2008 Legislature

WMS Final Legislative Report

~ March, 2008 ~

Please Note: Links are provided to the full text of bills on the Wyoming Legislature's website. You will need Adobe Acrobat Reader to view the bills. Please contact Dennis Ellis or Sheila Bush if you have any questions or need assistance.

 OVERVIEW OF WMS SUCCESS

The 2008 Budget Session of the Wyoming Legislature kicked off on February 11^th and wrapped up 20 days later on March 7^th.  The primary purpose of the 20-day budget session, held every two years, is to write the biennial budget document to guide state government spending for the next two years.  On Wednesday, March 5, Governor Freudenthal signed the $3.5 billion state budget for 2009 – 2010.  Beyond general state operations, the most significant items funded in the budget document were monies added to the corpus of the Wyoming Wildlife and Natural Resource Trust Fund and Hathaway Scholarship Foundation, as well as additional funding for highways and local governments.  For the most part, the budget process ran very smoothly with little political rancor.

Beyond the Budget Bill, over 270 additional legislative bills were considered in this 20-day time frame.  There were approximately 25 health-related bills considered during the session, however only about a dozen bills passed into law.  WMS was successful in obtaining additional Medicaid reimbursement for obstetric services, passing a bill to help with dentist and physician recruitment efforts and fighting off portions of a bill that would have created criminal liability for prescribers who knowingly prescribe pain medications to bad actor, physician shopping patients.  However, many health care advocates were disappointed that the Legislature did not approve several important bills, ranging from a medical liability reform measure, to a statewide smoking ban, to reimbursement for ever increasing Medicaid costs to healthcare providers.

The WMS Doctor of the Day program is still the best way for physicians to participate in the legislative process.  WMS gratefully extends our sincerest appreciation to the physicians and physician assistants who volunteered to spend a day at the Capitol during the 2008 session, providing basic healthcare services and enjoying a front row seat to legislative deliberations. 

Thank you to the following Doctors of the Day for promoting the medical profession:  Mark Wurzel, Lisa Brandes, Jeremy Eaton, Eric Wedell, Fred Baldwin, James Broomfield, Doug Parks, David Gajda, Helen Iams, Amy Trelease-Bell, Ron Malm, Doug Schmitz, Houman Bolourian, Edith Wilson, Rene Hinkle, Diane Noton, George McMurtrey, Randy Johnston, John Healey, Omid Dilmaghanian, Marion Smith, Gerald Smith and Dean Bartholomew.

2008 BUDGET BILL ITEMS

WMS worked to obtain the following two budget footnotes in the 2008 Budget Bill.  A budget footnote directs how certain monies must be spent over the coming two years.

Obstetric Medicaid Reimbursement:  WMS worked to reauthorize and fund a Budget Footnote that will extend the Medicaid reimbursement schedule for obstetric providers through next budget biennium.  The current schedule is set to expire on June 30, 2008.   Senator Charlie Scott (Natrona County) successfully sponsored this amendment on the Senate Floor and Representative Elaine Harvey (Big Horn/Park County) was successful in sponsoring this amendment on the House Floor.  By obtaining mirror amendments in each chamber, we were able to keep this amendment in final version of the Budget Bill that was signed by the Governor.

Primary Care Reimbursement:  WMS also attempted to obtain a budget footnote for primary care in the Senate with Senator Scott again as the sponsor.  This amendment unfortunately failed by a count of 6 votes in favor and 24 against.

LIABILITY REFORM

The medical liability reform issues continued regarding Wyoming’s ongoing medical liability challenges.  The House of Representatives showed strong support for medical liability reform, but we continue to face significant opposition to reform in the Senate.

HB 118: Loss of Chance Doctrine Abrogated. Sponsored by Representative(s) Hallinan, Cohee, Dockstader, Edmonds, Iekel, Jorgensen, Lubnau, McOmie, Miller, Millin and Stubson and Senator(s) Hines.  This legislation would abrogate the common law doctrine of loss of chance, and overrule a Wyoming Supreme Court case adopting the “lost chance doctrine.”  The doctrine provides that if a plaintiff does not recover from a medical treatment or procedure, and the chance of recovery or survival was lessened by medical malpractice, the proper measure of damages is the total damages multiplied by the percentage reduction in the chance of recovery or survival caused by the malpractice.  WMS Supports.  Passed Third Reading in the House, died in the Senate Labor, Health and Social Services Committee.

