By Dave Gessel, UHA Executive Vice President
The following is a review of some of the legislation discussed at this year's Utah State Legislature affecting hospitals and health systems.
Historic Session For Utah’s Hospitals And Health Systems!
Many positive things happened for Utah’s hospitals and health systems this session. We are grateful to the UHA Board, led by Chair Brian Dunn, and the UHA Government Relations Committee, chaired by Charlton Park, for giving excellent counsel and guidance on a wide variety of issues. We also appreciate the many UHA members and lobbyists who all worked together to make this a very positive session. UHA is grateful to work with so many committed to making healthcare policy better in Utah.
Huge Win For Hospitals In Obtaining New Medicaid Funding
UHA strongly supported S.B. 126 – Hospital Assessment Amendments that overwhelmingly passed the legislature. Our sponsors, Senator Evan Vickers and Representative Steve Eliason, did a wonderful job in guiding this important legislation through the legislative process. This legislation essentially doubles the amount of our current hospital assessment while also allowing us to access significantly more federal funds due to changes in federal law. Instead of our normal federal match rate, it will be significantly enhanced up to close to a commercially reasonable rate for reimbursement for both inpatient and outpatient services. We still need to work with the state as well as the federal government to finalize the rates but are confident that we will be successful. We are hoping for a July 1, 2023 implementation for this new funding. As part of this new funding, the legislation also requires the state to work with the federal government to develop some quality measurements that will be tied to this funding. This legislation will bring hundreds of millions of new reimbursement dollars to Utah’s hospitals. This is a once in a decade win for Utah’s hospitals and we sincerely appreciate all who worked so hard to make this happen.
2% Funding Increase In Medicaid For Hospitals and Health Systems
UHA worked with our legislative allies to successfully obtain tens of millions of dollars in other new overall state and federal Medicaid funding. This includes a 2% increase (nearly $120 million) in consensus new combined federal and state funding for hospitals, providers and ACOs for the coming year that hospitals and health systems should be aware of as they negotiate new contracts with ACOs. In addition, Medicaid overall is well funded through the upcoming fiscal year. Medicaid expansion funding remains healthy so there are no current concerns of using additional hospital assessment funds for that. There were also a number of targeted increases in Medicaid funding this year. For the first time in many years, the Legislature funded a large increase in Medicaid rates for air ambulance providers. An increase of over $5 million in federal and state Medicaid reimbursement for these providers is much appreciated. The Legislature also passed S.B. 133 – PostPartum Medicaid Coverage Amendments. This bill will provide millions in Medicaid funding to increase Medicaid postpartum coverage from two months to up to a year. In addition, S.B. 217 – Childrens Health Coverage Amendments passed. This will provide over $4 million to cover around 2,000 new children with CHIP-like coverage. This specifically covers children who have lived in Utah for at least 180 days but are not covered under traditional CHIP or Medicaid. This should help lower uncompensated emergency room visits. In addition, significant new funding is appropriated for autism reimbursement as well as reimbursement for medically complex children on Medicaid.
Mental Health Funding and Legislation
The large increases in mental health funding that have occurred over the past few years have been maintained and added upon. For example, H.B. 66—Behavioral Health Crisis Response Commission Amendments will provide over $5 million in new funding to continue to add new receiving centers and mobile crisis outreach teams. In addition, there were a number of bills that have passed to improve mental health policy. H.B. 248 – Mental Health Services For Adults provides an additional $1 million in funding for adults with mental health challenges. There was also significant new funding to help Utah’s first responders with mental health challenges. There were also a number of bills amending the civil commitment statutes. H.B. 177 – State Hospital Amendments did not pass. This legislation would have set up a commission to look at moving the state hospital. There were a number of other bills that passed and that did not pass impacting mental health that can be reviewed in the accompanying list of bills.
Healthcare Workforce Funding Is Also Very Positive
UHA and its members successfully lobbied for an additional $4.5 million dollars to expand public university healthcare program slots. In addition, the Legislature funded the Utah Board of Higher Education’s Behavioral Health Workforce initiative with an additional $2 million. However, H.B. 386 – Clinical Health Care Provider Grants Amendments did not pass. This legislation would have funded a number of grants for clinical placements of healthcare students.
Other Important Funding Impacting Hospitals and Health Systems
There were a number of other positive funding areas for hospitals and health systems this session. UHA helped to maintain $250,000 in funding for Get Healthy Utah to continue its population health initiative. The $300,000 in on-going funds for the rural physician loan repayment program was also maintained.
