Summer 2013: State of ER Governmental Affairs Jorgen Schlemeier

POSTED: September 6th, 2013
POSTED IN: Summer 2013,

2013 session concluded, 2014 session work has begun. Many years ago, there used to be a break between the two, now the end of the session and the work for the next session seem to overlap.

Here are the highlights:

First, medical malpractice – no solution yet. The trial bar wants nothing to do with reinstating the non-economic damages cap the legislature passed in 05 ($350,000). There counter continued to be $750,000 with an annual adjuster for inflation. Remember, prior to the passage of the 05 cap, which was kicked out by the Supreme Court last year, the cap was around $500,000. Today with inflation index, it would be in the $620,000 range. Their offer of $750,000 was a non-starter. Today however, we still have no cap, and continue to work with the other physician groups to think of alternative solutions.

Prescription Drug Monitoring – Same story, different year. The Senate, or actually one senator, continues to impede the progress of implementing a PDMP for the state of Missouri. The chances of passing could be declining for next session based on a few items. First, Florida’s PDMP had inadvertent leaks, which pokes a hole in our talking point that 49 other states have implemented the program without a leak. Second, the Dept. of Revenue hearings continue. These hearings by the legislature are attempting to discern how the Missouri Dept. of Revenue collected and remitted certain personal information of drivers. Finally, the federal scene of today coupled with the government collecting more information on Missourians’ private lives continues to be the hurdle we have to clear in order to pass this bill.

Medicaid Expansion or Transformation, whichever term you choose to use. The word “expansion” is not a good word in the conservative ranks of politicians. Transformation is translated as removing people from Medicaid in the “liberal” ranks of politicians. The key is not if a person is on Medicaid, but whether they have health care. Jay Barnes, the chair of the House Committee has been clear. He wants to cover more uninsured in the most cost effective manner, and that does not necessarily mean Medicaid. He wants to maximize the person’s resources for cost sharing, and utilize the Health Exchange and attempt to make Medicaid the last resort.

The House and Senate (Senate Committee Chaired by Gary Romine – R –Farmington) will meet throughout the interim and theoretically develop a proposal that each committee can take to their respective chambers, and eventually pass. Stay tuned.

Provider Practice Expansions – Nurses made their pitch for more independent practice, and it did not go over well. The nurses did pass a provision allowing tele-health nursing services to be provided outside the geographic proximity requirements of their collaborating physician agreement if such services are provided in a rural area located in a health professional shortage area in Missouri.

Physician Assistants were able to pass a bill with the consent of the physician groups to remove much of the administrative burdens the statute placed on the physician and PA. The law still clearly states that a PA can only practice where the Physician routinely sees patients, and not open their own practice site.

We Need Your Help!

Take 14 seconds and read this – You want to get involved but don’t have the time. I get it, me too. This is so darn quick, and will pay big rewards. Just Do it (swoosh)! Here is what you can do; (1) call or email your State Senator and State Representative, invite them to the ER once in the next 6 months, yes just once, and show them what you do for about an hour. That is it, don’t ask them for anything, don’t look now, but you have just started a relationship. I will alert you when the association has taken a stance on which we need your assistance with your Senator and Representative.

Don’t know who your state rep or senator is; look at the left column of – Legislator Lookup.