By Dave Gessel
The following is a review of some of the legislation discussed at this year's Utah State Legislature that affects hospitals.
Excellent legislative session for Utah’s hospitals and health systems!
The 2017 session was a quiet but very effective session for Utah’s hospitals and health systems with significantly increased Medicaid funding and other important funding and legislation. Thanks to the UHA Board, UHA Government Relations Committee and UHA members and lobbyists who all worked together so well to make this happen.
Large increase in Medicaid funding for hospitals
UHA worked with our legislative allies to successfully obtain significant new Medicaid funding for hospitals and ACOs for the coming year. The Legislature approved a 3.5% increase in the per member per month funding for Medicaid patients this year. This is the largest increase in funding since Utah moved to an ACO Medicaid model. This will allow hospitals and Medicaid ACOs to continue to work together effectively in treating Medicaid patients. This amounts to many millions in new funding dollars for the coming fiscal year that hospitals and health systems should be aware of as they negotiate new contracts with ACOs.
Other important funding for hospitals and health systems
There were many other positive funding areas for hospitals and health systems this session. UHA secured $250,000 in funding for the Get Healthy Utah population health initiative that matches a similar amount from the UHA board. A big thank you to House and Senate leaders for their support of this effort. In addition, $1.5 million was secured to fund a number of new primary care residencies in the state. Also, the UHA-sponsored Rural Physician Loan Repayment program continues to be fully funded. In addition, another $300,000 was funded to help repay loans for doctors, nurses and other mid-level professionals who work in rural or urban underserved areas. This new funding will allow rural hospitals to recruit and help get loan repayments for a variety of staff. The Legislature also appropriated $5 million to help rebuild the University of Utah Medical School and authorized up to $190 million in bonding for the medical school construction. No new funding was obtained this year for educating more nursing students.
Last year’s Medicaid expansion partially approved and funded
The federal government has not approved most of the Medicaid expansion from last session. This includes the funding that would have helped the homeless and those with mental illness and substance abuse issues, as well as the increased hospital assessment for this and for increased hospital outpatient payments. However, CMS did approve and the Legislature funded the expansion for adult parents of children on Medicaid. This will result in approximately $20 million dollars of new funding to cover approximately 4,000 more adult parents. We are grateful to the Legislature for moving forward on covering this population.
H.B. 395 did not pass but we all have work ahead
One of the bills that took a lot of time and effort this session was H.B. 395. The original intent of this bill was to address “surprise” balance billing in the emergency room setting. However, this issue proved to be very challenging and complex as it effectively would have impacted many contracts and amounted to government rate setting. In addition, several drafts of this bill would have significantly reduced payments to emergency room physicians and on-call physicians and hospitals. It went through many versions but consensus was hard to obtain. Thanks to all who worked so hard to educate the legislature on the complexity and challenge of this issue. This will continue to be an issue of discussion to find a permanent solution over the next year.
Other healthcare bills that passed of interest to hospitals
Several bills impacting hospitals and health systems did pass this session. On the positive side, UHA-sponsored H.B. 435 – Health Care Patient Privacy Amendments passed, which will protect any HIPAA information obtained on a police body camera as “protected” information under GRAMA. In addition, if the police are not at a healthcare facility for a normal police encounter as defined by statute, the body cameras should be turned off under this new law. H.B. 61 – Pharmacy Service For Discharged Patients allows patients to receive up to a three day prescription in limited circumstances when they are discharged from the hospital. A number of others bills impact hospitals and health systems in the future. H.B. 336 – Health Reform Amendments essentially streamlines the HMO/PPO laws in the code. H.B. 128 – Health Care Debt Collection Amendments changes the procedures for how all health facilities and healthcare providers deal with patients whose bills will go to collection agencies. Essentially the bill requires that patients be given notice through certified mail, priority mail or text message that their debt is being sent to collections. Text messaging is the quickest and cheapest way to do this but may require a change in your billing process. This bill was much more challenging when first drafted but UHA was able to add certain amendments that make it more feasible. Please review this new law to determine how it impacts your hospital or health system. Finally, H.B. 142 – Administration of Anesthesia Amendments passed and requires the Department of Health to create a database on adverse events with anesthesia in outpatient settings and requires informed consent in such settings and for healthcare providers in these settings to report adverse events.
