2015
Legislative Report
Every legislative session has its own distinct personality. But 2015 will definitely stand out as one of the
more unique legislative sessions in recent Oklahoma history. (The word most commonly heard around the
Capitol was “weird.”) Together, the three members of OSMA’s lobby team have nearly 80 combined years of
experience working in and around Oklahoma politics and this was as strange a year as any of us have ever
seen—not so much for what happened but for what didn’t happen.
While there was plenty of the usual bickering between parties and standoffs between the House and
Senate, there was no one big contentious issue that dominated this session. Aside from an early session
debate over transporting feral hogs (seriously) and an anticlimactic vote on the Native American Cultural
Center, no hot-button issues emerged this year to flood the Capitol with advocates. This whole session was
like a bad horror movie—you kept waiting for some big nasty monster to jump out and scare everyone,
but it just never happened.
That’s not to say the session was uneventful, however. In the absence of one overarching issue to consume
their time, lawmakers were able to consider a number of bills, many of which will impact Oklahoma
physicians and their patients. Here is a rundown of some of the biggest developments from the 2015
legislative session.
278 • OSMA Journal • June 2011
276
OSMA Journal • April 2011 • 143
BUDGET
The state budget cast a shadow over the entire legislative session. With a $611 million shortfall, we were
really preparing for the worst, with potential cuts to Medicaid providers of up to 18 percent. Even down to
the waning days of session, it looked like double-digit cuts were still a possibility. But, in the end, budget
negotiators were able to keep the overall budget reduction to a minimum and the Health Care Authority
was able to make up the difference through some targeted service reductions without the need for an
across-the-board provider rate cut.
Certainly no one wants to see services to Medicaid patients cut and many of the policy changes made by
the Health Care Authority (e.g. no longer paying for sleep studies or benign skin lesion removal, changes
in the number of ultrasounds they will pay for, etc.) will no doubt be unpopular. But given what the budget
crafters were up against, it was no small feat to escape 2015 with no provider rate cut.
And we must say a very special thank you to those of you who took the time to answer our survey earlier
this year about Medicaid cuts and your ability to see Medicaid patients. Your responses gave us the data we
needed to show that budget cuts would have real and serious implications on access to care by Medicaid
patients in their communities. You helped us educate lawmakers that the budget is about more than
dollars and cents, it’s about real people and their health needs. With the budget outlook for 2016 looking
even worse, your help will be needed more than ever.
PRESCRIPTION MONITORING PROGRAM
No issue over the last couple years has been more contentious than prescription drug abuse and a
proposal to require physicians to check the Bureau of Narcotics’ Prescription Monitoring Program (PMP)
before writing a controlled substance prescription. Going back to 2014, Governor Fallin backed legislation
that would have required prescribers to check the PMP on every prescription and refill and mandated a
$2,000 fine per violation. Although we made progress on some issues, we were unable to reach a final
compromise and, despite a full-court press by the governor and The Oklahoman (both Governor Fallin and
the editor-in-chief of The Oklahoman have family members who have struggled with prescription drug
abuse), the bill stalled in a joint House/Senate conference committee.
Over the interim, Rep. Doug Cox, MD, an emergency room physician from Grove, OK worked to piece
together a compromise bill. In its final form, HB 1948 requires prescribers to check the PMP before
prescribing opioids, benzodiazepines and carisoprodol. It will require a check at the initial prescription
and, for patients with a long-term need for these drugs, subsequent checks at least every 180 days. Dr.
Cox also put in many provisions OSMA had requested, including allowing staff to do the checks, moving
enforcement to the respective licensure boards and putting in a five-year sunset clause.
Dr. Cox accomplished a rare feat at the Capitol—finding a bill that no one really liked. We certainly did not
want to see a new mandate on physicians and, up until the last moments, Governor Fallin continued to
push for the “every prescription, every time” language. But in the end it reflected a compromise with which
both sides could live and HB 1948 was the first bill signed into law this session.
276 • OSMA Journal • June 2011
OSMA Journal • April
June 2011 • 143
279
277
LAWSUIT REFORM
While OSMA has been successful in winning most of the lawsuit victories we’ve sought over the years,
there are still a couple of remaining issues still hanging out there. We were able to address one of these
with SB 789, which deals with the admissibility of medical bills. Under current law, if you agree to write
off some of your charges and accept less than what you actually billed a patient, if you are later sued the
admissible amount the patient could seek is what you originally billed, even though they didn’t pay that.
