Legislative Update

October 30, 2017

While House Bill 273, the maintenance of certification (MOC) measure, has drawn the most attention from OGS, there are a number of other pending bills, rules and laws of interest for gastroenterologists.

 

Those who prescribe opioids to patients as part of a pain management plan should be aware that the state medical board has imposed new rules for treating acute pain conditions. As of Aug. 31:

 

  • 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

 

The state pharmacy board also has new rules related to prescribing opioids. The pharmacy board, to better track which doctors are prescribing opioids and for what reason they are prescribing the painkillers, will soon 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

  • On June 30, 2018, the first four-digits of ICD-10 codes must be included on prescriptions for any controlled substance

  • Physicians and individual practices should be preparing now to assure they can comply with these news rules

 

Meanwhile, a lawsuit blocking the implementation of a health care price transparency law that was supposed to have been started on Jan. 1 of this year is still pending. In late 2016, the Ohio State Medical Association (OSMA), Ohio Hospitals Association (OHA), OGS and other provider organizations filed a lawsuit against the State of Ohio seeking an injunction against law.

 

The primary concern driving this action was that it is impossible for many health care providers to realistically comply with this law as written. Since before the lawsuit, we have been working with interested policymakers to craft an alternative transparency proposal that is reasonable, functional, and meaningful.

 

The alternative proposed by the OSMA and OHA would place Ohio among the national leaders in government-mandated consumer price transparency and is comprised of statutory requirements with which physicians and hospitals can feasibly comply.

 

Depositions have been taken, the lawsuit is still pending and the law has not taken effect. Meanwhile, medical associations have continued to seek to work with state lawmakers to find a solution to this stalemate. To be clear, Ohio physicians are unequivocally in favor of the idea of providing clear, good faith cost estimates for necessary medical services to patients.

 

Lastly, lawmakers are again poised to address HB 191, a scope of practice measure that would give CRNA’s independent practice, prescriptive authority, and open the door to potentially contradictory orders from what a physician has ordered or determined.

 

We have significant concerns with that proposal. We value the contributions of CRNAs within the care team model but this bill goes too far. The CRNAs have not identified any problems with the current safe and effective delivery of anesthesia care and, most importantly, have not provided facts or data on how this bill will improve patient care.

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