12/15/2022

Lame Duck Legislative Update

OSMA is proud to represent you and advocate on your behalf. Your OSMA Advocacy team has experienced a whirlwind of activity at the Statehouse after the election, and has been carefully monitoring what has happened during the lame duck legislative session.

As you may know, with a new general assembly set to begin in January, any introduced legislation not passed by the end of December must start back at the beginning of the legislative process. As of very early this morning, legislators have adjourned for the holidays and completed their formal activity for the year, finishing up sessions through the night Wednesday and into today’s early morning hours. Now that things have wrapped up, we are here to provide a report regarding the issues relevant to our members.

OSMA will continue to push for meaningful change for physicians and the practice of medicine in Ohio in the coming year. Stay tuned to our communications as the new general assembly begins!

Lame Duck Issues:

• Co-pay Accumulator 
  The time ran out for co-pay accumulator (House Bill 135) to fully make it past the finish line during lame duck, but it will be reintroduced next year. As you may know, this legislation passed out of the Ohio House in March, and there have been several hearings on the bill in the Senate since, including one during lame duck. OSMA provided supportive testimony for this hearing, but the bill was unfortunately not voted out of committee in time to reach the Senate floor for a vote.
  
  As a reminder, co-pay accumulator refers to situations that occur when health plans and pharmacy benefit managers (PBMs) apply co-pay accumulator adjustment policies when patients attempt to use copay assistance programs. These prohibit a patient’s copay assistance amount from count toward their deductible and maximum out-of-pocket cap. OSMA supported HB 135 as it sought to require insurers and PBMs to count all payments made by patients directly or on their behalf toward their deductibles and out-of-pocket costs, increasing predictability as vulnerable patients face high out-of-pocket costs for their prescriptions.

• Medical Marijuana
  Senate Bill 261 passed in the Ohio Senate last December and has since had five hearings in the House Government Oversight Committee, but it also ran out of time to fully pass through the legislature in this general assembly. This legislation aimed to make several major changes to Ohio’s medical marijuana program, including by adding several additional conditions to the list of eligible conditions for recommendation of medical marijuana in Ohio.
  
  Our advocacy team communicated with the bill sponsor regarding our opposition to the bill. There was no activity scheduled for Senate Bill 261 this week in the House, effectively ending the bill’s chances of further movement.

• Abortion
  There had been a possibility that legislators might further act on abortion with legislation during the lame duck session. Ultimately, nothing concrete materialized, so while OSMA expects the issue to continue to receive attention in the coming year, we no longer anticipate any major activity on abortion-related proposals at the Statehouse from this general assembly.
  
  OSMA has focused much of our attention regarding this issue on the overall impact and potential clinical and medical ramifications of legislative initiatives that further limit abortion following the decision regarding Roe v. Wade. This is a global medical issue, which has significant and broad implications, and OSMA aims to demonstrate to elected officials that the impact goes beyond the specific issue of abortion. OSMA will keep our membership informed about this issue into 2023, as this will continue to be a priority for our organization.

• Gender-Affirming Care
  Another issue that gained traction during this lame duck session is gender-affirming care for transgender youth, but it also did not pass through the legislature before time ran out. House Bill 454, which OSMA opposed, would prohibit medical professionals in Ohio from providing gender-affirming care to minors. OSMA supports individualized, gender-affirming, evidence-based treatment and clinical practices in caring for transgender and gender minority patients. We testified against the bill, concerned about the bill being detrimental to the physician-patient relationship, criminalizing necessary medical care, and creating a hostile environment for young people and their families - as well as for the healthcare professionals from whom they seek guidance and care. After a November hearing, the bill failed to proceed any further in the legislative process and we have seen the last of it for now. We do expect this issue may resurface in the New Year.

• Opioids
  A recent legislative proposal caused concern in the medical community due to the inclusion of provisions that would further limit opioid prescribing and create additional limits or burdens that could be a detriment to physicians and patient care. OSMA has been working to demonstrate that legislation like this, while well-intentioned, is neither necessary nor effective.
  
  This bill, House Bill 356, was originally scheduled for a hearing several weeks ago, and OSMA was prepared to provide joint opponent testimony with the Ohio Psychiatric Physicians Association for this hearing; however, it was removed from the committee agenda and ended up not being discussed at all. Therefore, we have seen the last of this legislation for now.
  
  OSMA has worked over the past several years to try to shift the focus of the response to the drug abuse and overdose crisis in the state, promoting reduction of barriers to mental health and substance use disorder treatment (including medication-assisted treatment), utilization of telehealth, and access to harm reduction services. We will continue this work in 2023, especially with many new legislators taking office in January.

• Scope of Practice – Midwives
  This year, OSMA opposed House Bill 496, which sought to license certified midwives in Ohio and regulate their practice. Our members had numerous concerns about provisions in this bill regarding scope of practice, eligibility criteria, and license requirements. Dr. Amy Burkett recently testified at the Statehouse on behalf of both OSMA and the Ohio Chapter of the American College of Obstetricians and Gynecologists. After this hearing, the bill did not progress any further, but we could see similar scope of practice issues arise next year.

• Scope of Practice – APRNs
  For most of this general assembly, efforts to increase scope of practice for advanced practice registered nurses (APRNs) saw little movement. Recently, a large scope bill dealing with global signature authority was introduced, but it appears that the sponsor did not intend for this bill to do what the language inside entailed. Fortunately, due to quick action by our advocacy team, OSMA was able to stop this legislation in its tracks. We expect that, as it has been for years, scope of practice for APRNs and other allied practitioners will continue to be an area of focus in our advocacy agenda moving forward. OSMA is prepared to continue to advocate for physician-led, team-based care in 2023 and beyond.

Thank you for your continued support of OSMA’s advocacy activities in 2022. Please stay tuned as OSMA wraps up this lame duck session and moves into the new general assembly in January!