The Journal of the Arkansas Medical Society Med Journal June 2019 Final

CP: CRNA bills? SS: There was an AMS-opposed CRNA bill (SB184/Gary Stubblefield-R, Justin Gonzales-R) that had plenty of support from the other side. This would have removed physician supervision from CRNAs. It failed on its first attempt to pass the House Public Health Committee. On second at- tempt, it passed by one vote. It then failed on two occasions on the House floor due to overwhelm- ing lobbying efforts by the AMS and the Arkansas Society of Anesthesiologists. This was a close call, but thankfully, a win. CP: Were there any other AMS-opposed bills defeated? SS: There were several. One that comes to mind was an attempt to gut the Clean Indoor Air Act. The bill (HB 1696/Justin Gonzales-R, Mark Johnson-R) was an effort to poke a hole in the law by exempting all private businesses. The exemp- tion would have engulfed the rule, basically. AMS was prepared to help fight this bill, but it failed to get out of committee. CP: Telemedicine has been a big fight in re- cent years. What happened this year with telemedicine that stood out? SS: That shows the ridiculous nature of their argument. Even Teladoc agrees that leaving voice mail is no way to establish a relationship, and yet they want a simple phone call to suffice. CP: Could you describe more AMS-sup- ported legislation that successfully passed into law? DW/SS: Despite massive resources that went into defeating bad bills from the opposition, AMS worked with legislators to draft and pass the majority of its own good legislation. These wins included the following: • The fetal alcohol syndrome bill (HB 1861*/ Deborah Ferguson-D) requires establish- ments that have a permit to serve alcohol to post a sign warning of the dangers of preg- nant women consuming alcohol. • Health care contracting (SB 480/ Act 734/ Missy Irvin-R, Mark Lowry-R) and assign- ment of benefits (SB 512/Act 736) are two new laws that give physicians and other health care providers more leverage in con- tracting with insurance carriers. Act 734, among other things, prohibits so-called “all- products clauses.” Act 736 requires insur- ance carriers to recognize and accept as- signment of benefits for services provided by out-of-network providers. • The identification disclosure act (SB 527/Act 706/Cecile Bledsoe-R, Deborah Ferguson-D) requires insurance companies to clearly indi- cate on ID cards whether a plan is “insured” or “self-funded.” This will make it easier for clinics to determine whether a patient’s in- surance is governed by state or federal rules. • An amendment to the Patient Protection Act prohibits an insurance company from terminating a physician’s network member- ship over peer-review actions that do not involve standard of care or potential harm to patients. Essentially, this makes it clear to insurance carriers that if there’s a disciplin- ary action taken, that action must pertain to a patient-care issue. • A prior authorization bill (HB 1656*/Deborah Ferguson-D, Cecile Bledsoe-R) will prohibit prior authorizations for medication-assisted treatment for opioid abuse. > Continued on page 272. SS: The telephone-only bill (HB 1220/Dan Sullivan-R) was a telemedicine bill supported by a single telemedicine vendor, Teladoc. This was strongly opposed by AMS. The bill would have removed safeguards that AMS fought hard (for two sessions in a row) to achieve and would have allowed the doctor-patient relationship to be es- tablished without the physician ever having to see the patient in person or through audio-visual equipment – in other words, by telephone only. Teladoc amended its bill a couple of times to try to get it out of committee. It failed in House Public Health Committee, was amended and passed the second time by one vote, and then failed on two occasions to pass the House. DW: Representatives of Teladoc continue to try to make the case that Arkansas is the only state in the country that doesn’t allow “audio only” to establish a doctor-patient relationship. This is contrary to evidence from other states that this is not the case. An interesting note on the telemedicine discussion: Teledoc’s representa- tives, with a straight face, tried to make the case that states that prohibit “audio only” meant sim- ply that you could not use voice mail (a one-way communication). IT’S TIME TO FIGHT BACK Collectively, we can all work together to help combat the opioid epidemic that is destroying families and communities across the nation. We are excited to introduce our new educational training portal for medical professionals like you. These online professional education courses are available at no cost to you 24/7 so you can access them on your schedule. There are three ways to learn: visit artakeback.org/opioid-education/sign-up-for-opioid-education watch a weekly interactive video conference at arimpact.uams.edu learn on-demand with our new UAMS CME/CE portal at learnondemand.org. NUMBER 12 JUNE 2019 • 271

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