Employment and business legislation impacting hospitals and health systems
No new “non-compete” legislation passed this session. UHA joined the business community in opposing H.B. 81 – Post Employment Restrictive Covenant Amendments which was defeated on the House floor. UHA and its members also worked with the Salt Lake Chamber of Commerce and legislative leaders on a comprehensive study on non-competes in Utah that was released during the session. This data showed there was no need for further legislation in this area so no other bill came forward. In addition, H.B. 272 – Regulatory Impact Amendments passed and requires state agencies to do a more thorough analysis on how any new rule impacts businesses in the state before a rule is finalized. UHA expresses thanks to the legislative leaders and the Salt Lake Chamber of Commerce for their efforts on these issues.
Other interesting healthcare bills and debates
There was not much debate on medical marijuana this session although legislation did pass this year. H.B. 130 – Cannabinoid Medicine Research sets up a research process to allow institutional review board approved studies on the medical use of marijuana in Utah. This is the first step to approve the new use of medical marijuana to treat certain medical conditions if the research shows that would be useful for that condition. H.B. 141 – Unborn Child Protection Amendments requires a physician giving the drug Mifepristone to a patient for a medication induced abortion to read a statement about the effects of this type of abortion and how it can possibly be reversed before the second dose is taken.
Lots of bills on professional licensing
There were many bills that passed dealing with a variety of professional licensing issues for healthcare. Pharmacists, nurses, physician assistants, psychologists, dentists and physical therapists all had changes to their licensing statutes. UHA-supported S.B. 48 – Nurse Licensure Compact that passed and is an important update to the Interstate Nursing Licensure Compact that Utah is already a part of.
Some good legislative results on population health efforts
The legislature passed a number of important bills to improve public health in our state. Some good news is that several bills were passed to try to curtail the challenge with prescription drug abuse occurring in Utah, the most important of which allows partial filling of prescriptions. In addition, S.B. 159 – Helmet Requirement Amendments passed that raises the age required to wear a motorcycle helmet from 18 to 21. Also, several bills passed to help prevent suicide, including a new dedicated statewide hotline number that can be called anytime. Not so good news was that nothing was done on the tobacco front where bills taxing and regulating e-cigarettes and increasing the legal smoking age from 19- 21 did not pass again. Legislation helping those with substance abuse and mental health issues also did not pass.
Looking ahead for 2017-18 policy issues
The major issue of the next year will be planning and adjusting to any major Medicaid changes passed by the Congress. This will take strong collaboration between the hospitals and between the state and federal government. UHA is well positioned with both our state legislature and our federal delegation to help lead on these changes. There will be other issues impacting hospitals that will be discussed over the interim. Surprise billing and balance billing with be back as will discussions on end of life and workers’ compensation.
UTAH HOSPAC Golf Tournament in June!
One of the best ways to support UTAH HOSPAC, our political action committee, is our annual golf tournament that will be held once again at Thanksgiving Point on Monday, June 19, 2017. We encourage each hospital to provide a foursome at the tournament as that goes a long way for most hospitals in meeting their annual HOSPAC goal. Registration is now open for the golf tournament and other opportunities to support UTAH HOSPAC are also available.
UHA is here to help and serve
UHA is here to help you with any of your legislative questions or concerns. If you need even more bill or legislative information you can go to the legislative website at www.le.state.ut.us where you can read the legislation that passed this session. If you have specific questions or concerns, please e-mail Dave Gessel at and he would be happy to help you. Thank you for your support of UHA and Utah’s hospitals and health systems.