February 2, 2004

MHA's Monday Executive Briefing
February 2, 2004

Quote of the Week
"Yes, but the Rover didn't have to go through Congress."
Former Senator Bob Dole, explaining why it may have been easier to land the robotic Mars Rover than providing health insurance to every American

In this week's edition...
- State News -
1. MHA's Legislative Liaison available during Session
2. McCoy works on plans for House action
3. Freshman Upshaw named Insurance secretary
4. Mims introduces bills to curb lawsuit abuse
5. House approves bill to let optometrists prescribe drugs
6. Barbour unveils executive budget
7. No GOP Primary for Mississippi
8. Barbour State of the State text
- National News -
9. CMS plans education on coordination-of-benefits transactions
10. Hospitals in JCAHO preparedness study have until Feb. 6 to respond
11. President proposes $274 million in FY05 funding to improve bio-surveillance
12. Congress to target the uninsured, increasing liability costs, aides say
13. AHA Hospital Investment Practices Questionnaire now available
14. Senators Frist, Clintonoutline health care plans at conference
15. Senate passes pension reform bill, to be reconciled in conference
16. CMS extends comment period for psych PPS rule
17. Online resource for the presidential candidates' positions on critical health policy issues
18. Bioshield bill expected to win approval soon
19. Bill would require hospitals to report illegal immigrants for reimbursement
20. Bush calls for medical liability reform during visit to Arkansashospital>

- State News -

1. MHA's Legislative Liaison available during Session
   MHA has begun a new newsletter, The Legislative Liaison, that will only be published during the Mississippi legislative session each year. This newsletter is automatically e-mailed to chief executive officers and members of MHA's Grassroots Leadership Initiative. If you would like to receive this newsletter, please e-mail Shawn Lea at slea@mhanet.org with your name, title, e-mail address and phone number (if there is problems with the e-mail).

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2. McCoy works on plans for House action
   Speaker Billy McCoy says he's working on a comprehensive plan so the Mississippi House can help develop the state economy, protect public safety and improve schools, transportation and health care. He solicited two ideas from each of his 121 colleagues. He said one idea should affect the state budget in some way. The other should be an intangible goal about how to improve the state. Rep. Cecil Brown, D-Jackson, is helping McCoy compile the ideas into long-term and short-term plans.
   In some cases, the plans could lead to the introduction of bills by the end of February. In other cases, the ideas could lead to a long-term study of issues."It doesn't mean that's all we'll do. It doesn't mean we'll do all that. But at least we'll have some specific goals... rather than wandering in the wilderness," said McCoy, D-Rienzi. McCoy said the House plans could incorporate some ideas from Republican Gov. Haley Barbour, who took office Jan. 13.

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3. Freshman Upshaw named Insurance secretary
    Freshman Rep. Jessica Upshaw, R-Diamondhead, was elected secretary of the House Insurance Committee recently. "It's exciting to be given this opportunity as a freshman," she said. Upshaw, a lawyer, is being given many opportunities - and much responsibility - in her first term. She's serving on six House committees and was chosen for two Judiciary subcommittees.

