The Legislature just completed week four of the 2019 Legislative Session. This was a week where a lot of legislation moved. The LAFP advocacy team appreciates all of you who responded to our VoterVoice alerts and hope more of you will take action on legislation that moved out of committee to the floor.
What Happened Last Week
NURSE PRACTITIONERS seek GLOBAL SIGNATURE AUTHORITY
HB 276 by Representative Robert Johnson passed out of the House Health and Welfare Committee on Wednesday by a vote of 11-2. LSMS and many other physician groups are heavily opposed and showed up to testify and lobby the committee.
VOTING AGAINST HB 276 and WITH LAFP: Chairman Frank Hoffman and Representative Katrina Jackson.
VOTING FOR HB 276 and AGAINST LAFP: Representatives Larry Bagley, Bubba Chaney, Kenny Cox, Robert Johnson, Bernard LeBas, Wayne McMahen, Dustin Miller, Pat Moore, Joe Stagni, Julie Stokes, and Chris Turner.
HB 276 gives to nurse practitioners by legislation what they did not earn by education. We encourage all of you to make sure your legislators know that MEDICAL SCHOOL MATTERS! If you are presented with the opportunity to speak to them, please take it. We encourage you to share how you work with your nurse practitioners and what documents in particular for which you would never want them to have signatory privileges.
Should you wish to write your legislators, please use our VoterVoice link here to access email options designed for you.
The bill creates a "global signature authority" for nurse practitioners. This instrument claims to enhance the patient-provider relationship and promote transparency and accountability but does not define which documents nurse practitioners wish to be included. However, it grants global signature authority across the board. HB 276 is clearly an expansion of practice that will impact ALL physicians regardless of your specialty. If HB 276 passes, a nurse practitioner will by law be authorized to sign all documents that currently can only be signed by a physician. Please also consider how you will go about updating your collaborative practice agreements to exclude documents.
PHYSICIAN ASSISTANTS LEGISLATION is under WATCH
SB 166 by Senator Eric LaFleur as it was originally filed did two things: changed the relationship between a physician and a physician assistant from "supervising" to "collaborating" and shifted liability from the physician to the physician assistant. Senator LaFleur requested a meeting with LAFP and other physician groups, during which he explained that the legislation wasn't what he intended and that he would be offering amendments in committee, which he did (see link above). The bill now includes 4 issues:
- The ability for PA's to order Occupational Therapy. This was a request of the LSBME who says this was inadvertently left out of the bill LSMS worked with the PAs to accomplish a few years back.
- Prescribing ability with an "active unrestricted license" being changed to "current license." This also was a fix requested by the LSBME.
- The PAs are attempting to shift their liability from the MDs. According to them, they are losing jobs to Nurse Practitioners because under the current practice model PA liability is added to the liability of the MD, where the nurse practitioner's liability is separate. They also claimed that it's not fair for the MD to be responsible for their mistake if they are not a part of it.
- Changing the relationship from "supervisory" to something else. They agree that "collaborating" is toxic and would like to not use it. Their suggestion was "sponsoring." We were told that supervisory no longer reflects the relationship they have with physicians today. They also felt like this change aided in the shift of liability. A second thought was to remove the adjective completely and leave it in most places at "physician."
There are still many conversations being held around SB 166. We ask that you watch for any calls-to-action that may come next week as the bill begins to look like what it was supposed to look like.
SB 177 by Senator Bodi White limits non-compete clauses in the employment agreements of physicians and varying mid-level health care providers.
During the Legislative and Advocacy Committee, the LAFP was directed to seek or support legislation aimed at eliminating non-compete clauses for physicians. SB 177 takes a first step in that direction and is a fair piece of legislation in that it gives all parties five years to determine how they plan to move forward. Its aim is to allow any physician who has been with the same employer for five continuous years to be able to leave for other employment within the community without being in violation of a non-compete clause.
The bill came out of committee and is now on the Senate floor.
Coming Up This Week
House Administration of Criminal Justice
Tuesday, May 07, 2019 9:00 AM Committee Room 6
HB 45, Talbot
Provides for fines associated with selling tobacco, alternative nicotine, or vapor products to persons under the age of 18
Tuesday, May 07, 2019 At Adjournment Committee Room 5
HB 38, Hoffmann
Raises the minimum age relative to the distribution, sale, purchase, or possession of tobacco products, alternative nicotine products, or vapor products
HB 103, Leger
Provides for the ordinary operating expenses of state government for Fiscal Year 2019-2020
House Health & Welfare
Tuesday, May 07, 2019 9:00 AM Committee Room 5
HB 108, Pylant
Authorizes the installation and use of newborn safety devices at infant relinquishment sites designated in the Safe Haven Law
HB 129, Carmody
Provides relative to Medicaid nonemergency transportation providers and services
HB 207, Amedee
Requires the provision of certain information to patients or parents of patients prior to administration of an immunization or a vaccine
HB 211, Horton
Provides relative to Medicaid coverage of certain behavioral health services
HB 390, White
Relative to reimbursement rates paid to providers of disability services
HB 427, Smith
Provides for communication-related services for the deaf and hard of hearing in certain healthcare settings
HB 433, LeBas
Authorizes a pharmacist to decline to dispense a covered prescription drug if the coverage provider reimburses the pharmacy in an amount less than the drug's acquisition cost
HB 538, LeBas
Provides relative to pharmacy record audits
HB 568, Miller, D.
Provides that the regulation of therapeutic cannabis be placed under the authority of the Louisiana Department of Health
HCR 26, Bacala
Requests that the La. Department of Health resume implementation of a Medicaid managed long-term services and supports system
House & Governmental Affairs
Tuesday, May 07, 2019 10:00 AM Committee Room 2
Tuesday, May 07, 2019 10:00 AM Committee Room 2
HB 169, Hoffmann
Authorizes a data system for collection of information on health effects and outcomes associated with medical marijuana
HB 243, Miller, D.
Provides relative to opioid data reporting
Tuesday, May 07, 2019 9:30 AM Committee Room 3
HB 352, DuBuisson
Authorizes health insurance issuers to establish modern healthcare costs and quality programs
HB 432, Jordan
Provides for the regulation of pharmacy services administrative organizations
Senate Judiciary A
Tuesday, May 07, 2019 9:30 AM John J. Hainkel, Jr. Room
HB 372, Talbot
Enacts the Omnibus Premium Reduction Act of 2019
HB 425, Jackson
Stipulates that no provision of the constitution protects a right to abortion or requires the funding of abortion
Senate Health & WelfareSCR 70 Barrow
Wednesday, May 08, 2019 9:30 AM John J. Hainkel, Jr. Room
Creates the Louisiana Community Health Worker Workforce Study Committee
SCR 84 Appel
Requests the Louisiana Department of Health to take all steps necessary to approve peer support services as a Medicaid covered service
SB 113 Hensgens
Provides relative to the state medical assistance program. (8/1/19)
SB 219 Barrow
Requires health insurance policies to adhere to certain standards. (gov sig)