The bill died because it did not meet a required deadline to have cleared the committee of jurisdiction in the second chamber. 

PHYSICIAN PRACTICE & RECRUITMENT ISSUES

HB 38: Medicaid – Provider Reimbursements.  Sponsored by the Joint Labor, Health and Social Services Interim Committee.  Provides for regular revision of provider reimbursement schedules.  WMS Strongly Supports. Passed Third Reading in the House, failed in the Senate.

The bill had passed the House of Representatives as well as the Senate Labor, Health and Human Services Committee.  Unfortunately, on the Senate Floor the bill failed passage by a count of 13 – 17.  Senator Philip Nicholas (Albany County), the Chairman of Appropriations, opposed the bill on the Senate Floor.  Senator Nicholas stated that he believed the proposed process would treat healthcare providers differently than all other groups that seek state funding for any of a number of reasons.  WMS will work in the coming months to address these concerns and continue to search for a fair and rational reimbursement process for Medicaid providers.

HB 93: Universal Health Insurance. Sponsored by Representative Floyd Esquibel.  Provides for the Wyoming health care commission to solicit and review proposals for expanded health insurance coverage.  No position – WMS Monitoring Only.  Failed upon introduction in the House.

SF 35: Physician and Dentist Recruitment.  Sponsored by the Joint Labor, Health and Social Services Committee.  Provides a grant program for physician and dentist recruitment and repeals the previous local matching funds requirement for the physician and dentist loan repayment program.  WMS Supports.  Failed upon introduction in the Senate.

While this measure died initially as SF 35, it was reintroduced as HB 155 (see below) and was passed into law.

HB 155: Physicians and Dentist Recruitment.  Sponsored by Representative(s) Lubnau, Hallinan, Harvey, Iekel, Landon and Millin.  Provides a grant program for physician recruitment and repeals the local matching funds requirement for the physician and dentist loan repayment program. WMS strongly supports. Passed into law.

WMS worked very hard to gain passage of HB 155.  Several appropriations committee members in both the House and Senate opposed the bill.  At one point, HB 155 advanced on an initial vote on the Senate Floor by a vote of 15 in favor and 13 against, with two Senators excused.  If all 30 Senators had voted, the bill likely would have died on a 15 – 15 vote.  The bill initially provided for $800,000 to fund the program, which was stripped out by Senate Appropriations Chairman Phil Nicholas, and later a conference committee added $400,000 back into the program.  The bill finally cleared its final vote in the Senate by a count of 17 in favor and 13 against on the last day of the session.

HB 127: Prescription Drugs - Physician Shopping.  Sponsored by Representative(s) Simpson, Gingery and Lubnau and Senator Fecht. Amends the Wyoming Controlled Substances Act of 1971 to further specify illegal means of obtaining and dispensing controlled substances including prescriptions for controlled substances.  No position – WMS Monitoring Only.  Passed into law.

WMS, along with other interested entities, worked to remove a provision that would have given prescribers criminal liability for prescribing controlled pain medications “knowingly” to a bad actor who was physician shopping to illegally obtain excess controlled medications.  Dr. Hallinan, former WMS President and current Representative from Gillette, successfully led this charge on the House Floor.  The concern centered around a possible chilling effect on physicians treating pain patients in order to reduce the physician’s potential exposure to criminal liability.

HB 172: Homicide During Pregnancy.  Sponsored by Representative(s) Harshman, Gingery, and Olsen and Senator Ross. Establishes the offense of involuntary termination of pregnancy to penalize any offender guilty of willfully killing any pregnant woman causing the termination of the pregnancy. Establishes a penalty of not less than twenty (20) years imprisonment and not more than life.  No position – WMS Monitoring Only.  Failed upon introduction in the House.

SF 24: Health Insurance – Clinical Trials.  Sponsored by the Joint Labor, Health and Social Services Committee.  Requires health insurance policies to provide coverage for routine care related to an insured person’s participation in a clinical trial or study.  No position – WMS Monitoring Only.  Passed into law.

