Arkansas Hospital Association Legislative Bulletin 2009, No. 10 DATE: March 13, 2009 TO: FROM: SUBJECT: AHA VoterVOICE Contacts Bo Ryall, Executive Vice President 87 TH Arkansas General Assembly Senate Bill 582, which creates an assessment on Arkansas hospitals that, will be used to match federal Medicaid funds for a net return to hospitals of over $100,000,000, passed the Senate on Monday, March 9. The bill will now be considered by the House of Representatives Public Health Committee on Tuesday, March 17 and then will be considered by the entire House of Representatives on Wednesday, March 18. Please take time to contact your state representative TODAY and ask for their support on Senate Bill 582. This bill is extremely important to the survival of your hospital. Below, please find talking points that can be used when you make your contacts. TALKING POINTS ON HOSPITAL MEDICAID PROVIDER ASSESSMENT SENATE BILL 582 Arkansas hospitals lost $99,921,121 providing inpatient and outpatient care to the state s Medicaid recipients in 2006.* The Arkansas Medicaid program, on average, pays less than 70% of the costs incurred by hospitals for providing inpatient care to Medicaid recipients. For outpatient services, Medicaid paid less than 44% of costs. Arkansas hospitals are paid from the same outpatient fee schedule that was in effect in 1992 for most services and procedures. The almost $100 million loss in 2006 means that Medicaid paid hospitals that much LESS than it cost them to provide the care to Medicaid patients.
In effect, Arkansas hospitals are already paying an assessment, a hidden tax of $100 million to help subsidize Medicaid. This assessment serves the same purpose for hospitals as the Nursing Home assessment does for that group. It allows hospitals the benefit of the 3:1 federal government Medicaid match so that they can be adequately paid for the care they provide. The assessment will not be passed on to patients. There are 20 states that have enacted a hospital provider assessment. UNCOMPENSATED CARE Current economic conditions have led to an increased number of Arkansas citizens without health insurance. As a result, Arkansas hospitals are seeing their uncompensated care costs increase at an exceptionally high rate. In 2006* the state s hospitals absorbed $342 million in costs for which patients could not or would not provide payment. HEALTH OF ARKANSAS HOSPITALS Arkansas hospitals currently provide more than 49,000 jobs to Arkansans. Some communities have passed local sales taxes to financially support their hospitals enabling them to remain financially viable. Other community hospitals without a local tax are experiencing deep financial difficulty. There are 80 full service community hospitals in Arkansas and those hospitals typically represent the largest employer in the county. * 2006 is the most recent year for audited federal Medicare cost reports. Below, please find a summary of legislation of interest to all of us. Thank you for your help. If you have any questions regarding the sign-up process or VoterVOICE, please contact Amber Estrada at aestrada@arkhospitals.org. To use the VoterVOICE system for contacting public officials, go to the AHA Web site at www.arkhospitals.org and go to Legislative/Regulatory and click on VoterVOICE. TELEPHONE NUMBERS House of Representatives Switchboard - 501-682-6211 ===============================================
House Bill 1003 by Representative Brian King- Authorizes physicians and nurses currently licensed by the State Medical Board to maintain red rotating or flashing emergency lights on a vehicle for use when responding to an emergency. Do Pass in House Bill 1093 by Representative Sample- Requires government agencies, schools, other organizations and employers to issue their i.d. documents only to legal resident; prohibits illegal aliens from scholarships and in-state tuition; creates a Class D felony for harboring an illegal alien. House Judiciary Committee House Bill 1108 by Representative L. Smith- Prohibits physicians from referring patients to medical imaging facilities in which the physician or the physician's immediate family has a financial interest; provides exemptions for ancillary services and tests. House Bill 1134 by Representative Hall- To eliminate the mandated collaborative practice agreement between advanced practice nurses and physicians for prescriptive authority and to designate eligible advanced practice nurses as licensed independent practitioners. House Bill 1216 by Representative Shelby- Requires the State Medical Board and the State Board of Nursing to develop a joining application for collaborative agreements between physicians and advanced practice nurses. House Bill 1253 by Representative Shelby- Requires booster immunizations for children entering the seventh grade for diphtheria, tetanus toxoids, and acellular pertussis. House Education Committee House Bill 1254 by Representative J. Woods- Provides an income tax credit to taxpayers donating postnatal tissue and fluid to the Newborn Umbilical Cord Blood Bank. Do Pass from House Revenue and Tax Committee House Bill 1281 by Representative Carter- To require persons receiving benefits through the Department of Human Services to undergo drug testing on a random selection basis. (incomplete bill) House Bill 1288 by Joint Budget Committee- Appropriates funds to the Department of Health for 2009-10 operations. Joint Budget Committee House Bill 1407 by Representative Greenberg- Allows insurers to offer health care coverage insurance without regard for state-mandated benefits. House Insurance and Commerce Committee House Bill 1419 by Representative Wells- Prohibits nursing home employees from tampering with, disabling, or destroying a smoke alarm and providing that only a