This new law, which will take effect November 1st, simply says that the amount the patient actually paid is
what will be admissible in court.
The last remaining big issue is the statute of limitations for physicians in liability cases. As the law currently
stands, an obstetrician who delivers a baby today can be sued until that child turns 20 years old. This year,
we filed SB 765, which will bring the statute of limitations down to a more reasonable level in line with
that found in other professions. Unfortunately, the bill got caught up in some inter-chamber squabbling
between House and Senate committee chairs and did not pass this year. But it will carry over to 2016 and
will be one of our top priorities next session. Although this issue affects all physicians, it disproportionately
impacts obstetricians, and we really need to engage more OB/GYNs to contact legislators on this important
measure.
PUBLIC HEALTH
One area in which we had a surprising number of successes was in our efforts to improve public health
and safety. In her State of the State address, Governor Fallin called for a bill to ban texting and driving and
the issue took on new prominence after the tragic death of a state trooper because of a driver who was
doing exactly what this bill is intended to stop. The bill that began moving through the process, HB 1965,
was relatively weak and made the violation a secondary offense, meaning a police officer could not cite
violators for the offense directly but could only add it as an additional citation after pulling the person over
for something else. Sen. Ervin Yen, MD, an anesthesiologist from Oklahoma City, offered an amendment to
make texting while driving a primary offense and, through his tireless work, the amendment passed and
the more effective law will take effect November 1st.
Dr. Yen also carried SB 239, a new law that will make sure school athletic coaches receive training in the
signs and symptoms of sudden cardiac arrest. HB 1847 will codify new car seat guidelines to make sure
that small children are kept safe in the most appropriate car seats and restraints. We also worked closely
with the American Stroke Association and hospital groups on HB 1463, a new law that will help improve
triage and transport protocols for stroke victims. Finally, HB 1685 will require all public school campuses
to be completely tobacco-free 24/7.
276 • OSMA Journal • June 2011
OSMA Journal • April
June 2011 • 143
279
277
SCOPE OF PRACTICE
While scope of practice bills are always a source of concern, we are pleased to report that no scope of
practice bills passed this session. There were a couple of bills from the hospitals and the physician assistants
to which we had raised objections early in session. But, to their credit, both groups sat down with us and
our partners in the Patients First Coalition to craft compromise language that addressed our concerns.
MANAGED CARE
After the huge fight to kill a bill last year that would have outsourced and privatized the state Medicaid
system, perhaps the biggest surprise of the year that there was never a bill on this same subject even
introduced in 2015. There was a law passed (HB 1566) to create a managed care pilot program for the
aged, blind and disabled population, but nothing nearly as expansive as what was proposed last year. We
will keep a close eye on the results of this pilot project and continue to oppose privatization efforts in the
future.
IN CONCLUSION
For the Oklahoma State Medical Association it was a good year to survive and we were actually able to
make significant progress in some areas. You always hope to move forward on items like tort reform, and
we do still have the statute of repose effort moving. But to get to the end of session with no cuts to provider
rates for our doctors in this budget situation was huge. To be able to get the Governor’s own top priority
legislation into a form that we could live with, over her objections, was also quite an accomplishment. We
believe over the past few years the House of Medicine has become a real player at the Capitol, thanks in
large part to Dr. Cox, Dr. Ritze and now Dr. Yen. But we must continue to keep the pressure on. OSMA, the
Osteopathic Association and our partners in the Patients First Coalition have done a great job of helping
organize Oklahoma’s medical community but we need more rank-and-file physicians who are willing to
contact their legislators on important issues. And, with many of our long-time champions at the Capitol
being term-limited next year, it is vital that we raise OMPAC contributions to help us elect pro-medicine
candidates.
Your lobby team—Pat Hall, Jim Dunlap and Wes Glinsmann—is honored to represent you at the Capitol
and we look forward to furthering a medicine-friendly legislative agenda in the future.
276 • OSMA Journal • June 2011
OSMA Journal • April
June 2011 • 143
279
277