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4. Mims introduces bills to curb lawsuit abuse
    Echoing campaign promises, four bills authored by freshman Rep. Sam Mims V, R-McComb, aim to curb lawsuit abuse in Mississippi. Mims’ bills propose capping pain and suffering damages in civil lawsuits at $250,000, protecting sellers who may have sold defective products, preventing jury shopping and establishing a medical review board to decide if a malpractice suit bears merit.
   Mims, who works for SouthwestMississippiRegionalMedicalCenter, stressed the need for more tort reform while running for the District 97 seat last year. House bill No. 556 proposes capping non-economic, or pain and suffering damages, at $250,000. Under the proposal, caps on non-economic damages will not apply in cases in which a jury may reward punitive damages.
   House bill No. 555 suggests granting “innocent sellers” protection from lawsuits dealing with defective products that caused damages, deaths or injuries. The bill states the manufacturer of the product, not the seller, would be held accountable for its defects.
   House bill No. 498 suggests requiring civil cases to be heard in the court district where the first disputed “act or omission” that gave rise to the civil case occurred. If cases with multiple claims are combined into a class-action lawsuit, the trial’s venue must be related to each separate claim. If plaintiffs aren’t from the court district the case is being heard in, the civil action will be taken off the court’s docket and transferred to another venue.
   House bill No. 496 calls for the establishment of a “medical review panel” to examine medical malpractice claims to be argued in a state court. “If you file a lawsuit against a doctor, the doctor would have a lawyer and go before a medical review board of his peers,” Mims said. If the medical review board finds no grounds in the claim against the doctor, “the person who brought the lawsuit would pay for the doctor’s lawyers fees,” Mims said.
   The bill also outlines guidelines for filing requests for the panel to review a claim, the selection of review panel members and chairman as well as the qualifications they should hold, the panel’s procedural guidelines and guidelines for panel members’ pay. Mims’ waged pro-tort reform war is not being fought alone, as other representatives have filed similar bills.
    Reps. Roger G. Ishee, R-Gulfport, and Bill Denny, R-Jackson have filed similar House bills, which seek to protect sellers against defective product suits and make trial venue selections a more stringent process. All the bills must be heard before the House Judiciary A committee before they are voted on. That committee’s chairman is Rep. Edward Blackmon, Jr., D-Canton, a prominent trial lawyer whose wife, Barbara Blackmon, unsuccessfully ran for lieutenant governor against the pro-tort reform incumbent, Amy Tuck.

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5. House approves bill to let optometrists prescribe drugs
   The House on Tuesday passed a bill that would allow optometrists to prescribe narcotic drugs and perform "minor" surgical procedures. The bill, which passed 82-35, now goes to the Senate. Supporters said the bill would help provide rural residents with access to eye care. Ophthalmologists oppose the bill, saying optometrists lack the necessary medical background. Optometrists are graduates of optometry schools who provide primary eye care. Ophthalmologists are medical school graduates who work with the whole eye and may perform surgery.
   There are about 200 optometrists in 76 of Mississippi's 82 counties, said Rep. Steve Holland, D-Plantersville. Holland, chairman of the House Public Health and Human Services Committee, said of the 130 ophthalmologists in the state, one-third are in the Jacksonmetropolitan area. "None live in the rural areas of the state," he said.
   Forty-one states, including those surrounding Mississippi, allow optometrists to prescribe pain killers and other narcotics. In Mississippi, optometrists can only use external medicine on their patients. Under the House bill, optometrists could prescribe Schedule III, IV, and V narcotics. The bill is House Bill 279.

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6. Barbour unveils executive budget
   Governor Haley Barbour says a couple hundred state employees could lose their jobs under his budget. He released his spending plan Wednesday, saying said it could reduce the state's budget gap from $709 million this year to $356 million next year.  The governor said he wants to temporarily remove civil-service protection from executive branch agencies, including the departments of corrections and human services. He says this would allow $25 million in savings when people are fired or moved to different jobs.
   The governor's plan also could require state employees to pay out of their own pockets for health insurance. Right now, employees pay no premiums for themselves, only for their dependents. Their annual deductible is $450. Barbour says workers should have the option of paying higher premiums to get lower deductibles.

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7. No GOP Primary for Mississippi
   Mississippiwill not have a republican primary on March 9, known as "Super Tuesday".  The state party made the decision because there's no other republican candidate challenging President Bush for the party nomination.  It will save election officials from having to staff the polls with personnel to accommodate those who would cast ballots in the GOP primary. The Democratic Party will have its primary statewide. Several democrats are competing in the presidential race.  Polls will be open in Mississippifrom 7:00 a.m.to 7:00 p.m.on March 9 for registered voters to participate in the democratic primary.

