GOVERNOR PROVIDES INPUT ON “REPEAL AND REPLACE” LEGISLATION: In a 15-page letter to House Majority Leader Kevin McCarthy, Govenor Ducey last week urged congress not to repeal Obamacare until a well-developed replacement plan was enacted.
Last December McCarthy had requested from governors on how to “repeal and replace” the ACA.
Ducey’s recommendations includeded:
- Eliminate many of the basic insurance requirements and allow states to again set their own insurance rules
- Keep tax subsidies for individuals for now to keep the marketplace from melting down, stating he doesn’t want to see “any Arizonans have the rug pulled out from under them.”
- Offer states flexibility in managing their Medicaid plans, including limiting coverage in lean times and requiring healthy individuals to work or seek jobs to retain coverage
- Repeal taxes that pay for health insurance subsidies and other costs of Obamacare. He says the fees are just passed onto patients and states
- Allow insurers to lower plan costs for people who quit smoking, lose weight or meet other incentive goals
- States should take over regulation of small business and employer plans, with tax deductions for employers that provide health insurance be retained and extended to the self-employed
- Wants federal rules that keep older people from having to pay much, much more than younger people eliminated to lure younger people to buy insurance
LEGISLATIVE UPDATE, APRIL 2017: Governor Ducey signed an executive order calling on 27 state boards and commissions, including the AMB and AOB, to submit reports listing what professional licensing requirements are on the books. The order requires boards to justify the existence of those requirements deemed “excessive.” All are also required to detail the types of fines and fees assessed by the boards, the 10 most frequent violations for the profession the board regulates and how long it takes on average to get a license. Reports are due by June 30.
HB 2194 – Would prevent minor children (under 18) from using indoor tanning facilities and prohibit facilities from advertising or distributing promotional materials that claim that using a tanning device is free from risk or will result in medical or health benefits. PASSED THE HOUSE, AWAITS SENATE VOTE.
HB 2195 – Streamlines the AMB’s physician license application processes, including changes on primary source verification, testing, substance abuse programs, and compensation to board members. AWAITS GOVERNOR’S SIGNATURE.
HB 2030 – Will add urology services required to be covered in the telemedicine insurance parity statutes. PASSED HOUSE, AWAITS SENATE VOTE.
HB 2075 – Moves Radiation Regulatory Agency authority, powers, duties and responsibilities to the Dept. of Health Svs. PASSED HOUSE, AWAITS SENATE VOTE.
HB 2090 – requires hospitals to offer patients 65 and older a flu vaccine prior to discharge; there is already a CMS requirement on this. PASSED HOUSE, AWAITS SENATE VOTE.
HB 2134 – A bill empowering parents to send their kids to school or camp with sunscreen and allows them to apply it. Dermatologists are spearheading the passage of this measure. AWAITS GOVERNOR’S SIGNATURE.
HB 2195 – The Arizona Medical Board wants to streamline changes to their license application processes. The bill includes changes on primary source verification, testing, substance abuse programs, and board member compensation. SIGNED BY GOVERNOR.
HB 2205 – Repeals the Advisor6 Health Council, Prostate Cancer Task For and Biomedical Research Commission. SIGNED BY GOVERNOR.
HB 2208 - Inhalers; administration; schools; authorized entities. SIGNED BY GOVERNOR.
HB 2307 – Controlled substances prescription monitoring program. SIGNED BY GOVERNOR.
HB 2382 –. It allows a pharmaceutical manufacturer or its representative to engage in truthful promotion of an “off-label use of a drug, biological product or device. The amendment adds a provision that prohibits the state from enforcing federal statues prohibiting drug misbranding or otherwise prosecuting a pharmaceutical manufacture or its representative for doing so. AWAITS GOVERNOR’S SIGNATURE.
SB 1023 – Will add schedule V controlled substances to the state’s prescription drug monitoring program. SENATE APPROVED, AWAITS HOUSE VOTE.
SB 1028 – A bill to continue the Arizona Board of Osteopathic Examiners in Medicine and Surgery. AWAITS GOVERNOR’S SIGNATURE.
SB 1047 – Extends the statutory life of the Board of Medical Student Loans four year to July 1, 2021. SIGNED BY THE GOVENOR.
SB 1080 – A bill that would ban texting by new teen drivers for the first six months of licensure. APPROVED BY SENATE, AWAITS HOUSE VOTE.
SB 1133 -- clarifies the collaboration requirement in current law for nurse practitioners and to separately regulate certified nurse midwifes. SIGNED BY GOVERNOR.
SB 1235 - The bill allows podiatrists with proper training to perform toe and partial foot amputations. SIGNED BY GOVERNOR.
