Legislative Update: Telehealth, Mandatory Reporting, Medical Cannabis & More

Dave Renner, CAE, our legislative rep, shares the latest health care updates from the State Capitol, including more movement on telehealth expansion, a change for mandatory reporting, a flavored tobacco ban, medical cannabis modifications and more.

Budget Projections: From Deficit to Surplus

The budget forecast for Minnesota for the next two years was released on February 26. The state is now expected to have a $1.6 billion surplus for fiscal years 2022-2023—a dramatic change from the November 2020 forecast of a $1.3 billion deficit.

Budget officials cited several factors that changed the budget outlook, including the economy doing better than expected and the federal COVID relief package that passed in December.

Both the Senate and House will now begin work on developing their respective budget bills.

Telehealth Bill Passes First Senate Committee

Telehealth expansion is a legislative priority for the Minnesota Academy of Family Physicians (MAFP). Legislation to continue expanded coverage for telehealth and telephone services passed the Senate Health and Human Services Finance and Policy Committee on February 22.

“Access for health care must always be a priority and telehealth has been critical during the pandemic to maintain that access,” testified Kurt DeVine, MD, MAFP member (Little Falls).

The legislation, authored by Senator Julie Rosen (R-Fairmont), SF 1160, continues many of the coverage expansions that have been in place during the COVID-19 pandemic. It amends the definition of telehealth to include telephone-only services IF it is part of a scheduled patient visit. It also changes the definition of “site of service” to allow the patient to be anywhere, including at home. Under the old law the patient had to be at a hospital or clinic to receive telehealth services.

One new provision included in Rosen’s bill is the coverage of remote patient monitoring services (of clinical data related to the enrollee’s vital signs or biometric data). This is currently not covered by Minnesota insurers, even though many states now cover this.

The two issues that are most controversial in the bill: 1) language that requires insurers to reimburse for telehealth services at the same rate they would for in-person care and 2) a prohibition on the use of telehealth-only networks by payers. The Minnesota Council of Health Plans is arguing that these items should be left to negotiation between the payer and provider.

The bill passed on a unanimous vote and was referred to the Senate Commerce Committee, where the issues of payment parity and networks will be discussed.

The House companion bill, HF 1412, authored by Representative Kelly Morrison, MD (DFL-Deep Haven), was heard in the House Commerce Finance and Policy Committee on February 26. Kim Tjaden, MD, MAFP member (St. Cloud), testified. She stressed the need to continue coverage for telephone services: “I have seen firsthand how telephone-only visits are necessary to address obstacles to care.” The bill passed and was referred to the House Health Care Finance and Policy Committee.

Mandatory Reporting Change

On February 24, both the House and Senate acted on legislation to remove a mandate for physicians to report a pregnant person who is using a controlled substance.  The existing mandatory reporting requirement resulted in some patients choosing not to receive needed prenatal care because of fear of being reported.

The Senate Health and Human Services Finance and Policy Committee passed SF 1182, authored by Senator Michelle Benson (R-Ham Lake), and referred it to the Senate Judiciary and Public Safety Finance and Policy Committee.

The House companion bill, HF 1026, authored by Representative Kelly Morrison, MD (DFL-Deep Haven), was heard in the House Health Care Finance and Policy Committee where it was laid over for possible inclusion in the omnibus Health and Human Services budget bill.

Comprehensive Sexual Education

On February 24, the House Preventive Health Division heard HF 358, authored by Representative Sydney Jordan (DFL-Minneapolis). The bill requires comprehensive sexual health education for elementary and secondary students. 

A letter submitted by the Minnesota Medical Association President Marilyn Peitso, MD, stated, “The research into sexual education makes clear that comprehensive, medically accurate material can reduce the rates of both unintended pregnancies and sexually transmitted infections.” 

The bill passed and was referred to the House Health Care Finance and Policy Committee.

Flavored Tobacco Ban

The House Preventive Health Division passed legislation to adopt penalties on retailers for the sale of flavored tobacco and vaping devices. The bill, HF 904, authored by Representative Cedrick Frazier (DFL-New Hope), would prohibit all flavorings, including menthol, in an attempt to reduce the allure of these products to teens and other first-time smokers. 

The bill was referred to the House Health Care Finance and Policy Committee.

Provider Credentialing

Legislation, authored by Senator Jim Abeler (R-Anoka), to ensure timely approval of provider credentialing by health plans passed the Senate Health and Human Services Finance and Policy Committee. 

The bill, SF 753, requires health plans to make a determination on a clean application for provider credentialing within 45 days of receiving the application. The final language was negotiated between the Minnesota Group Managers Association and Minnesota Counsel of Health Plans.

The bill will become effective on January 1, 2022.

Medical Cannabis Modifications

Three bills modifying the laws related to medical cannabis use were heard.

HF 675, authored by Representative Jeremy Munson (R-Lake Crystal), reclassifies cannabis under Minnesota law from a Schedule I drug to a Schedule II drug. It also requires the Commissioner of Health to inform the DEA of this change and to ask that the federal designation as a Schedule I drug not apply to the medical use of cannabis.

HF 813, authored by Representative Heather Edelson (DFL-Edina), would allow the smoking of raw cannabis in the medical cannabis program. Minnesota is the only state with a medical cannabis law that does not allow smoking. The distribution of raw cannabis would only be allowed for patients aged 21 or older. While prohibiting smokable cannabis reduces the health risks of smoking, it makes our cannabis products the most expensive in the country.

HF 907, authored by Representative Aisha Gomez (DFL-Minneapolis), provides a criminal affirmative defense if a patient is enrolled in the medical cannabis program as a legal use of cannabis.

Recreational Cannabis Receives First Hearing

Legislation to legalize and regulate the use of adult-use cannabis passed its first hearing in the House Commerce Finance and Policy Committee on February 17. HF 600, authored by House Majority Leader Ryan Winkler (DFL-St. Louis Park), legalizes its use for people age 21 or older and licenses growers and sellers of the product.

The bill creates a Cannabis Management Board that is directed to promote public health, protect public safety, eliminate illicit markets, promote the industry and help communities that have experienced a disproportional negative impact from cannabis. The bill attempts to address the racial disparities on how cannabis laws are enforced and ensure that the product is regulated to address public health issues caused by cannabis use.

The bill still has many committees to pass before it gets to the House floor and most do not believe the Senate will hear the bill at all.

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