SF 74: Traditional Birth Care.  Sponsored by Senator(s) Johnson and Vasey and Representative(s) Anderson, R., Brechtel and McOmie. Provides an exemption to the Medical Practice Act for the practice of midwifery.  WMS Opposes.  Failed upon introduction in the Senate.

In a Budget Session, for a bill to be introduced and heard in committee, it must obtain two-thirds approval in the chamber of origin.  Therefore, in the Senate the rule requires that SF 74 would need 20 Senators to vote for introduction.  SF 74 only failed introduction by one vote, a count of 19 in favor of introduction and 11 against.  A vote in favor of introduction does not necessarily mean a particular legislator supports the legislation; they may just want to allow discussion in committee.  However, WMS will work in the interim to further educate legislators on the harm such legislation poses to patient safety.

SF 78: Prescription Drug Practices.  Sponsored by Senator Mockler. Requires pharmacy benefit managers to pass on any benefits or payments received from drug manufacturers to covered individuals. No position – WMS Monitoring Only.  Placed on General File in the Senate, was not considered in Committee of the Whole.

SF 85: Health Care Reform - Pilot Project.  Sponsored by Senator(s) Scott, Fecht, Haster, and Landen, and Representative(s) Hallinan, Harvey, Iekel, Landon and Millin. Establishes a commission to design a plan for an experimental health care insurance reform pool.  No position – WMS Monitoring Only.  Passed Third Reading in the Senate, died in the House Labor, Health and Social Services Committee.

ALLIED HEALTHCARE PROVIDER BILLS

HB 82: Trauma Care Services.  Sponsored by Representative(s) Lockhart, Cohee, Esquibel, F. and Martin and Senator(s) Perkins and Von Flatern. Extends the existing payment program to hospitals for un-reimbursed trauma care through July 2008.  WMS Supports.  Passed into law.

SF 62: Emergency Medical Technicians.  Sponsored by the Joint Labor, Health and Social Services Interim Committee. Creates a volunteer emergency medical technician pension fund.  WMS Supports.  Passed into law.

PUBLIC HEALTH BILLS  

HB 58: Safety Belt Violations.  Sponsored by Representative(s) Iekel, Bagby, Berger, Brown, Edwards, Gingery, Hammons, Jaggi, Landon, McOmie, Thompson, Walsh and Warren and Senator(s) Fecht, Sessions and Von Flatern.  Repeals W.S. 31-5-1402 (d) allowing motor vehicles to be stopped solely for safety belt violations.  WMS Supports.  Failed upon introduction in the House.

HB 87: Smoke Free - Enclosed Public Places.  Sponsored by Representative(s) Millin, Craft, Davison, Gingery, Harvey, Jaggi, Warren, Zwonitzer, Dn. and Zwonitzer, Dv. and Senator(s) Fecht, Hastert and Massie. Prohibits smoking in enclosed public places.  WMS Supports.  Failed upon introduction in the House.

SF 36: Public Health Emergencies – Volunteers.  Sponsored by the Joint Labor, Health and Social Services Committee.  Provides immunity from liability for volunteer health care providers without active licenses in the event that a public health emergency is declared by the State Public Health Officer.  WMS Supports.  Passed into law.

ALCOHOL AND TOBACCO RELATED BILLS

HB 2: Alcohol Taxes to Treat Substance Abuse.  Sponsored by the Select Committee on Mental Health and Substance Abuse. Increases the excise tax on malt beverages and earmarks the revenue for substance abuse prevention.  No position – WMS Monitoring Only.  Failed upon introduction in the House.

MENTAL HEALTH & SUBSTANCE ABUSE REALTED BILLS

HB 12: Veterans' Mental Health.  Sponsored by the Select Committee on Mental Health and Substance Abuse. Provides funding to address mental health and substance abuse problems of military personnel and their families associated with participation in military conflicts.  No position – WMS Monitoring Only.  Passed into law.

SF 6: Costs for Emergency Detentions-Limitations.   Sponsored by the Select Committee on Mental Health & Substance Abuse.  Limits use of the term hospitalization “costs” to those that are related to the treatment for the suspected illness within the first 72 hours of detention.  No position – WMS Monitoring Only.  Passed into law.

