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This Week at the Capitol

Sine Die
As has been the past few years, a special session after sine die is almost a certainty. This year, legislative leaders have already committed to fulfill Governor Lamont’s request to come in for a special session to discuss tolls. They are also likely to also bring up economic development, including a potential bonding package. The budget, which passed the House on Monday, passed the Senate late last night. With several of the big "talkers" out of the way, leaders will be negotiating the last batch of bills to be called in the hours leading up to midnight. 

The Enemy vs. the Opposition
There’s an old story often told at the Capitol about a freshman member of the House Democrats who had asked his Majority Leader where the Republican offices were, saying he wanted to "meet the enemy. The Leader replied, "The Republicans are not the enemy, they're the opposition. The Senate is the enemy." By Monday of this week, only twenty bills had passed both the House and Senate. As is typical this time of session, Senate leaders are House bills hostage until their bills are called in the House, and House leaders hold Senate bills hostage until their bills are called in the Senate. As a result, not much business moves until Democratic leaders in both chambers meet to negotiate their priorities. Expect the Senate and House to either run several bills in the last hour, or none at all if legislative leaders fail to reach an agreement.

Legislative Mood
Democrats are in high spirits as a large chunk of their priority list passed this year: A Minimum wage increase, Paid Family Leave, the "Time's Up" bill, and a number of election bills, and tolls are on the horizon. There will likely be fanfare and applause on the democratic side, (and a bit of melancholy on the republican side), but everyone will be celebrating a productive session.

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Hartford County Medical Association
End of Session Report

Prepared by

Focus Government Affairs

 

HCMA Priority Issues

AEDs
SB 795
AN ACT CONCERNING THE USE OF AUTOMATIC EXTERNAL DEFIBRILLATORS
Calendar Number: 21
File Number: 8
Current Status: Awaiting Signing by Governor
6/5: Voted out of House on consent, in concurrence with Senate
6/5: Voted out of Senate on consent
4/22: Voted out of Judiciary Committee 35-1
4/17: Referred by Senate to Judiciary Committee
2/27: Tabled for Senate Calendar
2/13: Voted out of Public Health Committee 26-0
1/30: Referred to Public Health
Notes:

  • This is the bill Dr. Gould has been working on for the last two years and that HCMA has taken up as a priority this session.
  • The bill would extend civil immunity to physicians who operate an automatic external defibrillator (AED) that results in personal injuries caused by the AED’s malfunctioning.
  • We believe the current law acts as a barrier to practitioners maintaining AEDs in their practices. By changing the law, more practitioners are likely to have AEDs in their office, resulting in an overall public health benefit.
  • An amendment was recently filed that represents a compromise between us and the Trial Lawyers Association, which clarifies that any negligence was not as a result of a healthcare provider. This will give the bill a greater chance of passage.
  • LCO Amendment 7270 (D) has been filed and adopted
  • On June 5, the last day of session, we worked closely with Sen. Anwar, Sen. Somers, and the CT Trial Lawyers to move this bill out of the Senate. At 11:25pm, the bill was marked “go” in the Senate, the amendment adopted, the bill voted on, and immediately transmitted to the House for action. At 11:45pm, the House called the bill and passed it in concurrence with the Senate. It now goes to the Governor for his signature

Medical Assistants
HB 6943
Calendar Number: 20
File Number: 7
Current Status: On House Calendar
AN ACT ALLOWING MEDICAL ASSISTANTS TO ADMINISTER VACCINES.
2/27: Tabled for House Calendar
2/13: Voted out of Public Health Committee 24-2
1/30: Referred to Public Health
Notes:

  • This bill allows for Medical assistants with sufficient education and training to administer vaccines under the direct supervision, control, and responsibility of a physician or APRN. This has been a recurring issue for the last few years.
  • The bill will require an amendment before passage clarifying that it does not require medical assistants to provide vaccines, and physicians and APRNs that do not feel comfortable with a MA administering a vaccine are under no obligation to allow them to do so.
  • This amendment has been filed, which we believe addresses the concerns of the opposition.
  • In the waning days of session, opponents of the bill had threatened to “talk” on the bill for hours in an effort to kill the legislation, as time becomes more and more valuable the closer the legislature gets to adjournment. We had learned that two high ranking democrats had concerns with the bill and were holding it from passage. Unfortunately, this can be enough to derail a bill from moving.

