Legislative Session by Casey L . Penn
Disheartening Losses , Reassuring Compromises
AMS Faced Unique Challenges During a Unique Legislative Session
H . SCOTT SMITH , JD
The practice of medicine , as it pertains to physicians and patients , took some punches during the 2021 Legislative Session . However , the hard work of the Arkansas Medical Society and a handful of medical-minded legislators helped mitigate the potentially detrimental effects of what the Society considered “ bad bills .”
“ To state the obvious , this was unlike any session we ’ ve had ,” said Scott Smith , JD , AMS governmental affairs director . “ No two sessions are alike , but COVID-19 restrictions brought a number of new challenges , such as limitations on how many people could be in a room . We know that a room full of physicians in white coats has a substantial impact on legislators , but there was none of that this year .”
In addition to the pandemic-associated difficulties presented this year , there were scopeof-practice battle scars waiting to happen . “ As you know , our most contentious issues are scope-of-practice issues ,” Smith continued . “ There are groups that we ’ ve been fighting for 16 years — such as CRNAs and APRNs . They come back year after year wanting to practice medicine without going to medical school . And , while we have been winning all these years , we had a significant loss and some big scares last session . And each time we win , as David Wroten has put it , ‘ We ’ re losing an arm and a leg .’
“ We finally got to the point where there was no stopping some of these bills . It was extraordinarily difficult . Compared to previous sessions , this one was disheartening because we had some true losses — the CRNA bill , the bill requiring Medicaid to recognize APRNs as primary care providers … those were real losses .”
There is a bright side , however . “ The result of that situation was that while we were not going to be successful at stopping some bills , we were extremely successful at working out compromises on many critical issues ,” said David Wroten , AMS executive director .
Compromising is never easy , and it can be impossible if all parties don ’ t leave the table feeling that they gained something . To achieve this , the AMS staff worked closely with physicians , legislators , and others — among them the Arkansas Academy of Family Physicians ; AMS Counsel , Mitchell , Blackstock , Ivers , & Sneddon , PLLC ; Representatives Lee Johnson , MD-R , Joe Cloud , MD-R , Deborah Ferguson-D , Denise Garner-D , Stephen Magie , MD-D ; and Senators Cecile Bledsoe-R , Missy Irvin-R , and Jonathan Dismang-R .
“ Dr . Johnson was particularly helpful during this session ,” credited Smith . “ An emergency-room physician in his second term , Rep . Johnson is well-liked and highly respected , and he was able to work in some very good amendments this year .”
Fighting Against Bad Medicine
Here is an overview of bills that AMS fought outright or supported only after compromises / protective language was added .
Arkansas State Medical Board Appointments ( SB 570 ) This bill , sponsored by Sen . Dan Sullivan , would have ended every Medical Board member ’ s term by December 31 , 2021 , and would have changed how future appointments would have been made . The bill failed on the Senate floor . “ This bill was simply a malicious attempt to lessen the governor ’ s appointment authority and to limit his consultation with AMS on medical-board appointments ,” said Wroten , noting that all other licensing boards are appointed in the same manner as the Medical Board .
Corporate Practice of Medicine ( SB 572 ) The Society stood against another Sullivan-sponsored bill that was defeated . “ This was a bad bill that would have allowed anybody to own a medical practice , amending the corporate practice of medicine statute ,” explained Smith . “ Essentially , venture capital firms could have owned and managed medical practices , with no oversight . We mounted a vigorous campaign against the bill , and though it made it through the Senate Public Health Committee , we were able to defeat it on the Senate floor … twice .”
Soft Drink Tax Repeal ( HB 1546 ) Sponsored by Rep . Lanny Fite and a host of others , this was an attempt to repeal a tax that serves as a savings account of sorts for the state ’ s Medicaid program . “ This was the first real effort by legislators to repeal the soda pop tax and replace that revenue with ‘ general ’ revenue ,” said Wroten , adding that the bill dates back to a huge deficit left in the Medicaid budget after Gov . Bill Clinton left office .
Wroten asked , hypothetically , “ What happens if there ’ s a shortfall in general revenue ? The soda pop tax is a consistent source of supplemen-
14 • The Journal of the Arkansas Medical Society www . ArkMed . org