tal funding because people aren ’ t suddenly going to stop drinking soft drinks .”
Giving a little more background on the tax , he explained , “ The state was facing a shortfall in Medicaid funding . To make up the money , they first tried to cut physician reimbursement . AMS and other organizations responded by filing a lawsuit – that resulted in the AMS vs . Reynolds Consent Decree that has been in place since . The governor still had to do something to cover the shortfall , so the Legislature passed a small tax — comparable to two cents per can of soft drinks — to go into a trust fund that supplies supplemental funding for Medicaid . It ’ s been in place for 25 years . After the Legislature adopted it , the bottling industry filed a referendum to repeal it in the General Election . In a surprise to them , the public strongly supported the tax , and because it was passed through a General Election , it now takes 2 / 3 ’ s vote of the Legislature to repeal it . We fought and beat this bill , even though it had several sponsors and had already been worked by the other side .”
Medicaid Recognizing APRNs as PCPs ( HB 1254 / Act 569 ) AMS opposed this because it will require Medicaid to recognize an APRN as a “ primary care provider authorized to carry out the
duties of a primary care case manager , including as the team leader of family practice professionals and the patient-centered medical home .” The bill was amended to prohibit an APRN from owning a patient-centered medical home . The bill passed .
CRNA “ In Consultation ” ( HB 1198 / Act 449 ) AMS opposed this bill that changes the requirement that CRNAs administer anesthetics “ under the supervision of ” a physician to administering anesthetics “ in consultation with ” a physician . The bill passed . Arkansas was not alone in its supervision requirements ( 21 other states have “ supervision of ” or “ under direction of ”). “ We are now somewhere in the middle as far as where we fit with other states ,” said Smith . “ A full 28 states mention neither ‘ under supervision of ’ nor ‘ under direction of .’ This bill passed , and we were not in favor of it .”
Pharmacist Oral Contraceptive Dispensing ( HB1069 / Act 408 ) The Society had soft opposition to the bill because the American College of OBGYN supported it . This legislation allows pharmacists to dispense oral contraceptives without a doctor ’ s prescription . Wroten reminds physicians , however , that “ they can dispense oral contraceptives from their offices as well .”
Certified Nurse Midwife Independent Practice ( HB1215 / Act 607 ) The Society opposed the bill until amending it to be neutral . The American College of OBGYN supported the bill . “ Under current law , certified nurse midwives must practice with a physician consultant – someone who practices obstetrics ,” said Wroten . “ This bill , as passed , removes that requirement . It doesn ’ t expand anything else , and it includes language – that the Society insisted on – saying that if a nurse midwife is going to do a birth someplace other than an accredited facility , they must have a transfer agreement .”
For the Win
The following bills passed with Society support and / or participation .
ARHome / Arkansas Works / Private Option ( SB 55 / Act 843 ) “ This is always a hard one ,” said Smith of the Society ’ s continued support for the perennial appropriation that maintains Medicaid expansion . “ Getting 75 % of the vote is always hard . It took five votes in the House to pass it .”
Physicians may remember that years ago , the Medicaid expansion issue went to the U . S . Supreme Court . After being allowed to stand ,
( Continued on page 16 )
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Volume 118 • Number 1 JULY 2021 • 15