 

Bills that were passed:
Opthalmology/Optometry
SB 838 / HB 7173
AN ACT CONCERNING CONTRACTS BETWEEN HEALTH INSURERS, OPTOMETRISTS AND OPHTHALMOLOGISTS.
Notes:

  • This bill prohibits a provider contract between a health carrier (e.g.,insurer or HMO) and a licensed ophthalmologist from requiring the ophthalmologist to accept as payment an amount the carrier sets for services, procedures, or products that are not covered benefits under an insurance policy or benefit plan
  • The original bill, HB 7173 needed a fix that would carve out Taft-Hartley plans under ERISA. In order for this to be fixed, the bill was rolled into SB 838, where it passed both chambers and now goes to the Governor’s office for his signature.

Sunscreen
SB 992
AN ACT ALLOWING STUDENTS TO APPLY SUNSCREEN PRIOR TO ENGAGING IN OUTDOOR ACTIVITIES.
Calendar Number: 130
File Number: 232
Current Status: Awaiting Governor’s Signature
6/4: Passes House in concurrence with Senate
4/18:Tabled for House Calendar
4/17: Passed by Senate 36-0
3/28: Reported out of LCO
3/8: Voted out of Public Heath
2/21: Referred to Public Health
Notes:

  • The bill allows students age six or older to possess and self-apply over-the-counter sunscreen in schools before outdoor activities, if the parent/guardian gave written authorization to the school nurse.

Hearing Aids
AN ACT EXPANDING REQUIRED HEALTH INSURANCE COVERAGE FOR HEARING AIDS
Calendar Number: 619
File Number: 998
Current Status: Awaiting Governor’s Signature
6/5: Passed Senate in concurrence
5/28: Tabled for Senate Calendar
5/23: Passed House
4/2: Tabled for House Calendar
3/14: Voted out of Insurance
Notes:

  • This bill eliminates an age restriction for mandated health insurance coverage for hearing aids, thus requiring certain insurance policies to cover hearing aids for any covered person. In doing so, it codifies existing regulations by the CT Department of Insurance.
  • Under current law, policies may limit hearing aid coverage to $1,000 within a 24-month period. The bill instead allows policies to limit coverage to one hearing aid per ear within a 24-month period, eliminating the $1,000 limit.

 

CMEs
HB 6522
AN ACT CONCERNING CONTINUING MEDICAL EDUCATION IN SCREENING FOR INFLAMMATORY BREAST CANCER AND GASTROINTESTINAL CANCERS.
Calendar Number: 337
File Number: 555
Current Status: Awaiting Signing by Governor
6/4: Senate passed on consent in concurrence
4/25: Tabled for Senate Calendar
4/24: House Passed 149-0
4/9: Tabled for House Calendar
3/22: Voted out of Public Health 21-0
3/12: Referred to Public Health
Notes:

  • The bill would permit continuing medical education credits for risk management to include screening for inflammatory breast cancer and gastrointestinal cancers, including colon, gastric, pancreatic and neuroendocrine cancers and other rare gastrointestinal tumors.
  • Note this is permissive and not mandatory; it does not require certain CMEs be taken.

