Minnesota State Bar Association Health Law Section

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Minnesota State Bar AssociationHealth Law Section

• 2007 Legislative Wrap Up

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The plan for today

• Tom Lehman,The Lehman Group
• Phil Griffin, Griffin Government Consulting
• Jon Lips, Care Providers of Minnesota

• Background
• Drugs
• Hospitals
• Mental Health
• Health Care Reform
• Health Plans
• Continuing Care
• Occupational Licensing
• Prospects for 2008

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New landscape going into session

• 53 new legislators
• 35 new House members 29 of these are DFL
• 18 new Senate members 15 of these are DFL
• 12 House Republican incumbents lost
• Senate statistics 44 DFL 23 Rs
• House statistics 85 DFL 49 Rs

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New legislative leadership

• House Speaker Margaret Anderson-Kelliher
  (Minneapolis)
• House Majority Leader Tony Sertich (Chisolm)
• House Minority Leader Marty Seifert (Marshall)
• Senate Majority Leader Larry Pogemiller
  (Minneapolis)
• Senate Minority Leader David Senjem (Rochester)

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Mostly New Health Care Chairs

• Senator John Marty at Health, Housing and Family
  Security Committee
• Rep. Tom Huntley at Health and Human Services
  Finance Committee
• Rep. Paul Thissen at Health and Human Services
  Policy Committee
• Rep. Neva Walker at Mental Health Division
• Rep. Cy Thao at Licensing Division
• Only Senator Linda Berglin returns to chair HHS
  Budget Division

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But not everything was different

• Constitution 2/3 of the members of each body
  are needed to vote to override a gubernatorial
  veto.
• This means 89 House members (85 DFL) and 45 (44
  DFL) Senate members needed to override a veto

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Great Expectations by DFL

• Property Tax Relief
• Cover all Kids and health care reform
• Enhanced K-12 funding
• Higher ed tuition relief
• New investments in transportation
• All Day kindergarten
• Bonding bill

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What Happened? Not as much as most hoped or
expected

• Hospital Issues
• Radiation
• Imaging
• Moratorium
• Administrative Simplification
• Domestic Partners
• Newborn Hearing Screening
• Doulas
• Circumcision not an MA-covered Benefit
• Funding

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Mental Health

• Progress made in 2006
• Aggressive agenda for 2007
• MHAG/Legislators
• Nearly 40 million in new spending
• Enhanced payments to providers
• Expanded eligibility and benefits. GAMC and
  MinnesotaCare benefits now mirror MA

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Drugs (Legal or otherwise)

• Pharmaceutical Issues
• Clinical trials
• Medical Marijuana
• Passed Senate, passed all House Committees
• Governor just said no

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Other Issues

• Family Planning up 25
• Critical Access dentist payments up 30
• GAMC drugs must be on MA formulary and have
  rebate agreements
• MinnesotaCare application shortened to 4 pages
  and renewals are now annually
• Free MinnesotaCare for veterans
• MinnesotaCare for adults w/o kids goes from 175
  of FPL to 200, increasing to 215 in 2009

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Other Issues (continued)

• No prescriptions based solely on online forms
• Electronic reporting system for controlled
  substances
• MDH Commissioner to study HPV vaccine
• Electronic health record system revolving loan
  program created
• DHS Commissioner to study whether to expand MA
  chiropractic services

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Continuing Care Issues

• Rate Increases
• 2 then rebasing for nursing facilities.
• 2 and 2 for other providers.
• One-time sprinkler funds and limited moratorium
  funding for nursing facilities.
• LOTS of worthy ideas were not funded
• Coverage for kids not expanded as far as some
  hoped
• Coverage of Part D co-payments
• MA Asset Limits MA-EPD for those over 65
• MR/RC Slot Increase

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Continuing Care Issues (contd)

• Assisted Living
• Elderly Waiver program changes enacted.
• Transitional Consultation must be offered in
  2008 and beyond.
• Study of role State can play in aiding choice.

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Continuing Care Issues (contd)

• Disability Services
• Self-Directed Supports Option
• Quality Assurance Improvement
• Personal Care Assistant Changes
• Centers for Independent Living

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Continuing Care Issues (contd)

• Long Term Care Access to Pharmaceuticals
• Safe Patient Handling (Omnibus Jobs and Econ
  Development bill Session Laws Chapter 135)
• Patient Bill of Rights changes

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Occupational Licensing

• New supervision requirements for social workers,
  effective 2011.
• New licensure requirement for physical therapy
  assistants.
• The licensing bill also affects X-ray operators,
  credentialing of foreign physicians,
  chiropractors, audiologists and speech-language
  pathologists, and licensed professional clinical
  counselors.
• See Session Laws Chapter 123.

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Safety Net Issues

• FQHC Grants (FY08 1.5M /FY09 1.5M)
• Funding for a Toll-Free Health Care Access Number
  (FY08 150,000 / FY09 150,000)
• Critical Access Dental funding (FY08 4.2M / FY09
  5.0M)
• Medical assistance coverage for Community Health
  Workers

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Safety Net Issues

• Funding for the Bright Smiles Program -- one of
  three Oral Health Innovation grants (FY08
  400,000)
• e-health grants (FY08 7.0M / FY09 7.0 M)
• Grant funding for the Center for Urban Health
  Note line item(FY08 300,000)

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Health Plan Issues

• Premium Caps not adopted
• Colorectal screening mandate
• Hearing aid mandate
• HSA preventive care mandate not adopted
• Amino acid formula not adopted
• SSN action delayed to 2008
• Administrative Simplification adopted

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The Biggest Health Issue

• Freedom
• To
• Breath!

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Prospects for 2008

• Health care access will be a major issue
• Constitutional amendment
• Many other bills on this topic are still alive.
• Numerous legislators campaigned on this issue in
  2006.
• June 12th, HCAC mtg.

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Interim Studies may shape agenda

• Legislative Commission on Health Care Access
  universal coverage
• Health plan purchasing pool study group
• Health Care Transformation Task Force
• The insurance exchange is a 500,000 study
  (Should be a good one Huntley added)
• PCA study

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Prospects for 2008

• Some 2007 proposals likely to rise again
• Statewide Teachers Health Pool? (Vetoed)
• Medical marijuana
• Bad Faith
• False Claims
• More mandates
• Clinical Trial regulation
• LTC COLA
• Expanded Access

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Prospects for 2008

• 2008 is an election year for national and state
  offices, incl the MN House.
• Much will depend on the State budget forecast.

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Questions?