SB 1236 – Requires Dept. of Child Safety and AHCCCS to prepare reports twice a year that compares the prescription rate of “psychotropic medications” prescribed to foster children who get services from AHCCCS with those prescribed to non-foster kids who receive services. AWAITS GOVERNOR’S SIGNATURE.
SB 1269 – Will allow pharmacists to dispense oral fluoride rinse, prescribe nicotine replacement drugs in conjunction with tobacco cessation programs, and do short term emergency refills on medications for chronic conditions when the prescriber cannot be reached. SIGNED BY GOVERNOR.
SB 1336 – The unresolved issues concerning the definition of “direction” for physicians and surgeons and anesthesiologists, and on the limitations on CRNAs for providing chronic pain services remain have been resolved by stakeholders. The bill can now proceed through the normal legislative process in the House. SENATE APPROVED, AWAITS HOUSE VOTE. It is expected to win approval.
SB 1367 – If a human fetus or embryo is “delivered alive,” the physician performing the abortion is required to document and report to DHS the measures the physician performed to maintain the life of the fetus or embryo. ONLY NEEDS GOVENOR’S SIGNATURE.
SB 1437 – Known as the “right to earn a living” measure, limits all occupational regulations to those demonstrated to be necessary to specifically fulfill a public health, safety or welfare concern. SIGNED BY THE GOVERNOR.
SB 1439 – Forbids discriminating against a health care entity on the basis that the entity does not provide, assist in providing or facilitate in providing any health care item or service for the purpose of causing or assisting in causing the death of any individual. SIGNED BY GOVERNOR.
SB 1440 – Calls on the AHCCCS Director to establish an internal clinical oversight review committee to analyze data specific to agency initiatives and populations. PASSED SENATE, AWAITS HOUSE VOTE.
SB 1441 – Sets up a dispute resolution process for patients facing “surprise,” out-of-network bills more than $1,000. SENATE HAS APPROVED, AWAITING HOUSE VOTE.
SB 1452 - Makes changes to the health licensing board laws, particularly related to what portions of a health professional licensee's disciplinary records must be posted on the licensing board's website. APPROVED BY THE SENATE, AWAITING HOUSE VOTE.
PIMA DERMATOLOGY OPENS NEW SATELLITE CLINIC: Pima Dermatology is accepting patients at their new TMC Rincon Health Campus, 10350 East Drexel Road, Suite 120 from 8 a.m.-5 p.m. each Thursday. Matthew Beal, MD and physician assistant Jennifer Allison, will be alternating assignments at the new facility.
Services include skin checks for suspicious lesions, moles and possible skin cancer. Treatment and assessment of many skin conditions such as acne, psoriasis, eczema, rashes, rosacea, warts and other dermatology services are available. Call 795-7729 to schedule an appointment.
Dr. Beal joined Pima Dermatology and PCMS in 2013. Allison is licensed by the Board of Medical Examiners and has practiced at Pima Dermatology for 15 years.
TMC’S MEGA RAFFLE RETURNS: Tucson Medical Center’s TMC Mega Raffle is back for its fifth year. The 2017 event will award more than 5,600 prizes, with net proceeds benefiting patient care programs and services. Tickets are available to the public beginning Thursday, Feb. 9.
This year there are two grand prize packages. The first is an elegant A.F. Sterling custom home located in the 253-acre Stone House community, adjacent to the Santa Rita Mountains or the winner can choose the cash option of $600,000. Grand prize #2 is a 2017 Lincoln Continental plus cash or $150,000 cash.
Each raffle ticket has a one in 20 chance of winning a prize. Participants that enter before midnight, March 9, will be eligible to win the two Early Bird prize packages both valued at more than $60,000. Early Bird prize #1 is a 2017 Toyota 4Runner 4x4 SR5, a six-night luxury vacation package for two to explore the Greek Islands and $16,000 in cash. Early Bird prize #2 is the 2017 Toyota Avalon XLE, a five-night retreat at the luxurious Moorea Manava Beach Resort and Spa, plus $15,500 in cash.
In addition to the Grand Prize and Early Bird packages, the 50/50 raffle is back, which totaled $595,880 last year. Participants will also be eligible to win a host of new cars, luxury vacation packages, cash prizes along with a popular selection of electronics, jewelry, and home accessories.
The final cut-off for purchasing tickets is Thursday, March 30. Grand prize winners will be announced by early April.
Tickets are $100 each with a limited number of three-ticket packages available for $250. To purchase tickets, visit www.TMCmegaraffle.org or call (800) 395-8805.
