mandates.
SCHA does not support the legislation in its current form, nor does the American Hospital Association. We are concerned about the potential loss of coverage for low-income and aging individuals and feel that moving forward to vote on legislation prior to a score from the CBO is premature. We will continue to monitor legislation and maintain contact with our Congressional delegation and AHA throughout the debate. Hospital and healthcare leaders are encouraged to contact their Representatives to share their concerns. For more information and to get the latest as the debate continues, please visit our Repeal & Replace website.
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Behavioral Health Legislation Moves in Senate Committees
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Crisis Stabilization Units
A subcommittee of the Senate Medical Affairs committee heard brief testimony on Tuesday in favor of S. 354 (Alexander). The bill defines a crisis stabilization unit as 'a facility operated or authorized by the Department of Mental Health that provides a short-term residential program, offering psychiatric stabilization services; detoxification services; and brief, intensive crisis services twenty-four hours a day, seven days a week.' Operated by DMH, crisis stabilization units would not be subject to the certificate of need laws; however, since these facilities will be a partnership with and receive funding from hospitals, the bill clarifies that these units will have a separate licensure category from DHEC that does not include a certificate of need.
Allan Stalvey, Executive Vice President of SCHA, and Dr. Chris Lombardozzi, an ER physician from Spartanburg, testified in favor of the legislation noting the need for psychiatric units to better treat behavioral health patients in crisis. Currently, hospital emergency rooms are where psychiatric patients go during a crisis even though most emergency rooms are not equipped or staffed to provide intensive psychiatric services.
Senator Corbin (R-Greenville) expressed his support of the legislation, but made it known that it appears hospitals, who have historically supported certificate of need laws, are now trying to circumvent the laws for their convenience. While it was explained that the certificate of need language is meant only as a clarification if a question arises in the future, the appearance was understood and Sen. Corbin's dislike for the certificate of need laws was noted.
There was no testimony in opposition of the bill and it received a favorable report as amended from the subcommittee. A companion bill, H.3666 (G.M. Smith), also received a favorable report from a House Ways and Means Legislative subcommittee on Thursday.
Alcohol Exclusion Repeal
On Wednesday, the Senate Banking and Insurance committee met on S.9 (Hutto), the alcohol exclusion repeal bill. The committee adopted an amendment to the bill which inserts that any insurance plans applying or renewing after December 31, 2017, would be prohibited from including an alcohol exclusion provision in their policies. The purpose of the amendment is to limit the fiscal impact on the state by avoiding duplicative reviews of current policies by the Department of Insurance.
The bill was reported out to the Senate floor favorably with amendment from the committee.
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In Other News
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- Medical Community Weighs in on Medical Marijuana: Physicians and other healthcare providers provided testimony on S.212 (Davis), a bill to legalize the use of medical marijuana for certain individuals. The second hearing on this bill drew more than a dozen witnesses. Proponents of the bill argued that it helps patients with pain relief and could curb the opioid addiction causing crisis in the state and nation. Those with concerns on the bill included the SC Board of Pharmacy, which expressed a need for more research to better determine the appropriate way to monitor and regulate medical cannabis. Senators in the subcommittee recognized the potential benefits medical marijuana could present, but a few were concerned that this step could make it easier for marijuana to get into the hands of those who would abuse it. The subcommittee carried over the bill again, and more testimony is expected in subsequent meetings.
- State Health Plan: DHEC released the draft 2017-2018 State Health Plan on Monday and the public comment period opened on Wednesday, March 8th. It is open for public comment until 5:00pm on April 7, 2017. Comments can be submitted via email to coninfo@dhec.sc.gov or by mail to the Certificate of Need Program at DHEC in Columbia. Public hearings on the draft are being held throughout the state, and a schedule can be found here. SCHA is working with member hospitals to address the plan and respond.
- Vaccination Awareness: A resolution was introduced Wednesday by Senator Cromer (R-Newberry) to declare August 14-21, 2017, "Immunization Week" in South Carolina to increase awareness of the importance of receiving vaccinations. Citing the lower than average rates of children receiving vaccinations in South Carolina, as well as increases in deaths due to influenza and recent outbreaks of shingles and whooping cough, the resolution urges citizens to receive vaccinations and stay current on their vaccination schedules.
- LEAd: This is a pivotal time for healthcare in our country and it is more important than ever to be involved in the conversation. Thank you for your continued support of SCHA and healthcare initiatives. Please share LEAd with your colleagues and others interested in health policy at a state and federal level. If healthcare industry leaders are not shaping the debate on health policy, who is?
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Chamber Action
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- S.105 (Rankin) - establishes that a request for a contested case under the administrative law court stays a case for 30 days - received 3rd reading in Senate and sent to House
- S.351 (Alexander) - allows an income tax credit for preceptors for each clinical rotation served by a physician, advanced practice nurse, or physician assistant - received 3rd reading in Senate and referred to House Ways and Means committee
- S.179 (Hutto) - provides limited immunity for a person seeking medical assistance for another person experience a drug or alcohol-related overdose - received 2nd reading in Senate
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Committee Action
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Senate Banking and Insurance
- S.9 (Hutto) - repeals the exclusion for alcohol or drug-related claims in medical expense policies - favorable as amended, Senate Banking and Insurance Committee
Senate Medical Affairs
- S.354 (Alexander) - defines crisis stabilization unit facility and establishes that such facilities are not subject to the certificate of need process - favorable as amended, Senate Medical Affairs subcommittee
- H.3438 (Henderson) - allows a pharmacist to substitute an interchangeable biological product for a specific biological product in a prescription - favorable as amended, Senate Medical Affairs subcommittee
- S.212 (Davis) - allows individuals with certain diseases or medical conditions to use cannabis for medical purposes and provides for the recommendation and sale of cannabis for this use - received testimony, Senate Medical Affairs subcommittee
House Judiciary
- H.3930 (Pitts) - amends concealed weapon laws and removes the prohibition of carrying guns in certain locations, including hospitals - favorable as amended, House Judiciary subcommittee
House Medical, Military, Public and Municipal Affairs (3M)
- H.3809 (Finlay) - requires health insurance policies to cover a twelve-month supply or refill of contraceptive drugs - favorable report, House 3M Committee
- H.3064 (Rutherford) - Allows pharmacists to prescribe hormonal contraceptives without an order by a physician - favorable as amended, House 3M Committee
- H.3487 (Ridgeway) - allows a parent or guardian of a minor patient to request or revoke a 'do not resuscitate' order for emergency services - favorable report, House 3M Committee
- H.3132 (G.M. Smith) - Establishes licensing requirements for hospice programs - carried over in House 3M Committee
House Ways and Means
- H.3666 (G.M. Smith) - defines crisis stabilization unit facility and establishes that such facilities are not subject to the certificate of need process - favorable, House Ways and Means subcommittee
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Intros of Interest
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Pharmacy
- H.3926 (Spires) - modifies standards for Minimum Good Compounding Practices in pharmacies - referred to House 3M Committee
- S.506 (Shealy) - increases the allowable prescription a pharmacist may dispense in a State of Emergency from a fifteen-day supply to a thirty-day supply - referred to Senate Medical Affairs Committee
Safety
- H.3930 (Pitts) - amends concealed weapon laws and removes the prohibition of carrying guns in certain locations, including hospitals - referred to House Judiciary committee
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March 10, 2017
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