COVID-19 Related Bills and Issues
There were a couple of bills dealing with the COVID pandemic that passed this year. H.B. 131 – Vaccine Passport Prohibition finally passed this year, but healthcare facilities were exempted from this bill. Another bill also passed dealing with visitation policies for licensed health care facilities. H.B. 133 – Health Care Facility Visitation Amendments passed and requires facilities licensed by the Utah Department of Health and Human Services (“DHHS”) to have a visitation policy in writing and filed with the DHHS. The visitation policies must also be on the facility’s website and cannot be more restrictive in most instances for visitors than what the facility requires of its employees. There is still significant room for flexibility, but hospitals and other licensed facilities will need to update their visitation policies to comply with this new law.
Other Health Care Bills That Passed Of Interest To Hospitals
There were a number of other bills that passed of interest to hospitals. H.B. 312 –Patient Medical Records Access Amendments passed. This bill deals with timely response to medical records requests from patients and their representatives and will have no impact if records are sent in a timely manner. This is a bill that your medical records department should review. S.B. 214 – Utah False Claims Act Amendments passed and clarifies the definition of health care providers to include all individual health care providers and not just licensed facilities. S.B. 64 – Bureau of Emergency Medical Services Amendments passed and transfers the Bureau of Emergency Medical Services from the Department of Health and Human Services to the Department of Public Safety. Areas of potential impact for hospitals are in the areas of trauma designation and ambulances as well as other areas but it with take a while to see if these are positive or negative developments. S.B. 193 – Pharmaceutical Amendments passed and prohibits a health insurer from requiring a pharmacy to dispense a clinician-administered drug directly to a patient with the intent that the patient will transport the drug to the clinician for administering.
Two Unique Medical Malpractice Bills Passed This Session
Two bills dealing with medical malpractice passed. S.B. 171 – Health Care Practitioner Liability Amendments passed and changes the duty of care in certain circumstances where a practitioner deviates from established medical norms. It also allows practitioners to advertise those changes under certain circumstances. S.B. 247 – Medical Malpractice Amendments passed and makes clear that sexual abuse in the healthcare setting will not be a part of the current Utah malpractice statute for litigation purposes. S.B. 215 – Insurance Adjuster Claim Amendments did not pass and could have potentially impacted hospital liens in certain circumstances.
Bills That Did Not Pass Potentially Impacting Hospitals
There were a number of bills potentially impacting hospitals that did not pass this session. H.B. 239 – Medical Records Access Amendments did not pass. This was a bill requiring the four major healthcare systems to find a better way to share electronic medical records with individual physicians and clinics. The bill was defeated mainly due to privacy and cybersecurity concerns but the issue will likely continue to be discussed in the future. S.B. 170—Post Employment Restrictions Modifications did not pass. This bill would have made any non-competes illegal in healthcare.
Many Bills Dealing With Provider Scope of Practice and Licensing This Session
As usual, there were many bills dealing with scope of practice and licensing for advance practice nurses, mental health professionals, social workers, physicians, naturopathic physicians, CNAs and others. These can be reviewed on the attached list of bills. We did want to specifically mention H.B. 159 – Health Care Professional Licensing Requirements that passed. This legislation allows an out-of-state healthcare provider to obtain a temporary license in Utah for telehealth services. Also, S.B. 36 – Professional Licensing Amendments passed and removes restrictions on an advance practice nurse to prescribe Schedule II drugs.
Abortion Legislation
At least six abortion bills were filed even though the Utah courts have not made a determination on the current “trigger” law. H.B. 467 – Abortion Changes passed. This legislation clarifies where and when abortions can take place in Utah. It does not require hospitals to do abortions but prescribes how they are to be done in a hospital setting. UHA recommends that your legal counsel review this legislation with you. It is possible this legislation will be litigated but even if it isn’t there may be additional legislation in the future depending on how the Utah courts rule on the “trigger” law that is currently on hold in the courts.
UTAH HOSPAC Golf Tournament in June!
One of the best ways to support UTAH HOSPAC, our political action committee, is our 23rd annual golf tournament that will be held once again at Thanksgiving Point on Monday, June 12, 2023. 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. Look for additional information soon on the golf tournament as well as other opportunities to contribute to UTAH HOSPAC. You can go to the UHA websiteto register your team now.
UHA Is Here To Help And Serve
UHA is here to help you with any of your legislative questions or concerns. Please review the attached list of bills for additional information. If you need even more bill or legislative information you can go to the legislative website at www.le.state.ut.uswhere 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. He and Greg Bell would also be happy to come and brief your board or staff on the legislative session and the importance of engaging in the political process. Thank you for your support of UHA and Utah’s hospitals and health systems.