You must read the next slide regarding CME conflict of interest before continuing with the presentation.

Transcription

1 You must read the next slide regarding CME conflict of interest before continuing with the presentation.

2 PLANNING CMTE. SPEAKER OBJECTIVES At the end of live activity, participants should be able to: (1) List the 2014 legislation in Indiana that affects the practice of medicine, patient care and/or public health; (2) Describe the affect each bill will have on the practice of medicine, patient care and/or public health; (3) Apply deadlines, dates and/or new requirements of this legislation to their practice of medicine; (4) Prepare a resolution to the ISMA House of Delegates on issues affecting the practice of medicine, patient care and/or public health and what the applicable deadlines and requirements are for doing so. CME CREDIT INFORMATION Credit Designation Information: The Indiana State Medical Association (ISMA) designates this live seminar for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Accreditation Information: The ISMA is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Disclosure Information: To comply with ACCME accreditation requirements, the ISMA is including the Speaker and Committee Financial Relationship Disclosure Grid for this program (see following pages for grid). In accordance with the ACCME Standards for Commercial Support, educational programs sponsored by the ISMA must demonstrate balance, independence, objectivity and scientific rigor. Financial disclosure or relationships with a commercial product or manufacturer of commercial services that might be discussed or referred to in the educational activity must be made to the audience prior to the activity. To receive CME credit, you must complete the evaluation at the close of this seminar, providing name and attestation of hours. The CME certificate will be ed. FINANCIAL DISCLOSURE CONFLICT OF INTEREST GRID The ISMA has implemented a process where everyone who is in a position to control the content of an education activity has disclosed to us all relevant financial relationships with any commercial interest. In addition, should it be determined that a conflict of interest exists as a result of a financial relationship this will need to be resolved prior to the activity. Name Commercial Interest What I received My Role Conflict/Resolved Mike Brady I do not have any relevant financial relationships with any commercial interests. N/A N/A None Name Commercial Interest What I received My Role Conflict/Resolved Jill Bruce I do not have any relevant financial relationships with any commercial interests. N/A N/A None Sandy Miller I do not have any relevant financial relationships with any commercial interests. N/A N/A None Mike Rinebold I do not have any relevant financial relationships with any commercial interests. N/A N/A None Mike Brady I do not have any relevant financial relationships with any commercial interests. N/A N/A None

3 2014 Legislative Wrap-up Mike Brady Legislative Coordinator Indiana State Medical Association

4 [Governor] Pence summed up the session this way: Because of the leadership in the House and Senate and, frankly, because of a strong bipartisan effort of members of both chambers, I believe we've made measurable progress on jobs and schools and infrastructure. (Indianapolis Star) [House Minority] Leader Scott Pelath from Michigan City issued the following statement on the 2014 session of the Indiana General Assembly: To adequately describe the worthlessness of the latest legislative session, one must look at what was said by Ed Ziegner of the Indianapolis News after the first legislative short session back in 1972: It has been a bad session in about every way a session can be bad, which is a good many. (Howey Politics Indiana)

5 Senate: 37 Republicans (Super Majority) 13 Democrats House: 69 Republicans (Super Majority) 31 Democrats

6 New Members: House: Rep. Greg Beumer, R-Farmland Dist. 33 (Rep. Bill Davis) Rep. Casey Cox, R-Fort Wayne Dist. 85 (Rep. Phyllis Pond) Rep. Holli Sullivan, R-Evansville Dist. 76 (Rep. Suzanne Crouch)

