Minnesota Academy of Family Physicians (MAFP) legislative rep Dave Renner, CAE, shares the latest health-care-related updates from the Minnesota Legislature, including:
- All-Payer Claims Database Update Passes Another House Committee
- Senate Tax Committee Supports Preceptor Tax Credit
- MAFP Testifies in Support of Rural Training Grants
- Legislation to Preserve Access to Needed Prescription Drugs Heard
- Legislation to Help Patients With Chronic Pain Receives Support
- Pregnancy Care Bills Pass House Committee
- Legislative Committee Deadlines: Next Deadline—April 1
All-Payer Claims Database Update Passes Another House Committee
HF 3696 (Representative Jennifer Schultz, DFL-Duluth), which would update and improve the health care payment data the state collects, passed the House Judiciary Finance and Civil Law Committee on March 22, 2022.
This legislation will:
- Update the state’s All-Payer Claims Database (APCD).
- Direct the Minnesota Department of Health to collect and report payment information that is not included in claims (like value-based payments).
HF 3696 was developed by a large coalition of primary care providers, led by the MAFP. Deb Dittberner, MD, MBA, MAFP President, testified in strong support of the bill, stressing the importance of value-based payments to support primary care services.
“There are several non-claims-based payments that affect the way that I, as a physician, and others in my practice provide care for patients,” Dittberner said. “Value-based payments support physicians in taking on patients with increased complexity, such as multiple chronic diseases, which take more time and effort outside of routine office visits to effectively manage.”
This bill was referred back to the House Health Finance and Policy Committee where it likely will be included in the omnibus Health and Human Services bill.
Senate Tax Committee Supports Preceptor Tax Credit
The Senate Tax Committee heard SF 3563 (Senator Greg Clausen, DFL–Apple Valley), a bill that would allow a physician or other health care provider who volunteers as a preceptor for a health professional student or medical resident to qualify for a tax credit equal to $5,000.
Most preceptors work voluntarily and are rarely compensated. Given the valuable role they play in offering clinical training to future health care workers, this bill would offer an incentive for their time precepting.
Emily Onello, MD, an assistant professor at the University of Minnesota Medical School, Duluth campus, testified on behalf of the MAFP in support of the bill. Onello noted that “preceptors often do this work without compensation because they see the value in it.” She went on to say that this bill “will help recruit physicians to recruit others, ensuring we have a well-trained health care workforce in the future.”
SF 3563 was laid over for inclusion in a Senate tax omnibus bill.
MAFP Testifies in Support of Rural Training Grants
Deb Dittberner, MD, MBA, MAFP President, testified before the House Health Finance and Policy Committee in support of legislation for new grants to train primary care physicians and other professionals.
HF 4576 (Representative Tina Liebling, DFL-Rochester) includes a number of provisions for the Department of Health, including new grants for the following:
- a new rural residency program
- rural clinical training settings for medical students and other professionals
- community health workers
These provisions are designed to address the looming shortage of rural physicians in Minnesota.
“Expanding our primary care physician workforce is about more than just increasing the supply,” said Dittberner, “It is about reinvigorating the practice of primary care—to keep the number of physicians we have and to make the profession more attractive to young physicians.”
Legislation to Preserve Access to Needed Prescription Drugs Heard
A bill that prevents insurers and pharmacy benefit managers (PBMs) from forcing a patient to change to a new medication during the contract year, once a therapy has begun, was heard in the House Health Finance and Policy Committee last week.
Nothing in current law prohibits insurers and PBMs from changing their drug formulary or preferred drug list at any time during the year, a practice sometimes referred to as “non-medical switching.” Yet, an enrollee in a health plan is bound to remain in that health plan for the remainder of their enrollment year. This legislation would protect patients by prohibiting insurers from the practice of non-medical switching for an enrollee who has started a drug therapy that is working.
The legislation, HF 58 (Representative Steve Elkins, DFL–Bloomington), addresses four key points:
- Requires drug manufacturers to annually report drug prices and only increase prices if they provide the Commissioner of Commerce a 90-day notice.
- Requires insurers and PBMs to use a real-time prescription benefit tool that informs prescribers in real-time what drugs are covered.
