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01/08/2018

Legislative Update: 2017 Recap and Hot Issues For 2018

MOC

The Ohio House has begun hearings on House Bill 273, a measure that could ban maintenance-of-certification (MOC) as a prerequisite for licensure, insurance plan participation, hiring, and hospital admission privileges. Ohio is now one of about a dozen states that have or is currently seeking to curtail the use of MOC as a tactic that could impact a physicians’ ability to practice medicine.

The impact of MOC in Ohio has divided many specialties with some outright opposed to it, others in favor of it, and many who are neutral. The OOS has taken a neutral stance and is watching for developments on the bill. Those who support the anti-MOC bill say requirements are becoming to frequent, redundant and expensive and have little to do with improving patient care. Those who support MOC say the requirements help distinguish their practice of medicine and does help to keep the upon new developments within their specialty.

The bill is still in a House committee and could receive more attention once legislators return from holiday break in December.

Scope of Practice

An underlying issue at the American Academy of Ophthalmology Annual Meeting in New Orleans in November was the battle optometrist in many states continue to wage as they seek authority to do more surgical procedures that are typically reserved for Ophthalmologists.

AAO officials said that its national PAC fund spent money and other resources in nearly a dozen states this year assisting with scope battles. The AAO said optometrist were largely successful in Alaska and Georgia where legislatively they were able to secure some additional roles over the objections of ophthalmologists. However, the AAO said its advocacy efforts were more successful in most other states, including Florida, North Carolina, and Pennsylvania.

While Ohio has not seen such challenges from optometrists, some officials at the AAO felt it was inevitable that Ohio will eventually be subject to a scope battle. This is a good time to remind OOS members that supporting the OOS’ PAC is critically important.

New Opioid Prescribing Rules

If you prescribe opioids the state pharmacy board has new rules you must follow. The pharmacy board, to better track which doctors are prescribing opioids and for what reason they are prescribing the painkillers, will now require ICD-10 codes to be included on the actual prescription that patients take to a pharmacy to be filled:

  • On Dec. 29, 2017, the first four-digits of ICD-10 codes must be included on opioid prescriptions. If your electronic systems cannot generate the proper codes, the codes can be handwritten on the prescription.
  • On June 30, 2018, the first four-digits of ICD-10 codes must be included on prescriptions for any controlled substance.

And, as a reminder, the state medical board implemented new rules that started on Aug. 31 for when prescribing opioid for acute pain conditions:

  • Physicians cannot prescribe more than a 7-day supply to adults for an initial opioid prescription.
  • Physicians cannot prescribe more than a 5-day supply to minors for an initial opioid prescription.
  • The drugs cannot exceed a 30-MED daily average and must be short-acting opioids.
  • Physicians do have the discretion to exceed these limits but must provide a documented reason in the patient’s medical records.

Price Transparency

With the state’s price transparency law still on-hold due to pending litigation, state Rep. Stephen Huffman (Tipp City-R) has introduced legislation that he says will give patients a clearer idea of what their doctor or hospital bill will be before a medical procedure is performed.

His proposal is a direct response to a state price transparency law that was set to go into effect in January 2017; however, multiple healthcare associations, including the Ohio State Medical Association (OSMA), sued the state claiming the new statute has unworkable provisions that could frustrate and harm patients. A hearing on that lawsuit has been postponed until March 2018.

“My legislation would address those concerns while still providing price transparency for patients,” Huffman said during a press conference in November at the Statehouse where he introduced his legislation. Huffman, a physician, said he believes the litigation could last another two years.

The law currently in litigation would require physicians and hospitals to tell patients in advance how much their medical services will cost and how much they will have to pay versus what their insurance will cover.  But healthcare organizations have argued it is impossible in many cases for a physician or hospital to provide that level of detail because insurance coverages vary so significantly from patient to patient. This information is also not always readily available to the provider. Therefore, the current law’s mandates are unrealistic to ask of providers and doing so would negatively impact the delivery of efficient health care.

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