7 Bill # Bill Title 1st Chamber 2nd Chamber ISMA SUPPORTED BILLS AUTHOR VOTE SPONSOR VOTE HB 1051 HEPATITIS C TESTING & STUDY OF NEEDLE EXCHANGES ERRINGTON Patricia Miller HB 1097 IMMUNITY FOR PROVIDING HEALTH CARE FRIZZELL 86-4 Patricia Miller 48-0 HB 1139 SELLING HEARING AIDS BAUER 87-8 Patricia Miller 43-5 HB 1218 DRUG TREATING AND REPORTING (INSULIN SALES) DAVISSON 95-0 GROOMS 48-0 HB 1258 DISTANCE TREATMENT BY PHYSICIANS SHACKLEFORD 95-1 Patricia Miller 47-0 HB 1360 ADDICTION TREATMENT AND SERVICES C. BROWN 93-0 Patricia Miller 48-0 SB 50 MINORS AND TANNING DEVICES Patricia Miller ZENT SB 222 STUDENT ATHLETE CONCUSSIONS HOLDMAN 45-1 ARNOLD 95-3 SB 233 PHARMACY TRCHNICIANS AND AA LICENSURE GROOMS 47-1 DAVISSON 93-0 SB 245 SCHOOLS AND AUTO-INJECTABLE EPINEPHRINE Patricia Miller 49-0 ZENT 74-0 SB 262 BIOSIMILAR DRUGS HERSHMAN CLERE 92-5 SB 285 TRAMADOL GROOMS 49-0 DAVISSON 9 10 Bill # Bill Title 1st Chamber 2nd Chamber ISMA OPPOSED BILLS AUTHOR VOTE SPONSOR VOTE HB 1060 CERTIFIED REGISTERED NURSE ANESTHETIST FRIZZELL HB 1106 EPHEDRINE AND PSEUDOEPHEDRINE KUBACKI HB 1114 LEGEND DRUG PRESCRIPTIONS BY OPTOMETRISTS DAVISSON 85-8 GROOMS HB 1248 METHAMPHETAMINE SMALTZ SB 145 PHYSICAL EXAMINATION BY NURSE PRACTITIONERS CRIDER SB 219 PHYSICIAN ORDER FOR SCOPE OF TREATMENT HOLDMAN SB 290 MEDICAL DEBT COLLECTION PROCEDURES TALLIAN 47-1 DELANEY SB 294 WORKER'S COMPENSATION BOOTS 48-0 OBER 95-1 SB 346 MEDICATION THERAPY MANAGEMENT AND MEDICAD GROOMS KEY LEGISLATIVE PROCESS First Reading-First Chamber COLOR INDICATOR 6 Committee Passed 2 Committee 7 Second Reading Died 3 Second Reading 8 Third Reading 4 Third Reading 9 5 First Reading-Second Chamber Conference Committee 10 Governors Office AMENDED- LANGUAGE MOVED

8 118 th Indiana General Assembly-Second Session

9 SCOPE OF PRACTICE

10 Scope of Practice Enacted SB 233 Pharmacy Technicians and Anesthesiologist Assistants Dead HB 1060 Certified Registered Nurse Anesthetists HB 1114 Legend Drug Prescriptions by Optometrists SB 145 Physical Examinations by Nurse Practitioners

11 SB 233 Pharmacy Technicians and Anesthesiologist Assistants Author: Sen. Ron Grooms, R-Jeffersonville Sponsor: Rep. Steve Davisson, R-Salem ISMA Supported Originally just dealt with changes to Pharmacy Technicians Amended to provide for the licensure of Anesthesiologist Assistants (AA) Class B misdemeanor for professing to be an AA without a license

12 LEGAL

13 Legal Enacted HB 1139 Selling Hearing Aids* HB 1258 Distance Treatment by Physicians HB 1323 Epinephrine in Institutions of Higher Education SB 50 Minors and Tanning Devices* SB 56 Medical Malpractice Patient s Compensation Fund SB 139 Health Matters *Designates an ISMA Resolution

14 Legal (Continued) SB 222 High School Student Athlete Concussions SB 245 Schools and Auto-Injectable Epinephrine* SB 294 Worker s Compensation Dead HB 1097 Immunity for Providing Volunteer Health Care Services SB 244 Health Care Professional Registry SB 290 Medical Debt Collection Procedures SB 346 Medication Therapy Management and Medicaid *Designates an ISMA Resolution

15 HB 1139 Selling Hearing Aids* Author: Rep. Patrick Bauer, D-South Bend Sponsor: Sen. Patricia Miller, R-Indianapolis ISMA Initiative, Supported Provides that a person may not sell, lease or rent a hearing aid in Indiana unless the hearing aid has been fitted by a hearing aid dealer or an audiologist Also calls for a study by the ISDH to:» Determine the number of Indiana residents who are less than 19 and are hearing impaired» Calls for a study to determine cost of a state program and health insurance requirement» Deadline of September 1, 2014 *Designates an ISMA Resolution

16 HB 1258 Distance Treatment by Physicians Author: Rep. Robin Shackleford, D-Indianapolis Sponsor: Sen. Patricia Miller, R-Indianapolis ISMA Supported Requires the Medical Licensing Board to establish: A pilot program to allow treatment, including issuing a prescription, without the establishment of an in-person patient/physician relationship Standards and procedures for the physician in the pilot program

