December 16, 2016

State Legislatures PreFile Bills for 2017 Sessions

More than half of the nation’s state legislatures have already begun to prepare for 2017 when all 50 state legislative bodies, including those in Texas where lawmakers meet biannually, will convene.

Early preparations are underway in 31 states that allow bill pre-filing, a practice that reduces legislative preparation time. Once agenda schedules are finalized, deliberations can begin at the very start of the legislative session.

Some states don’t allow bill pre-filing, and legislators in other states choose not to use the opportunity to pre-file legislation.

Below are examples of radiology-related bills already pre-filed for 2017:

Medicaid Rates – Nevada SB 28 would require an annual review of the adequacy of rates paid by Medicaid in Nevada. The report would propose reimbursement rates to be paid by Medicaid in Nevada at "appropriate, consistent and competitive levels which accurately reflect the required costs of providing health and human services."

Referrals under Stark Law – New Jersey S 2724 would permit a medical practitioner to refer patients to a health care service in which the practitioner has beneficial interest when the referral is related to the alternative payment model (APM) registered with and approved by the State Department of Health. With limited exceptions, current law prohibits a practitioner from referring a patient to a health care service in which the practitioner or an immediate family member has a significant beneficial interest. This bill would create an additional exception for referrals made within the context of an APM.

Price Transparency – Texas HB 307 would require a health care facility or practitioner to disclose prices and fees related to health care services before a patient receives the services. The estimated prices and fees, including deductibles, copays and coinsurance costs, should be based on the patient's health plan’s cost-sharing policy.
With national health care reform in flux, the American College of Radiology expects more new state legislation to consider scope of practice and state health exchange issues.

Scope of Practice - As in prior years, groups of ancillary health care professionals may seek modifications within statutes or regulations to expand their scope of practice. We anticipate scope-related legislation for nonphysicians who want to perform, supervise and interpret diagnostic imaging without first accumulating necessary training and supervised experience in medical school and their residency and specialty fellowship programs. It is important that patient safety and quality of care be the top concerns when legislators are faced with proposals to expand scope of practice, especially as it relates to equipment that exposes patients to ionizing radiation.

State Health Exchanges - Some insurers have reduced the number of providers within their networks, since the implementation of state health marketplaces under the Affordable Care Act. The College supports efforts by state chapters to address inadequate networks for insurance products sold on the state marketplaces and to educate insurance regulators about the need to mandate an adequate number of in-network hospital-based specialists at their in-network facilities.

ACR members who coordinate state-level advocacy activities can streamline their efforts by knowing where to gain quick access to resources for state legislative and regulatory issues of interest. To learn about advocacy and to utilize the resources on state-related issues, please explore the following:

• ACR Chapter Leaders Portal (member login required) https://chapterportal.acr.org/
  Go to: ACR resources > Government Relations > State GR. This resource library contains documents and forms collected by staff to assist chapter officers and executives.

• Grassroots and Radiology Advocacy Network (RAN) - We now can send targeted Call-to-Action alerts at state level by working with our CQ Engage vendor. Please contact ACR staff to learn more about this feature! http://cqrcengage.com/acradiology/home

Websites for State Legislatures

• State Legislation Tracking – Contact ebrandt@acr.org to receive weekly alerts from StateScape for bills currently being tracked in your state.

ACR state affairs staff is an essential resource for monitoring state legislative activities relevant to radiology, interventional radiology, radiation oncology and medical physic. Look to ACR Advocacy in Action eNews for ongoing coverage of state-level legislative relating to scope of practice, surprise/balance billing, price transparency, teleradiology licensing, medical liability reform and other issues.