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8.  Barbour State of the State text

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- National News -

9. CMS plans education on coordination-of-benefits transactions
   If you've been having problems processing coordination-of-benefit transactions, the Centers for Medicare and Medicaid Services would like to know about it, and soon: The agency is giving covered entities until tomorrow to send in their reports of any problems they might be having processing COB transactions with states and other third-party payers. Many of the problems being reported now stem from changes under HIPAA in the way Medicare treats inpatient and outpatient claims. Based on the responses to it request for comments, CMS may conduct provider education on data requirements under HIPAA. If you have any problems to report with COB third-party transactions, please send your comments to Mklischer@cms.hhs.gov . In the subject line, put the words PROVIDER IMPACT.

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10. Hospitals in JCAHO preparedness study have until Feb. 6 to respond
   The Joint Commission on Accreditation of Healthcare Organizations has extended to Feb. 6 the response date for hospitals participating in a JCAHO emergency preparedness study. In mid-January, JCAHO sent a letter to the CEOs of roughly 1,500 randomly selected hospitals to invite them to participate in the study, funded by the Agency for Healthcare Research and Quality to better understand existing hospital-community linkages based on a nationally representative sample of hospitals. The study will compare linkages between organizations that have experienced or are at high risk for a disaster with those that have not had such experiences or exposures, and identify exemplary practices to share with the field. In addition, the study's seven-part questionnaire addresses community-wide education, training and drills; supplies and equipment; surveillance, reporting and feedback; laboratory capacity; surge capacity; incident management; and communication. For more information, contact JCAHO's Nicole Finn at (630) 792-5976 or nfinn@jcaho.org, or Barbara Braun at (630) 792-5928 or bbraun@jcaho.org.

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11. President proposes $274 million in FY05 funding to improve bio-surveillance
   President Bush will propose budgeting $274 million in fiscal year 2005 for a Bio-surveillance Program Initiative designed to protect the nation against bioterrorism, the departments of Health and Human Services and Homeland Security announced today. The initiative would enhance and integrate existing surveillance programs in areas such as hospital and local preparedness, vaccine research and procurement, food safety and environmental monitoring, officials said. HHS would allocate $130 million to the Centers for Disease Control and Prevention to improve linkages between public health laboratories and border health and quarantine stations, while DHS would use $129 million to enhance its bio-surveillance efforts. "Better bio-surveillance will mean early detection and improved response to bioterrorism and other public health emergencies," HHS Secretary Thompson said. For more, see the announcement at www.hhs.gov.

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12. Congress to target the uninsured, increasing liability costs, aides say
   Congressional staffers Thursday told attendees at the National Health Policy Conference in Washingtonthat tackling the problem of the uninsured and containing increasing medical liability costs will be major objectives for Congress in 2004. The speakers noted that Medicare reform was accomplished in bipartisan fashion last month, and said that while differences are sure to arise, they hoped for further bipartisan efforts on these and other health care issues in this election year. "We're leading into a new year where health care is fast becoming one of the next signature issues," said an aide to Senate Majority Leader Bill Frist, R-TN, noting that health care has been the No. 1 or 2 issue in voter exit polls in New Hampshire and Iowa. Aides representing various majority and minority members of the Senate Finance, House Waysand Means, and House Energy and Commerce committees addressed the conference, sponsored by AcademyHealth and Health Affairs journal.

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13. AHA Hospital Investment Practices Questionnaire now available
   For more than a decade, the AHA has produced the Hospital and Multi-Hospital System Investment Practices Survey. The survey identifies trends in health care investment strategies and provides benchmarking data on such issues as the size, returns and allocation of corporate assets, types of retirement and pension plans offered, and healthcare foundation and endowment investment strategies. The investment consultant to the AHA Investment Program, CCM Advisors LLC, conducts the research. The 2004 questionnaire is now available on-line at  www.ahafinancialsolutions.com. To request a paper copy, call Polly Mulford at (800) 242-4677 ext. 2526.

