Statehouse Update: Protection of Personal Assets, Continuity of Care Bills

The 129th General Assembly (GA) enters the late stages of lame duck session with a full schedule of committee meetings and lengthy legislative agendas. After this week, it is likely that only one week remains for legislative activity and the OSMA Government Relations team continues to monitor upwards of a dozen bills, including bills that impact the protection of personal assets, patient continuity of care, and telehealth. Bills of particular significance slated for activity this week are outlined below.

Senate Judiciary Committee

House Bill 479 – Protection of Personal Assets
HB 479 will modernize Ohio’s legal infrastructure in the areas of trust and asset protection by establishing a domestic asset protection trust (DAPT). It will also update other trust statutes, modify the existing homestead exemption and enhance safeguards for IRA’s and 529 plans. With specific regard to the homestead exemption, the bill would increase the current maximum limit from $20,200 to $125,000.

The OSMA supports.

Senate Insurance, Commerce and Labor Committee

House Bill 417 – Patient Continuity of Care
HB 417 provides that a patient be notified by a health care entity when a physician’s employment is terminated. This bill is effectively an effort to ensure a patient’s continuity of care remains intact.

The OSMA has worked with the bill’s sponsor, the Columbus Medical Association, the Ohio Hospital Association (OHA) and other interested parties to strike a tentative compromise that satisfies all parties. The compromise provides a 30-day window for health care entities to notify a patient of a physician’s termination and an exemption that notification is not required if there is a good faith concern that the notification could jeopardize the health and safety of the patient.

The bill has passed the Senate and will be headed to Gov. Kasich for this signature sometime next week.

The OSMA supports.

House Health and Aging Committee

House Bill 598 – Pervasive Developmental Disorders in Mental Health Parity Law
HB 598 would include pervasive developmental disabilities in the mental health insurance parity law. Among others, autism is defined in the bill as a pervasive developmental disability and thus insurers would be required to offer coverage. There is a $50,000 annual maximum benefit for related coverage and insurers may opt out if they offer proof that premiums have increased more than one and a half percent as a result of the bill’s provisions.

The OSMA actively supports this bill, but many pediatricians are worried that legislating the definition of pervasive developmental disabilities may omit disabilities identified in the future. They also have questions about how mandates, like the one provided for in this bill, will be impacted by the Affordable Care Act (ACA), specifically the component pertaining to essential health benefits.

The OSMA supports. (Note: there is a companion bill in the Senate – SB 381).

House Bill 609 – Telehealth Services
HB 609 would mandate that Medicaid cover certain telehealth medical services in an amount not to exceed that which would pertain to a face-to-face visit. The bill would also authorize – but not mandate – other health care insurers to offer coverage for telehealth services.

An interested party meeting brought to light some concerns with the introduced version of the bill regarding the definition and scope of telehealth medical services and how best to ensure quality of patient care in a telehealth setting. In response, a substitute bill is likely to be taken up by the committee that requires the Office of Medical Assistance to determine which telehealth services should be appropriately covered by Medicaid.

The OSMA supports the bill at this time on the grounds that it is a positive and forward-thinking concept that may expand patient access to care. Any future amendments to the bill will be taken under advisement by the OSMA.

The OSMA supports.

House Bill 217 – Breast Reconstruction
HB 217 has evolved into a substitute bill that would require a surgeon to provide information regarding breast reconstruction to a patient before obtaining the patient’s consent for a mastectomy, lymph node dissection or lumpectomy.

The OSMA actively opposes this bill on the grounds that it is legislating and, in fact, mandating a standard of care on the surgeon community. Our opposition is rooted in two facts. First, a 2009 article in the Journal of Clinical Oncology found that over 80 percent of women are already having the conversation about breast reconstruction options with their surgeons. Second, the American College of Surgeons has an accreditation process in place that requires a surgeon to offer a pre-operative consultation with a plastic surgeon to the patient.
What the OSMA proposes in lieu of this bill is a public education effort on breast reconstruction options to be developed and rolled out by the Ohio Department of Health.

The OSMA opposes.

Senate Health, Human Services & Aging

House Bill 284 – Physician’s Assistant
HB 284 seeks to modify the physician assistant practice in Ohio. What is of greatest importance to the OSMA is that the bill in its current form does not change the requirement that a physician assistant work under the supervision of a physician, nor does it change the definition of supervision.

The OSMA is neutral.

Senate Bill 381 – Pervasive Developmental Disorders in Mental Health Parity Law
SB 381 would include pervasive developmental disabilities in the mental health insurance parity law. Among others, autism is defined in the bill as a pervasive developmental disability and thus insurers would be required to offer coverage. There is a $50,000 annual maximum benefit for related coverage and insurers may opt out if they offer proof that premiums have increased more than one and a half percent as a result of the bill’s provisions.

The OSMA actively supports this bill, but many pediatricians are worried that legislating the definition of pervasive developmental disabilities may omit disabilities identified in the future. They also have questions about how mandates like the one provided for in this bill will be impacted by the Affordable Care Act (ACA), specifically the component pertaining to essential health benefits.

The OSMA supports. (Note: there is a companion bill in the Senate – HB 598).

SCR 33 – PSA Resolution
SCR 33 seeks the withdrawal of the United States Preventive Services Task Force recommendation against prostate-specific antigen-based screening for prostate cancer for men in all age groups. The OSMA worked in conjunction with the Ohio Urological Society and the Ohio Urology Coalition in advancing this measure.

Sen. David Burke (R-Marysville) provided sponsor testimony and Herb Riemenschneider, MD, provided proponent testimony as well. The resolution was voted out of committee and will likely be considered by the full Senate next week.

The OSMA supports.

House Bill 492 – Melanoma and Skin Cancer Awareness
HB 492 would declare May as “Melanoma and Skin Cancer Prevention and Detection Month” in Ohio. Due to the increasing prevalence of skin cancer and the public’s lack of awareness about the severity of exposure to ultraviolet rays, the OSMA and the Ohio Dermatological Association have brought this bill to the legislature.

HB 492 will likely be reported out of the Committee and sent to the Senate Floor for a vote before the lame duck session expires.

The OSMA supports and will testify.

Other Notable Legislative Activity

House Bill 334 – Pseudophedrine Sales Tracking
HB 334 would add Ohio to a multistate, real-time, stop-sale system called the National Precursor Log Exchange (NPLEx) to monitor purchases and attempted purchases of products containing pseudoephedrine (PSE). The bill was passed out of the Senate on Tuesday and will return to the House for final approval before heading to Gov. Kasich.

The OSMA supports.

House Bill 143 – Return to Play for Youth Concussions
HB 143 deals with youth concussions and the conditions upon which an athlete who suffers a concussion can return to play. The bill also contains an educational component for coaches and referees regarding how to recognize and evaluate concussions.

The bill was passed unanimously out of the Senate on Tuesday and will return to the House for final approval before heading to Gov. Kasich.

The OSMA supports.

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