firefighter may silence the alarm; creating fines for noncompliance. House Public Health Committee House Bill 1481 by Representative Shelby- Increases the maximum age of operators and passengers of motorcycles that must wear protective headgear from 21 to 25 years of age. House Public Transportation Committee House Bill 1492 by Representative Overbey- Allowing the sale of a county hospital to occur without an election if it has been vacant for more than 120 days. Passed House and Senate House Bill 1546 by Representative Shelby- Decreases from 180 to 90 days the time period within which health care insurers must make a decision on applications from physicians licensed under the Medical Practices Act for participation or renewal in the insurers plan. ACT 350 House Bill 1568 by Representative Hobbs- Revises various provisions of the Adult and Long-Term Care Facility Resident Maltreatment Act; expands definition of exploitation; changes procedures for Human Services Dept. investigations; expands definition of various offenses. Passed House of Representatives House Bill 1569 by Representative Hobbs- Revises provisions of the Adult Maltreatment Custody Act; expands definition of exploitation; provides for court to seal health records, to appoint a public defender, and for written, audio or video statement rather than court appearance. Passed House of Representatives House Bill 1575 by Representative L. Smith- Requires a physician ordering an anatomic pathology service from another physician or laboratory where he or she does not supervise or perform a component of the service to disclose certain cost information to the patient and the insurer. House Bill 1601 by Representative Maxwell- Requires pharmacy benefit managers to itemize reimbursement amounts sought for pharmacist services and pay the amounts it receives to the pharmacies or pharmacists that provided the services. House Insurance and Commerce Committee House Bill 1703 by Representative Shelby- Applies the Patient Protection Act of 1995 to a health care provider network utilized by a self-funded health benefit plan provided by the state to state employees and public school personnel. House Public Health Committee House Bill 1891 by Representative Nickels- Establishes an expanded and unified health care benefit program for all publicly funded employees, including employees and retirees of the state, school, county, municipality, towns and institutions of higher education. Effective Jan. 1, 2010.
House Bill 1916 by Representative Hawkins- Providing that a closed block of business is a form or contract that is not a group health insurance policy; requiring closed block to be within the same classification previously closed; allowing Commissioner-approved rate increases. Passed House of Representatives House Bill 1922 by Representative Shelby- To amend terms and provisions of the Patient Protection Act of 1995. (Incomplete bill) House Bill 1927 by Representative Shelby- Authorizes the Arkansas State Medical Board to discipline physicians for ethical violations. House Bill 1950 by Representative Shelby- Authorizes a community matching income incentive program through the Rural Medical Practice Student Loan and Scholarship Program, adding geriatrics to the list of approved medical fields for the program. House Public Health Committee House Bill 1967 by Representative Wagner- Requires the House and Senate Interim Committees on Public Health, Welfare, and Labor to conduct an interim study of ways to encourage physicians to practice medicine in rural areas. Passed House and assigned to Senate Public Health Committee House Bill 1969 by Representative Clemmer- Amends ACA 20-77-307 relating to the assignment and recovery of third-party liability for Medicaid costs by the Department of Human Services. (Incomplete bill) House Bill 1985 by Representative Clemmer- Authorizes the Department of Human Services to collect a 10% penalty, costs, and attorney fees from persons disposing of settlement or award money before reimbursing the Department for Medicaid costs. House Bill 1998 by Representative Cowling- Authorizes licensure of a hospice agency for operation in a border city without obtaining a permit of approval from the Health Services Permit Commission. House Bill 2103 by Representative L. Smith- Proposes creation of the Arkansas False Claims Act to encourage recovery of fraudulently collected state funds. (Incomplete Bill) House Bill 2136 by Representative Hall- Includes criminal background information as a requirement for physician credentialing, and providing release of criminal history background check reports on applicants and those licensed by State Medical Board. House Bill 2168 by Representative J.R. Rogers- Extends from 180 days to 1,880 days the period in which action must be taken on a lien under the Medical, Nursing, Hospital and Ambulance Service Lien Act.