 

Physical Therapy Board Bill
HB 7195 / SB 920 Section 522
AN ACT CONCERNING MEMBERSHIP OF THE CONNECTICUT STATE BOARD OF EXAMINERS FOR PHYSICAL THERAPISTS / AN ACT CONCERNING THE DPH RECOMMENDATIONS FOR VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES
Note that while SB 7195 ultimately did not move, this bill was rolled into an amendment on SB 920, which ultimately did pass.
Notes:

  • The legislation would remove the physician appointment from the five-member board of examiners for physical therapists.
  • By way of background, the physician appointment had apparently been vacant for a number of years so the physical therapists had asked that it be removed and replaced with another physical therapist.
  • Working with CSMS, we have submitted a name to the Governor’s office to fill the appointment and rectify the situation, hopefully removing the need for this bill.
  • We had reached out to the Public health committee and informed them we believe the legislation is no longer necessary
  • This bill was rolled into the Department of Public Health “aircraft carrier” bill at the last minute, at midnight the day before the end of session, over our objections. Working with the Governor’s office, we reached an agreement that one of the non-physical therapist appointments to the Board of Examiners will be a physician, and we have a commitment that next year the Governor’s office will propose legislation to place a physician appointment back on the Board, although the majority of the Board will still be made up of physical therapists.

Physician Assistant Bill
HB 6942
AN ACT CONCERNING A COLLABORATIVE RELATIONSHIP BETWEEN PHYSICIAN ASSISTANTS AND PHYSICIANS.
Calendar Number: 107
File Number: 142
Current Status: Awaiting Signing by Governor
6/5: Senate Passed on consent, in concurrence
5/30: Tabled for Senate Calendar
5/28: Passed House 144-0-7
3/26: Tabled for House Calendar
3/8: Voted out of Public Health 23-0
1/30: Referred to Public Health
Notes:

  • The bill was amended in committee to dramatical neuter the bill, only changing one section of the statutes, from “supervisory” to “collaborative.” The previous language would have made sweeping changes to statutes governing Physician Assistants, potentially giving them independent practice after a number of years.
  • The bill was voted out unanimously with the far less controversial substitute language, and was ultimately passed by both chambers. We do not expect this bill to come up next session.

 

Other Issues of note:
Surgical Center Tax
HB 1131 / HB 7424 (Budget)
Notes:

  • The Finance Revenue and Bonding Committee approved a revised tax package and REMOVED the Administration’s proposal to eliminate the $ 1 million exemption currently in place for Ambulatory Surgical Centers (ASCs).  At the same time, the committee unanimously approved this bill, SB 1131 to provide additional relief to the surgery centers. 
  • While HB 1131 ultimately did not move, the important note is that the budget that the legislature passed (HB 7424) did not contain the Governor’s provision on removing the relief for ASCs scheduled to go into effect on July 1. A more favorable tax structure that we had gotten passed in last year’s budget remains unchanged, which is a win for ASCs.

 

Bills that did not pass:
Formularies
HB 6096
AN ACT LIMITING CHANGES TO HEALTH INSURERS' LISTS OF COVERED OUTPATIENT PRESCRIPTION DRUGS.
Calendar Number: 249
File Number: 396
Current Status: On Senate Calendar
6/3: Tabled for Senate Calendar
6/1: House Passed
5/14: Tabled for House Calendar
5/13: Voted out of Appropriations Committee 34-10
5/10: Referred by House to Appropriations Committee
4/4: Tabled for House Calendar
3/19: Voted out of Insurance Committee 16-4
3/8: Referred to Insurance Committee

Notes:

  • This is the “frozen formularies” bill from last year. It prohibits health insurers from implementing mid-year changes in their drug formularies.
  • Senate President pro tem Martin Looney had a similar proposal, and his concept has been incorporated into this bill. It appears to be a priority for him.
  • LCO Amendment 10394 (J) has been filed
  • While the bill did move out of the House, it ultimately was not called in the Senate, as Senate Republicans filed several amendments on the bill, threatening to turn it into a “talker”.

