I Know What You Did Last Session Blayne Miley, JD ◦ ISNA Director of Policy & Advocacy ◦ Adjunct Professor, Indiana State University ◦

2016 Indiana General Assembly Convened Jan 5 – Mar Bills Introduced ◦ 217 Passed by General Assembly to the Governor ◦ 215 Signed Into Law ◦ 2 Vetoed – College Cop Records & Limit on Environmental Regulations 2017 Session Will Be a Budget Year Interim Study Committees Will Meet This Summer

Medical Malpractice Act Reform Cap on Damages Increased ◦ Currently $1.25 million total  $250,000 from provider, rest from patient compensation fund ◦ Reform to $1.65 million effective 7/1/17, then $1.8 million 7/1/19  $400,000 from provider effective 7/1/17, then $500,000 on 7/1/19 ◦ Provider amount = amount of professional liability insurance Medical Review Panel Stays the Same ◦ Current exception if damages sought < $15,000 ◦ Reform proposal to $35,000 removed by amendment Resurrected by stripping the content of SB 28 (privacy fences) and inserting pieces of SB 152

Palliative Care Council Establishes the Palliative Care and Quality of Life Advisory Counsel – SB 272 ◦ Members appointed by the state health commissioner ◦ Must include a member representing nursing ◦ At least two members must be a physician or nurse specialized in hospice and palliative care Purpose is to: ◦ Educate the public, healthcare providers, and healthcare facilities ◦ Develop initiatives ◦ Make policy recommendations

Other Advisory Councils Medicaid Advisory Committee ◦ ◦ Stakeholder input to FSSA Attorney General’s Prescription Drug Abuse Prevention Task Force ◦ Governor’s Task Force on Drug Enforcement, Treatment, and Prevention ◦ Governor’s Health Workforce Council ◦ ◦ Taskforces on (1) Education/Pipeline/Training and ◦ (2) Mental/Behavioral Health

Ephedrine/Pseudo Restrict sale to reduce production of meth Passed: stop sale for anyone with a drug-related felony in the last 7 years - SB 161, HB 1157 Passed: must meet one of the paths to purchase - SB 80 ◦ Consumer is a patient of record with the pharmacy ◦ Pharmacist determines there is a legitimate need ◦ Purchase only 720mg of 30mg tablets ◦ Purchase an extraction resistant form of ephedrine ◦ Get a prescription Failed: make ephedrine a schedule III controlled substance - SB 237, HB 1390

Prescribing Allows telemedicine prescribing for non-controlled substances - HB 1263 ◦ Requires audio & visual or store & forward technology Felony to prescribe a controlled substance without a medical purpose - SB 174 ◦ Originally applied to administer/provide outside scope of practice Standing orders for overdose intervention drugs - SB 187 ◦ From ISDH to Pharmacies ◦ Making Narcan as close to OTC as possible Opioid Restrictions - SB 214 & SB 297 ◦ No Medicaid for buprenorphine prescribed for pain ◦ Opioid treatment providers must drug test & limit take home ◦ Methadone clinics must comply with Medicaid regulations ◦ Medicaid coverage for inpatient detox

Health Insurer Regulations Regulating step therapy protocols – SB 41 ◦ Limits insurer policies to make them more consumer-friendly ◦ Provider may apply for exception to the protocols to bypass try and fail ◦ Insurer still has final say over exceptions Claim Denial Information – SB 30 ◦ Requires Dept. of Insurance to post info on consumer grievance procedures ◦ Requires insurers to include that website in info provided to consumers whenever policy is issued/renewed and when claim denied ◦ Requires Dept. of Insurance to report to the General Assembly if there is a pattern of denials of coverage  Catalyst = investigatory/experimental denials  Initial version required insurers to report denials

APN’s and Mental Health Medicaid reimbursement and treatment plan supervision for NPs and CNSs in CMHCs – HB 1347 ◦ Practice agreement requirement added by amendment changes practice agreement content requirements for APNs in CMHCs ◦ Also requires reimbursement for clinical addiction counselors and grad-level interns Governing entity of state institutions can grant the same privileges as the governing board of a private hospital – SB 206 ◦ In preparation of new state hospital at Community East opening in 2018

Hospital Employee Immunizations Did not pass - SB 162 Mandatory for all employees/contractors with direct patient contact ◦ (1) Influenza, (2) Varicella, (3) measles, mumps, rubella, (4) tetanus, diptheria, and pertussis Exceptions: ◦ Already immunized – requires documentation from your healthcare provider & hospital can overrule them ◦ Medically contraindicated ◦ Religious belief – hospital can determine whether your religion actually prohibits immunizations Hospital has immunity for any wrongful discipline/termination House amended to interim study committee, then bill died in conference committee

Indiana State Nurses Association Sequel next year