17 SB 245 Schools and Auto-Injectable Epinephrine* Author: Sen. Pat Miller, R-Indianapolis Sponsor: Rep. Dennis Zent, R-Angola ISMA Initiative, Supported Allows a health care provider with prescriptive authority to prescribe auto-injectable epinephrine to a school or school district Sets requirements for certain individuals employed by a school or school district to fill, store and administer autoinjectable epinephrine *Designates an ISMA Resolution

18 SB 245 (Continued) Provides civil immunity for: Certain school employees in the administration of auto-injectable epinephrine Health care providers in the prescribing of epinephrine and the training of school personnel in the administration of autoinjectable epinephrine

19 HB 1323 Epinephrine in Institutions of Higher Education Author: Rep. David Ober, R-Albion Sponsor: Sen. Patricia Miller, R-Indianapolis ISMA Supported Allows a postsecondary educational institution to develop a policy for the emergency administration of an auto-injectable epinephrine to a student, faculty member, or staff member under certain circumstances Sets forth requirements for the policy and for those employees who act as trained designees and administer the epinephrine. Requires the state department of health to set forth guidelines for the policies

20 HB 1323 (Continued) Allows a health care provider to write a prescription for epinephrine for a postsecondary educational institution and allows a pharmacist to dispense the prescription Requires storage of the epinephrine in a safe location Provides for civil immunity for licensed campus medical professionals, trained designees, and certain healthcare providers in the administration of epinephrine in compliance with the policy and guidelines

21 SB 50 Minors and Tanning Devices* Author: Sen. Pat Miller, R-Indianapolis Sponsor: Rep. Dennis Zent, R-Angola ISMA Initiative, Supported Prohibits a person younger than 16 years of age from using a tanning device in a facility Repeals a provision requiring a person less than 16 years of age to be accompanied by a parent or guardian when using a tanning device in a facility Requires the ISDH to adopt standards concerning the use of tanning devices *Designates an ISMA Resolution

22 SB 56 Medical Malpractice Patient s Compensation Fund Author: Sen. Allen Paul, R-Richmond Sponsor: Rep. Richard Hamm, R-Richmond ISMA Supported Requires claims for payment from the Patient s Compensation Fund to be computed and paid every three months instead of every six months

23 SB 139 Health Matters Author: Sen. Vaneta Becker, R-Evansville Sponsor: Rep. Ed Clere, R-New Albany ISMA Supported Amends the definition of attendant care services to include providing assistance for taking of medications, including controlled substances and prescription drugs Removes the July 1, 2014, expiration date of the Anatomical Gift Promotion Fund

24 SB 222 High School Student Athlete Concussions Author: Sen. Travis Holdman, R-Indianapolis Sponsor: Rep. Lloyd Arnold, R-Leavenworth ISMA Supported Provides that a high school student athlete who has been removed from play because of a suspected concussion or head injury may not return to play until at least 24 hours have passed since the incident Training: Beginning July 1, 2014, the bill requires football coaches and assistant football coaches who are coaching individuals less than 20 years of age to complete a course concerning player safety and concussions at least once during a two-year period. Provides immunity for coaches under certain circumstances

25 SB 294 Worker s Compensation Author: Sen. Phil Boots, R-Crawfordsville Sponsor: Rep. David Ober, R-Albion ISMA Opposed Changes the worker s compensation law by providing that: A medical service provider may not be reimbursed for more than one office visit for each repackaged legend drug prescribed The maximum period during which a medical service provider, may receive reimbursement for a repackaged legend drug begins on the date of the injury or disablement and ends at the beginning of the eighth day after the date of the injury or disablement A medical service provider is distinguished from a medical service facility on the basis of the provider s billing form for Medicare reimbursement

26 PHARMACY

27 Pharmacy Enacted HB 1218 Drug Treatment and Reporting, Insulin Sales HB 1360 Addiction Treatment and Services SB 262 Biosimilar Drugs Died HB 1248 Methamphetamine SB 285 Tramadol

28 HB 1218 Drug Treatment and Reporting, Sales of Insulin* Author: Rep. Steve Davisson, R-Salem Sponsor: Sen. Patricia Miller, R-Indianapolis ISMA Initiative, Supported Expires standards for operation rules concerning prior authorization for a take home supply of opioid treatment medication Current law requires rules to require prior authorization for more than 14 days of medication Prohibits an opioid treatment program from prescribing, dispensing, or providing more than a seven day supply of opioid treatment medication to a patient to take out of the facility *Designates an ISMA Resolution