High Deductibles
SB 902
AN ACT CONCERNING HIGH DEDUCTIBLE HEALTH PLANS.
Calendar Number: 194
File Number: 371
Current Status: Awaiting Senate Action
4/3: Tabled for Senate Calendar
3/14: Voted out of Insurance 11-9
2/21: Referred to Insurance Committee
Notes:

  • This is a pro-consumer bill for individuals who have high deductible health plans (HDHP).
  • The bill would require certain high deductible health plans to prorate annual deductibles to reflect (A) the portion of the calendar year during which coverage under such plans is effective, and (B) a deduction for payments made by individuals covered under HDHPs while they were covered under other HDHPs in that same year.
  • While this bill ultimately was not passed, Sen. Looney proposed legislation to create a task force to study HDHPs, which ultimately got included in the budget.

Naturopath Bill
HB 6544
AN ACT CONCERNING THE PRACTICE OF NATUROPATHY
Calendar Number: 418
File Number: 682
Current Status: Awaiting House Action
4/17: Tabled for House Calendar
3/29: Voted out of Public Health 14-11
3/7: Referred to Public Health
Notes:

  • While the original naturopath bill was never put on a public health agenda, we had learned just before the 3/29 meeting began that HB 6544 (a bill on genetic testing and life insurance) would by amended by committee to include naturopath language.
  • The committee typically makes such language available to the public before the vote, but this was not done for this bill. The language appears to be brokered between the Bridgeport delegation and leadership. Ultimately, it passed PH by a vote of 14-11. The bill allows the Department of Public Health, in consultation with the State Board of Naturopathic Examiners, to establish educational requirements for prescriptions and to establish a naturopathic formulary.
  • This is a highly politically charged bill—House Democratic leadership as well as committee leadership is well aware that this is bad public policy, but the Bridgeport delegation has made this a top priority and this bill is an effort to placate them. We are still opposing, but if the bill is going to pass, we are working to be sure it includes physician oversight on formularies.
  • Through the collective efforts of HCMA, FCMA, CSMS, and the entire physician community, we were successfully able to defeat this bill and prevent it from being called. The Bridgeport delegation had attempted to file several amendments to either place this language onto another bill, or to “water down” the bill, which we still objected to and resulted in this bill not being called.

 

Physician Recruitment
SB 96
AN ACT ESTABLISHING A WORKING GROUP TO ENHANCE PHYSICIAN RECRUITMENT IN THE STATE.
Calendar Number: 66
File Number: 99
Current Status: The bill can no longer move forward
5/13: No action taken by Judiciary Committee
5/8: Referred to Judiciary Committee
3/21: Tabled for Senate Calendar
3/1: Voted out of Public Health 24-0
2/15: Referred to Public Health

 

Public Option
HB 7267
AN ACT CONCERNING PUBLIC OPTIONS FOR HEALTH CARE IN CONNECTICUT.
Calendar Number: 231
File Number: 353
Current Status: On Senate Calendar
6/4: House Passed
5/3: Tabled for House Calendar
5/2: Voted out of Appropriations 29-19
4/24: Referred to Appropriations
4/3: Tabled for House Calendar
3/19: Voted out of Insurance 11-8
2/28: Referred to Insurance
Notes:

  • Democratic legislative leaders, Governor Lamont, and the State Comptroller unveiled a new version of this bill at a press conference on 5/23. The new legislation would require health insurance companies bidding for a pool managed by the Comptroller’s office to lower premiums by 20%.
  • The legislation would also reinstitute the individual mandate on individuals who choose not to purchase insurance at $695 per adult or 2.5% of annual income, whichever is greater
  • The new legislation would also place a small tax on prescription opioids.
  • LCO Amendment 10326 (D) has been filed.
  • The bill had been watered down dramatically in the period of time between when it was released and when it was called in the House. Among other things, the bill would have set an onerous reporting requirement for physician institutions to the Office of Health Strategy, which would have required physician offices to disclose expenses and revenues. Ultimately, however, the bill was not called in the Senate.