- Requires insurers to provide a 60-day notice to prescribers, pharmacists and enrollees prior to making any changes to the utilization review requirements related to drug coverage.
- Prohibits insurers or PBMs from forcing patients who are taking a covered medication to another medication through the remainder of their contract year.
The bill does not prohibit PBMs from changing their formularies throughout the year. Insurers and PBMs would still be allowed to add new drugs if desired and add new generic brands when they become available.
This legislation was laid over for inclusion in the House Health and Human Services omnibus bill.
Legislation to Help Patients with Chronic Pain Receives Support
A bill intended to protect patients with chronic pain from forced tapering of their medications and ensure safety in opioid prescribing passed the Senate Health and Human Services Committee last week.
The bill addresses unintended consequences of past legislation and of opioid prescribing guidelines aimed at reducing the use of and dependence on opioids. SF 3566 (Senator Greg Clausen, DFL-Apple Valley) and its House companion HF 3786 (Representative Robert Bierman, DFL-Apple Valley) ensure that patients with severe, chronic pain have access to the opioid prescriptions they need.
Based on the misinterpretation of some opioid prescribing guidelines, some patients with severe, chronic pain report that prescribers have been forced to reduce their use of long-term opioids, even when that reduction has not been in the patient’s best interest. These instances of forced tapering are the result of how some health plans, pharmacy chains and others have interpreted the Centers for Disease Control and Prevention guidelines designed to reduce the overuse of opioids.
This legislation has received strong bipartisan support in both the House and Senate.
Pregnancy Care Bills Pass House Committee
A pair of bills relating to pregancy care—HF 4146 and HF 4145, both authored by Representative Kelly Morrison, MD (DFL, Deephaven)—were heard in the House Health Finance and Policy Committee on March 22, 2022.
1) Last session, lawmakers passed legislation that removed the requirement for physicians to report to social services pregnant persons who are using or abusing controlled substances. The legislation allowed provider discretion as long as the patient was continuing prenatal care and working with their provider on their care plan. This was to remove barriers to prenatal care and to help improve patient outcomes.
However, the practice of mandatory reporting is continuing as health care systems are unclear when it is appropriate to report or not. HF 4146 establishes a Task Force on Maternal Health and Substance Use Disorder that will be made up of legislators, health care practitioners, law enforcement and others to develop uniform standards for when medical professionals should or must administer and report the results of toxicology tests for prenatal exposure to a controlled substance. The task force would also evaluate family-focused substance use disorder treatment models.
2) HF 4145 requires Medical Assistance (MA) and MinnesotaCare to reimburse for the provision of long-acting reversible contraceptives (LARC) immediately following a delivery, if requested by the patient. The bill also makes it clear that the placement and removal of LARCs shall not require a co-payment and deductible. Currently, the Department of Human Services says they cover LARCs, but they do not provide an additional reimbursement beyond the global payment that is made for delivery services.
LARC methods such as intra-uterine devices (IUDs) and subdermal contraceptive implants are among the most effective forms of contraception. They can be safely placed immediately following childbirth prior to hospital discharge. In the U.S., an estimated 45% of pregnancies are unintended, and one-third of all pregnancies are conceived within 18 months of delivery. This bill attempts to ensure access to contraception in the postpartum period to reduce unintended pregnancy, improve health outcomes and reduce costs.
Both pieces of legislation were laid over for possible inclusion in the House Health and Human Services omnibus bill.
Legislative Committee Deadlines: Next Deadline—April 1
While bills can be introduced anytime throughout legislative session, the Legislature establishes annual deadlines for committee action on bills. This means bills need to meet certain deadlines to remain on track for passage.
- First deadline: March, 25, 2022: Bills needed to be favorably acted upon in all policy committees in either the House or Senate before this date.
- Second deadline: April 1, 2022: Bills will need to have passed all policy committees in both chambers to be considered “alive” (does not apply to finance-related committees).
- Third deadline: April 8, 2022: Committees need to act favorably on major appropriation and finance bills. By then, budget targets will need to be established by leadership for committees to pass major tax and spending bills.