SF 10: Mental Health & Substance Abuse Appropriations.  Sponsored by the Select Committee on Mental Health & Substance Abuse. This legislation included various appropriations for the following:  counties receiving federal strategic prevention framework incentive grants to increase prevention efforts in the areas of substance abuse and underage drinking;  Substance abuse residential treatment for women and women with children;  and Crisis stabilization services for 4 regions in the state.   Provides specialized training to judges, attorneys and mental health, substance abuse and other providers who work with persons who may need mental health or alcohol or substance abuse treatment services.  No position – WMS Monitoring Only.  Passed into law.

SF 13: Mental Health Professions Practice Act-amendments.  Sponsored by the Select Committee on Mental Health & Substance Abuse. The amendments to the licensing act modify certification and provisional licensing requirements and certification reciprocity.  The purpose of the change is to address workforce needs and reciprocity; providing for licensure under the laws of another state whose requirements are substantially similar to those required by Wyoming.  No position – WMS Monitoring Only.  Passed into law.

WMS, in monitoring this measure, ensured that no amendments were added which allowed for any additional abilities to mental health professionals beyond those traditionally reserved for licensed physicians.

OTHER HEALTH CARE BILLS
 

HB 13:  Psychologist Licensure.  Sponsored by Select Committee on Mental Health and Substance Abuse Services.  Amends the Psychologist Licensing Act to remove separate licensing requirements related to school psychologists, revise the composition of the state board of psychology and revise the grounds and evidentiary standard for disciplinary actions.  No position – WMS Monitoring Only.  Passed Third Reading in the House, died in Committee in the Senate.

WMS, in monitoring this measure, ensured that no amendments were added which allowed for any additional abilities to psychologists beyond those traditionally reserved for licensed physicians.

HB 31: Medical Safety Event Reporting.  Sponsored by the Joint Labor, Health and Social Services Interim Committee.  Authorizes the Department of Health to define safety events for purposes of mandatory reporting by health care facilities.  No position – WMS Monitoring Only.  Passed into law.

HB 47: Long Term Care Access.  Sponsored by the Joint Labor, Health and Social Services Interim Committee.  Establishes a statewide network of aging and disability resource centers.  Amends the state Medicaid plan and provides for an appropriation.  No position – WMS Monitoring Only.  Failed upon introduction in the House.

HJ 4: Designation of Disabilities.  The designation of “Mental Retardation” should be removed and replaced with a more respectful term throughout the agencies within the State of Wyoming. No position – WMS Monitoring Only.  Placed on General File in the House, was not considered in Committee of the Whole.

2008 INTERIM HEALTH CARE TOPICS

The Joint Labor, Health and Social Services Interim Committee (Committee) will study the following four priority issues during the interim between the 2008 Budget Session and the 2009 General Session:

Workers’ Compensation.  The Committee will conduct a broad review of workers’ compensation, including:

• The means for computing benefits.  Most benefits are computed using formulas which change with inflation, but there are certain fixed dollar amounts that will be reviewed;
• The administrative process by which benefits are calculated and awarded; and
• Co-employee tort immunity.

Healthcare Access and Affordability.  The Committee will work with the Wyoming Healthcare Commission, incorporating the Commission’s past research with concepts from this session’s SF 85 (Healthcare Reform – Pilot Project), to propose a system to improve the healthcare of a large group of low-income citizens in the state.  The bill died in the House Labor, Health and Social Services Committee.

Smoking in Public Places.  The Committee will consider the scope of a statewide smoking ban in public places, assess public opinion and propose legislation if appropriate.

Review of Reports.  The Committee is required to receive reports on the following issues:

• Medicaid Provider Reimbursement.  Report from the Department of Workforce Services on a detailed plan and procedures to review Medicaid providers’ reimbursement schedules in order to maintain availability of services.
• Medical Practice Act.  Report from the Board of Medicine concerning proposed revisions to the Medical Practice Act to address telemedicine and other technology issues.
• Aging.  Updates on pilot projects concerning Greenhouse, adult foster care and remodeling of nursing homes.
• Healthcare Facilities Capital Projects.  Report from the Department of Health on revisions to statutes to expedite pan review and building construction inspections.

Click Here for a downloadable pdf version of this document.

2008 legislative contact information for the Wyoming Medical Society:

            President            Executive Director          Communications Director

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