House Bill 2188 by Representative Blount- Requires hospitals to post on their website information on their pricing, collection and charity policies, the value of their public subside and their exemption from taxes and fees, annual reports, financial requirement for treatment, more. House Bill 2189 by Representative Blount- Prescribes procedures for hospitals to administer financial assistance and charity care programs, including notice of policies and programs on its website. Requires the Health Department enforce this chapter and issue annual report to the public. Senate Bill 10 by Senator Altes- Provides that any tax, fee, or other item levied and collected for deposit into a special fund or designated as special revenue shall be considered as general revenues. Senate Revenue and Tax Committee Senate Bill 23 by Senator Altes- Creates the Prescription Drug Monitoring Program Act, requiring the Department of Health to establish an electronic program for monitoring the prescribing and dispensing of all Schedule II and Schedule III narcotics. Senate Public Health Committee Senate Bill 29 by Senator Hendren- Requires motorcycle operators and passengers to wear helmets unless they are covered by a health insurance plan that would pay expenses incurred as a result of an accident; provides for the issue of decals to drivers that prove coverage. Senate Transportation Committee Senate Bill 78 by Senator Wilkins and Representative Allen- To improve the safety of motorists on highways and roads in the state of Arkansas by making the mandatory seat belt law a primary law for enforcement purposes. ACT 308 Senate Bill 79 by Senator Johnson- Provides for regulation by the State Medical Board of radiologist assistants, radiology practitioner assistants, and nuclear medicine advanced associates. Received Do Pass Senate State Agencies Committee Senate Bill 143 by Senator Broadway- Provides for licensure of emergency medical services personnel, rather than certification; changes various references to emergency medical technicians in the Arkansas Code to "emergency medical services personnel." Passed Senate and assigned to Senate Bill 216 by Senator Altes and Representative Glidewell- Makes persons receiving certain public assistance subject to drug testing on a random selection basis, with individuals failing a drug test to complete a one-year drug treatment program or lose the assistance benefits. Senate Public Health Committee Senate Bill 239 by Senator Bledsoe- Authorizes physicians to delegate to qualified employees under the physician's supervision the performance of tasks that do not require substantial specialized knowledge as determined by the State Medical Board. Passed Senate and House of Representatives
Senate Bill 309 by Senator J. Jeffress and Representative Shelby- Prohibits persons with a learner's license or an intermediate driver's license from using a cellular phone or other interactive wireless communication devices while operating a vehicle, and other restrictions. ACT 394 Senate Bill 315 by Senator Steele- Authorizes the Department of Health to grant funds to emergency medical care providers, ambulance providers, trauma rehabilitation service, and to hospitals to assist qualification as trauma centers; to create a communication network; more. ACT 393 Senate Bill 354 by Senator Laverty and Representative Saunders- Levies a provider fee on intermediate care facilities for individuals with developmental disabilities of 5.5 percent of the aggregate annual gross receipts of each facility divided by twelve. Passed Senate and House of Representatives Senate Bill 356 by Senator Broadway- Adjusts the provision requiring ambulance operators to consider service area restrictions in relation to the patient's choice of care facility. Passed Senate and assigned to Senate Bill 460 by Senator P. Malone- Requires pharmacy benefit managers to itemize individual claims on billing, including the pharmacy name, the amount paid to the pharmacy, and the prescription number; makes violations a deceptive trade practice. Senate Insurance and Commerce Committee Senate Bill 582 by Senator Teague- Levies a fee on privately operated hospitals at an annually calculated rate not to exceed 1 percent of net patient revenue; proceeds to be used for Medicaid hospital access payments; rehab and specialty hospitals exempted. Passed Senate and assigned to Senate Bill 787 by Senator Madison and Representative Roebuck- Requires hospitals and birthing centers provide information to maternity patients describing the various types of delivery and risks associated with each. Prescribes information to be disclosed, including statistics from the Health Department. Senate Public Health Committee Senate Bill 798 by Senator Elliott- Requires health care facilities that provide emergency care to rape survivors to provide the person with information about emergency contraception and provide emergency contraception upon request of the victim. Senate Public Health Committee Senate Bill 806 by Senator T. Smith- Insurance Department general omnibus bill making various updates and technical corrections, including payment of workers' comp benefits by ETF, permitting biennial collection of license fees, continuing education requirements, more. Senate Insurance and Commerce Committee Senate Bill 819 by Senator Laverty- Consolidates the requirements for background checks by Department of Human Services and Department of Health related to licensed
providers of child care and services to the elderly and persons with disabilities. Senate Public Health Committee Senate Bill 844 by Senator Baker- Revises various provisions of the Physical Therapy Act, authorizing the Board of Physical Therapy to establish assessment of the continuing competence of therapists and to report disciplinary actions; clarifies exemptions from licensure. Senate Public Health Committee Senate Bill 933 by Senator Baker- To clarify the Medicaid Fairness Act and other laws regarding provider participation and administrative appeals (Incomplete bill). Senate Public Health Committee Senate Bill 1000 by Senator Horn- Increases to $1,000,000 the expenditure for renovations of a health care facility exempt from permit of approval, if bed capacity not increased. Prohibits new outpatient rehab facilities or long-term care hospitals before Mar. 9, 2013. Senate Public Health Committee