29 HB 1218 (Continued) Requires an opioid treatment program to follow the standards and protocols adopted by the division of for each opioid treatment program patient Requires the dispenser at an opioid treatment program to transmit certain information to the division within specified time frames Provides that the information is subject to federal patient confidentiality regulations Requires a provider to release certain information from a committed patient's mental health records upon request of a court

30 HB 1218 (Continued) Requires the Indiana professional licensing agency to study the impact of including all prescription drugs in the INSPECT program and sets forth requirements of the study. Requires the legislative council to assign a committee to study: Security of the INSPECT program If opioid treatment programs should be prohibited from allowing patients to take home opioid treatment medication Prohibits the sale of insulin without a prescription from an authorized provider

31 HB 1360 Addiction Treatment and Services Author: Rep. C. Brown, D-Gary Sponsor: Sen. Patricia Miller, R-Indianapolis ISMA Supported Adds psychiatrists pursuing fellowship training and certification in addiction psychiatry to persons eligible for the loan forgiveness program Provides that a psychiatrist pursuing fellowship training and certification in addiction psychiatry may receive loan forgiveness grants for not more than five years Requires the board to give consideration to annually funding two psychiatrists pursuing fellowship training and certification in addiction psychiatry

32 SB 262 Biosimilar Drugs Author: Sen. Brandt Hershman, R-Buck Creek Sponsor: Rep. Ed Clere, R-New Albany ISMA Supported Allows a pharmacist to substitute an interchangeable biosimilar product for a prescribed biological product if certain conditions are met It requires the Indiana Board of Pharmacy to maintain an Internet website listing the biosimilar biological products determined to be interchangeable Allows the pharmacy to adopt rules and provides that a written or electronic prescription for a biological product must comply with existing prescription form requirements

33 PUBLIC HEALTH

34 Public Health Enacted SB 88 Mental Health Witnesses in Criminal Cases SB 408 Neonatal Abstinence Syndrome Died HB 1051 Hepatitis C Testing and Study of Needle Exchanges HB 1309 Medicaid Matters SB 219 Physician Order for Scope of Treatment

35 SB 88 Mental Health Witnesses in Criminal Cases Author: Sen. Ron Alting, R-Lafayette Sponsor: Rep. Ron Bacon, R-Chandler ISMA Monitored Specifies who may be appointed as a mental health expert in a criminal case

36 SB 408 Neonatal Abstinence Syndrome Author: Sen. Vaneta Becker, R-Evansville Sponsor: Rep. Rebecca Kubacki, R-Syracuse ISMA Supported Defines "neonatal abstinence syndrome" (NAS) The ISDH shall: (a) Meet with representatives of certain associations to study and make recommendations on issues concerning NAS. (b) Report, before November 1, 2014, on certain issues concerning NAS to the Legislative Council for distribution to the appropriate interim study committee Allows the ISDH to establish, one or more pilot programs with hospitals that consent to participate in the programs to implement appropriate and effective models for NAS identification, data collection, and reporting.

37 LEGISLATIVE MORGUE

38 Scope of Practice HB 1060 Certified Registered Nurse Anesthetists (Opposed) HB 1114 Legend Drug Prescriptions by Optometrists (Opposed) SB 145 Physical Examinations by Nurse Practitioners (Opposed)

39 Legal HB 1097 Immunity for Providing Volunteer Health Care Services (Supported) SB 244 Health Care Professional Registry (Monitored) SB 290 Medical Debt Collection Procedures (Opposed) SB 346 Medication Therapy Management and Medicaid (Opposed)

40 Pharmacy HB 1248 Methamphetamine (Opposed) SB 285 Tramadol (Supported)

41 Public Health HB 1051 Hepatitis C Testing and Study of Needle Exchanges (Supported) HB 1309 Medicaid Matters (Monitored) SB 219 Physician Order for Scope of Treatment (Opposed)

42 Simple steps for writing a resolution By following these five easy steps, you can write a resolution: Determine a clear action or stand you would like the ISMA to take on an issue and the reasons why. Write a short title. Include your name or names of ISMA members introducing the resolution. Develop one or more Whereas statements explaining the issue and why ISMA action is requested. Conclude with one or more Resolve statements that must stand alone and say what you want the ISMA to do in a clear and concise action plan. For example: RESOLVED, that the ISMA form an ad hoc commission to study the problem of drug-addicted neonates and propose a solution within one year. Only ISMA members may submit resolutions. Need help? The ISMA staff is always willing to provide assistance in helping you with your resolution. Also, find a tutorial at Only ISMA members may submit resolutions.

43 THANK YOU Contact Info: Mike Brady Legislative Coordinator Indiana State Medical Association cell office