Health Care Legislation Update

By:  Tyler S. Lemen and Alyssa C. Hughes

Summer isn’t only about the outdoors and hotdogs (though we do contend those are essential elements of the season).  Every year on July 1st, the most recently passed statutes take effect.  For the busy professional, we understand it can be a challenge to stay abreast of the recent updates within your field.  Below, you’ll find a brief overview of the new statutes affecting health care practitioners in Indiana.  For each, we’ve included an outline of the bill’s substance, practice areas it may affect, why it could be important to you, and the effective date.  Enjoy, and don’t forget to wear sunscreen!

House Bill 1116 – Dental Hygienist Access

Who: Dentists, Dental Hygienist

What: Broadens the areas in which a licensed dental hygienist may practice.  A licensed dental hygienist may now practice unsupervised when practicing under an access practice agreement with an access practice dentist. The bill lays out specific requirements for both access practice agreements as well as qualifications required of the dental hygienist.

Why it might be important: If you’re in the dental world and are looking to reach more patients, this bill may allow a dental practice to increase its daily exposure to patients looking for routine cleanings and care.  Effective date: July 1, 2018.

House Bill 1117 – Nursing Facility Medicaid Reimbursement Rates

Who: Nursing Facilities

What: Changes nursing facility reimbursement rates. In determining nursing facilities’ reimbursement rates for services provided to Medicaid recipients, the Office of Medicaid Policy and Planning shall use the report card score published by the Indiana State Department of Health on June 30, 2017, to establish the nursing facility’s total quality score.

Why it might be important: This bill will change the way reimbursement is calculated before being paid to a nursing facility and will reward those facilities that do well on periodic regulatory surveys. Effective date: July 1, 2018.

House Bill 1119 – Physician Order for Scope of Treatment (POST) and Consent

Who: Physicians and Health Care Providers

What: This bill includes several changes to POST forms and establishes a priority order to determine who makes health care decisions on behalf of an incapacitated adult.  This priority level allows multiple individuals with the same priority level (as established by this statute) to reach a consensus on health care decisions; if a consensus cannot be reached, majority controls.

Effective date: July 1, 2018.

Why it might be important: This bill provides updates to the POST forms.  Further, there is clear guidance on determining who makes health care decisions for incapacitated adults.

House Bill 1260 – Issuance of Hospital License

Who: Hospital Administrators

What: Beginning January 1, 2019, this bill permits the ISDH, after an initial survey, to issue a hospital license based on the hospital’s accreditation from a recognized accrediting agency.  If a hospital is not accredited by a recognized accrediting organization, ISDH must conduct an annual survey.  The bill allows the ISDH to investigate complaints against an accredited hospital for substantial noncompliance with accredited standards and requires the ISDH to conduct random validation surveys on behalf of the Centers for Medicare and Medicaid Services–when requested.

Finally, the bill requires the ISDH to work with recognized accrediting organizations to identify, develop, implement, and implement common accrediting and licensure standards.

Why it might be important: This bill provides another incentive for becoming an accredited facility.  Further, current accrediting and licensing standards may change based on the ISDH’s involvement.

House Bill 1317 – Health Matters

Who: Pharmacists

What: This bill forbids outside insurance companies from limiting a pharmacy or pharmacist’s right to provide individuals with information concerning the individual’s cost share for a prescription drug or discussing a more affordable alternative.  Further, the Board of Pharmacy is required to adopt rules concerning telepharmacy under the laws regulating remote dispensing facilities. Effective date: July 1, 2018.

Why this might be important: This bill protects pharmacists wishing to offer value to customers by preventing reprisal for recommending alternative medications.  Moreover, we will likely be seeing new telepharmacy laws.

House Bill 1384 – Chiropractors

Who: Chiropractors

What: This bill amends the definition of chiropractic, sets educational requirements, and expands the functions chiropractors are allowed to perform for the purposes of diagnosing and treating injuries, conditions, and disorders. Effective date: July 1, 2018.

Why this might be important: This bill includes many changes to the chiropractic code and should be reviewed by any professional practicing in this area.

Senate Bill 190 – Health Facility Certificate of Need

Who: Comprehensive Care Facilities

What: This bill establishes a comprehensive care facility certificate of need program administered by the ISDH and sets forth certificate of need application requirements and exemptions.

Why this might be important: This bill replaces the moratorium, preventing the licensure of new comprehensive care facilities, with a new licensing process. Also, it defines under what criteria new long term care beds may be added or constructed. This licensing process, unlike the limited term set by the previous moratorium, has no end date and will be used to license all new facilities.  Effective date: July 1, 2018.

Senate Bill 221 – INSPECT program

Who: Physicians, Pharmacists

What: This bill expands the manner in which dispensers of ephedrine, pseudoephedrine, or controlled substances sales information are transmitted to the INSPECT program.  Importantly, this bill sets timelines for the mandatory use of INSPECT prior to any prescriber issuing an opioid or benzodiazepine.  Beginning January 1, 2019, a practitioner who provides services to the patient in the emergency department of a hospital or a pain management clinic must utilize INSPECT.

Lastly, this bill requires practitioners to apply for certification to receive INSPECT information and sets a waiver procedure for bypassing the INSPECT check. Effective date: July 1, 2018.

Why this might be important: This bill is clearly aimed at continuing efforts to prevent abuse of opioid prescriptions.  All prescribers and dispensers should review this bill to ensure compliance with the updated statute.

Senate Bill 225 – Continuing Education Requirements

Who: Dentists, Physicians, Nurses, Pharmacists, Veterinarians, and other Health Professionals

What: This bill requires anyone licensed by a board as defined in Indiana Code § 25-1-9 to complete a minimum of two hours of continuing education during the previous two years addressing the topic of opioid prescribing and opioid abuse. Effective date: July 1, 2018.

Why this might be important: This bill will affect which continuing education courses must be completed prior to renewal of a professional license.