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From the Statehouse – Legislative Update

April 20, 2017

The Ohio Legislature has been a flurry of activity in the past month, and the Ohio State Medical Association (OSMA)’s Government Relations team has been on hand to represent the voices of OSMA members. The OSMA Government Relations staff has been present at dozens of hearings and meetings—providing written or verbal testimony, as well as meeting with legislators—as the Legislature discusses major state initiatives and reforms impacting health care.

Here are some of the major issues that the OSMA is involved in that are currently advancing in the legislative process:


1. 2018-2019 Budget:

The OSMA has been generally supportive of the budget proposal currently being deliberated in the Ohio Legislature for the 2018-2019 biennium, apart from a portion that would enact a new tax upon cosmetic medical procedures. The budget bill, HB 49, contains several additional major health care initiatives including: continued expansion of Medicaid, an increase in investment in primary care reimbursement, plans to address the continued drug problems impacting Ohioans, efforts to lower Ohio’s infant mortality rate, consolidation of health care regulatory boards, an increase in tax upon cigarettes and alcoholic beverages, and small business tax changes. The OSMA remains firm in voicing opposition to the elective cosmetic medical procedures tax, and is currently meeting with key legislators to assert the problematic nature of the proposed tax and the impact it would have upon Ohio’s physicians and patients. A substitute bill is expected to be introduced next week, and the OSMA anticipates that it will contain several changes from the version originally introduced. 

2. Opioid Prescribing:

At the end of March, Republicans of the Ohio House and Senate held a Statehouse press conference introducing legislation with stringent prescribing guidelines for opioid prescribing. These guidelines affected both acute and chronic pain patient care and imposed mandatory training requirements for physicians. The next day, Ohio Governor John Kasich introduced a separate proposal also concerning opioid prescribing. The closely-timed announcements addressing the same issue caused some confusion within the medical community. Gov. Kasich’s proposed rules give Ohio’s regulatory boards the ability to impose their own prescribing guidelines without legislative approval. This proposal, however, applies only to acute care conditions and unlike the legislative proposal, does allow for certain exceptions to prescribe beyond the proposed limits. The OSMA has extensively reviewed both proposals, and has indicated preference for the Governor’s proposal due to greater flexibility and the ability to make exceptions to the rules based on clinical and professional judgement. As the two possible proposals are discussed, the OSMA will have a seat at the table. A physician advisory committee will offer input on the process as invited by Gov. Kasich and legislative leaders. For more information on the opioid prescribing proposals, visit the Health Matters story from April 6, 2017. 

3. “One-Bite”:

Over a year ago, the State Medical Board of Ohio proposed to eliminate the “one-bite” rule which currently allows for impaired physicians to seek early intervention and referral on a single occasion without being reported to the Board. The concerned medical community and physician associations including the OSMA reached a consensus with the Board after months of meeting and collaboration on the issue, and HB 145 is the resulting legislation.   Ultimately, HB 145 revises current law to maintain the confidentiality protection and clarifies the eligibility requirements for participation in the “one-bite” program. The OSMA, as a founding member of the Ohio Physicians Health Program (OPHP), an advocate for physicians in recovery, has offered strong, active support of this bill and will continue in the coming months to work to move the legislation through the Ohio House and Senate chambers. 

4. Sale of Dextromethorphan to Minors:

HB 73 would prohibit a retailer or terminal distributor of dangerous drugs from selling or otherwise providing a drug containing dextromethorphan to a person under the age of 18 without a prescription. Violation of this rule once enacted into law would be classed as a minor misdemeanor. This bill would make the law in Ohio similar to the restriction on sales of pseudoephedrine to minors. The legislation has the support of not only the OSMA, but also the Ohio Chapter of the American Academy of Pediatrics and the Ohio Children’s Hospital Association. The OSMA will actively monitor this bill as it moves forward and continue to voice support when needed. 

5. Physical Therapy:

HB 131 is a revisited issue from several prior General Assemblies, during which the OSMA was in steadfast opposition. The OSMA continues to oppose this legislation, which seeks to modify the scope of practice of a physical therapist, allowing PTs to evaluate, diagnose, and determine a plan of therapeutic treatment for a patient. The bill as currently written also allows a PT to order tests, including diagnostic imaging and studies. The OSMA has continued to express concern with PTs providing a medical diagnosis to patients without the same medical education and training of a physician, as well as concerns about unnecessary, duplicative tests driving up health care costs, and undue interruption of treatment caused by a delay in proper diagnosis. The Government Relations team at the OSMA continues to meet with the sponsors of the legislation regarding these concerns to ensure that should the legislation advance, it will not grant physical therapists an expansion to scope of practice that exceeds their training and background. 

The OSMA will continue to work on these and other advocacy issues in the coming months.
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