Two Weeks to Go in MN Legislative Session: Health-Care-Related Updates

The Minnesota Legislature has about two weeks left in the 2022 Legislative Session.
 
Minnesota Academy of Family Physicians (MAFP) legislative rep Dave Renner, CAE, provides an update from the Capitol, including:

  • The passage of frontline worker pay.
  • Continued movement on MAFP priority issues (e.g., updates to the All-Payer Claims Database, rural primary care residency training funding and limits to mid-year formulary changes).
  • Mental health support for health care workers and more.

Leaders Compromise on Frontline Worker Pay, Unemployment Insurance 

One good sign that shows a split legislature can find agreement is the deal reached on “hero pay” for Minnesota’s frontline workers and settling the state’s unemployment insurance debt. 
 
Legislative leaders announced that $500 million will be distributed to approximately 666,000 frontline workers in the form of $750 checks. Frontline workers include those who work in health care, long-term care, public health, corrections, childcare, schools, food service, retail, public transit and building maintenance, who were employed for at least 120 hours between March 15, 2022, and June 30, 2021, and not able to work remotely. The final bill includes income limits for qualified health care workers of $350,000 for married taxpayers and $175,000 for single taxpayers.
 
The compromise bill also included $2.7 billion to repay the $1.3 billion unemployment insurance debt the state owes the federal government and refill the state’s unemployment insurance fund to its pre-pandemic amount. This was money used at the start of the pandemic that the state was required to pay back.
 
The bill was signed into law by Governor Walz on April 29, 2022, resolving one of the largest legislative deadlocks of the session. 

House & Senate Pass Health & Human Services Omnibus Bills

The Senate passed its version of the Health and Human Services (HHS) omnibus bill on April 26, 2022. The bill includes:

  • $1 billion for long-term care workers, personal care attendants and disability care providers and an additional $322 million to address staffing and other workforce shortages in care facilities. This effort was led by Senator Jim Abeler (R-Anoka) and Senator Karin Housley (R-Stillwater). 
  • Language that would add Minnesota to the interstate nurse licensure compact, a nationwide agreement allowing nurses in other states to obtain one license to be valid across all member states. This is strongly supported by many of the state’s health care systems and strongly opposed by the Minnesota Nurses Association. 
  • Language to ensure patients with chronic pain have access to needed, ongoing opioids. Physicians who prescribe opioids cannot be sanctioned solely for exceeding arbitrary dose limits that may not be best for patients.
  • Changes to physician and other health care worker licensing, designed to streamline the criminal background check process for health care workers and to issue a temporary, 90-day license at the time of application for individuals licensed in another jurisdiction who are applying for a license in Minnesota. 

The House passed its version of the HHS omnibus bill on May 3, 2022. The bill includes a number of priority issues for the MAFP:

  • Updating the All-Payer Claims Database (APCD) to authorize the collection of non-claims-based payment information. Currently, more and more physician payments are value-based payments that are not included in a claim, which means we are not gathering the right information on how we pay for health care. Language also directs the Minnesota Department of Health to report how much of non-claims-based payments are paid for primary care services.
  • Funding for new primary care rural residency training grants to train more physicians in rural areas. It also includes increased funding for loan forgiveness programs for physicians and others who practice in rural and underserved regions.
  • Limiting the ability of insurers and pharmacy benefit managers to force patients to change their drug therapy in the middle of their enrollment year. The bill’s language protects patients who have started a drug therapy and are told by their insurer that they must change drugs mid-year. For many patients, especially those with chronic conditions, they often select their insurance plan because the medication they need is covered. Yet, nothing in current law stops an insurer from changing their drug formularies in the middle of a contract year, even though the patient cannot get out of that coverage for the rest of the year.

Also included in the bill:

  • Expansion of MinnesotaCare coverage.
  • “Buy-in” option to allow more Minnesotans to purchase coverage through MinnesotaCare.
  • Language for the development of a statewide registry for completed Provider Orders for Life Sustaining Treatment, or POLST, forms.
  • Expanded coverage of tobacco cessation services by Minnesota’s public programs.
  • Language protecting patients with chronic pain from forced tapering of their opioids.

Because the language in the House and Senate bills include many differences, a conference committee must meet and hash out the differences if a final bill is to pass.
 
Senate conferees include Senators Jim Abeler (R-Anoka), Michelle Benson (R-Ham Lake), John Hoffman (DFL-Champlin), Mark Koran (R-North Branch) and Paul Utke (R-Park Rapids). House conferees include Representatives Tony Albright (R-Prior Lake), Aisha Gomez (DFL-Minneapolis), Tina Liebling (DFL-Rochester), Dave Pinto (DFL-St. Paul) and Jennifer Schultz (DFL-Duluth).
 
The conference committee is scheduled to begin meeting on May 9, 2022, and needs to reach agreement before the Legislature adjourns (which will be before May 23, 2022). 

Senate Mental Health Package Passes Committee 

The Senate Finance Committee added an amendment to its omnibus mental health bill (SF3249) that allocates $2.34 million for grants to fund “programs that are evidenced-based or evidenced-informed and are focused on addressing the mental health of health care professionals.” 
 
The amendment, offered by Senator Michelle Benson (R-Ham Lake), is a one-time appropriation to address growing mental health concerns experienced by physicians and other health care professionals amidst the COVID-19 pandemic.  
 
Grants would be available to health care systems, hospitals, nursing facilities, community health clinics or consortium of clinics, Federally Qualified Health Centers, rural health clinics or health professional associations “for the purpose of establishing or expanding programs focused on improving the mental health of health care professionals.” 
 
“We know that health care workers have been incredibly stressed through this pandemic,” Benson expressed in committee. Chair Senator Julie Rosen (R-Vernon Center) and Benson also credited Senator Matt Klein, MD (DFL-Mendota Heights), with his work on this effort. In past committee meetings, Klein noted that physicians are experiencing not only burnout, early retirement and workforce shortages, but increased violence, hostility and rates of suicide.  
 
The bill passed the committee and was referred to the Senate floor. 

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