LEGISLATIVE REVIEW OF 2017 SUNRISE APPLICATIONS BEGINS: Arizona law (A.R.S. § 32-3104, 32-3105) requires health professions seeking regulation or an increase in scope of practice to submit a written report (sunrise application) on or before September 1 to the President of the Senate and the Speaker of the House of Representatives.
The report is reviewed by a Health Committee of Reference which will make a recommendation whether the health profession should be regulated or whether a request for an expanded scope practice be approved. There are several factors that must be addressed in sunrise applications including how the proposal will protect and benefit the public as a result of the new regulations or expanded scope of practice.
There are nine sunrise applications submitted for the upcoming legislative session:
Proposed Regulation of Health Profession
Applicant - Arizona Community Health Workers Association
Establish voluntary certification and standardization of practice for community health workers
Applicant - Art Therapy Association
Establish licensure of the practice of art therapy
Applicant - Dental Care AZ
Establish licensure and regulation of dental therapists
Applicant - Lauren Moore - Phlebotomist
Establish phlebotomy as a specialty to allow independent billing
Proposed Scope of Practice Expansion
Applicant - Arizona Pharmacy Association
- Allow pharmacists to administer oral fluoride varnish to eligible patients according to national guidelines.
- Allow pharmacists to administer the Tuberculin Skin test (TST) and interpret the results for the purposes of referral for treatment following a positive test according to national guidelines.
- Allow pharmacists the ability to prescribe over the counter nicotine replacement products as well as FDA approved prescription products indicated to aid in smoking cessation treatment for eligible patients according to national guidelines.
- Allow pharmacists the ability to prescribe FDA approved prescription medications to eligible patients testing positive for influenza or strep throat consistent with current clinical guidelines.
- Allow pharmacists the ability to extend a routine, non-controlled, chronic medication for an additional 30-60 days.
Applicant - Arizona Naturopathic Medical Association
Allow intravenous administration of antibiotics
Applicant - Arizona Naturopathic Medical Association
Allow ability to sign medical exemptions for students from Arizona K-12 school immunization requirements
Applicant - Certified Registered Nurse Anesthetists
- Remove the “direction and presence” requirement to provide analgesic services
- Clarify the ability to “prescribe” a medication instead of “order” a medication; applicant states this will restore the ability to prescribe analgesics and is not a scope of practice expansion
Applicant - The Core Institute
Allow doctors of podiatric medicine to perform amputation of toes, would still exclude foot and leg.
LEGISLATIVE HEALTH COMMITTEE APPOINTMENTS ANNOUNCED: The following House and Senate members will serve on their respective health committees during the 2017 session.
House Health Committee
Chair – Heather Carter, R-LD15
Vice Chair – Regina Cobb, R-LD5
Jay Lawrence, R-LD23
Tony Rivero, R-LD21
Maria Syms, R-LD28
Michelle Udall, R-LD25
Kelli Butler, D-LD28
Oteniel Navarrete, D-LD30
Pamela Powers Hannley, D-LD9
Senate Health and Human Services Committee
Chair – Nancy Barto, R-LD15
Vice Chair – Kate Brophy McGee, R-LD28
Debbie Lesko – R-LD21
Steve Montengro, R-LD13
Kimberly Yee, R-LD20
David Bradley, D-LD 10
Katie Hobbs, D-LD 24
PRE-MED STUDENT MENTORING: The UA Pre-Health Advising office offers an internship called Med Mentor for undergraduates in Tucson. Through this internship, students have the opportunity to experience hospital, specialty, and group practice settings, develop mentoring relationships with health care professionals and explore career options. The success rate of admission into medical schools for the students who participate in this internship is more than 90%. The students are carefully screened for maturity, professionalism, capability and because they have demonstrated a commitment to becoming excellent physicians. They have been selected from a large pool of applications as this is one of the most sought-after internships on campus. These students understand the value of your time and experience and are thrilled to observe and learn from you. If you are a participating physician, you would host 2 students, one at a time, during the months of Feb-April, 2017. The first student would be with you for 6 weeks beginning Feb. 1 and the second would begin with you in mid-March through the end of April. If you are interested in joining or learning more about the program, please contact Vanessa Perez at VanessaPerez@email.arizona.edu.
WALK-WITH-A-DOC: The Society is teaming with the Arizona Chapter of the American College of Physicians (ACP) to host and provide physician leaders for the monthly Walk-With-A-Doc outings. Walkers sign in at the ramada east of Swan Bridge on the south bank.PCMS physicians are encouraged to urge patients to participate in the program. Each walk begins with a brief discussion on a health topic and includes a one- or two-mile walk on level ground. Please contact Dennis Carey at 795-7985 or email@example.com for more information or if you have questions.