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14. Senators Frist, Clintonoutline health care plans at conference
   Senate Majority Leader Bill Frist, R-TN, and Sen. Hillary Rodham Clinton, D-NY, last week outlined their respective health care proposals for 2004 at the World Health Care Congress convention in Washington, D.C. Frist touched on many of the health care issues in the president's State of the Union address, including the need to focus on the problem of the nation's uninsured, which numbered more than 43 million in 2002, and the need to enact meaningful tort reform legislation as it applies to medical liability claims. The senator also said he plans to introduce legislation next month aimed at reducing health care disparities. Clinton discussed a five-point plan she recently introduced in legislation (S. 2003) that calls for increasing research on health care quality and improving investments in information technology, among other provisions. She also suggested a revolving loan fund be created to help health care providers with IT costs.

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15. Senate passes pension reform bill, to be reconciled in conference
   The Senate voted 86-9 to approve legislation that would replace the 30-year Treasury bond rate used to calculate employers' pension plan contributions with a corporate bond index, a change supported by hospitals and other employers. The legislation now will go to a conference committee to reconcile differences between the Senate bill and a bill passed by the House Oct. 8. Temporary congressional rate relief expired Dec. 31, 2003, promising to send contributions, required as soon as April, even higher without relief.

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16. CMS extends comment period for psych PPS rule
   The Centers for Medicare and Medicaid Services is extending the comment period for the proposed prospective payment rule for psychiatric facilities by 30 days to Feb. 26; the notice of extension is scheduled to be published in the Jan. 30 Federal Register. CMS is extending the original Jan. 27 deadline to allow those submitting comments more time to analyze the potential impact of the proposed rule. Published Nov. 28, the rule would replace the current cost-based system used to reimburse psychiatric hospitals and units with a prospective payment system, as required by a 1999 law. Don May, AHA vice president for policy, said that while the AHA supports the move to a prospective payment system, the rule, as proposed, would have a significant financial impact on many hospitals with distinct-part psychiatric units, and ultimately could result in unit closures. May said the AHA plans to post its key concerns with the rule to www.aha.org and is encouraging hospitals affected by the rule to refer to the AHA key points to supplement their comments. He also emphasized that those who have already submitted comments may re-submit their comments to CMS to provide additional concerns and recommendations.

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17. Online resource for the presidential candidates' positions on critical health policy issues
   Kaisernetwork.org, the Kaiser Family Foundation's health policy news and information website, introduces a new online resource that provides easy access to the candidates' positions on critical health policy issues, as well as election-related news and analysis. Access the Election 2004 Issue Spotlight  here. 
   Features include:
-- Candidate profiles, including issue statements, speeches, audio/video interviews and transcripts, news coverage, and additional resources on all major candidates.
-- A searchable archive of public opinion questions on health issues related to the election.
-- A reference library of election websites and publications.
-- Multimedia resources, including webcasts of interviews, discussions, and debates.
-- Election-related health news headlines.
   The Election 2004 Issue Spotlight will be updated regularly to include new information and developments throughout the campaign cycle. If you have any questions about this or any of the Foundation's resources, please call 202/347-5270 or send an email to webmaster@kff.org.

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18. Bioshield bill expected to win approval soon
   Federal health officials said January 22 that they believe Congress will soon pass the Project Bioshield bill, which aims to strengthen the country's biological defenses and loosen restrictions on hiring biological experts and the use of emergency drugs, GovExec.com reports. House lawmakers passed the legislation last year, but it stalled in the Senate after some senators voiced concerns that the bill would allow the White House to give out large, no-bid contracts.
   Project Bioshield includes a nearly $6 billion incentive for drug companies to develop otherwise unprofitable medicines, vaccines, and countermeasures to combat biological weapons. While Congress has already approved that funding, lawmakers are still debating portions of the plan that allow the government to use unlicensed drugs in the event of a biological terrorist attack and ease limits on drug procurement and hiring at the National Institutes of Health.

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19. Bill would require hospitals to report illegal immigrants for reimbursement
   Legislation introduced last week by Rep. Dana Rohrabacher, R-CA, would require hospitals to report illegal immigrants to receive any of the $1 billion in federal funding provided in the Medicare Prescription Drug, Improvement, and Modernization Act to help reimburse hospitals with high percentages of illegal immigrants for some of the costs of providing emergency care to such patients. AHA views the Rohrabacher legislation, H.R. 3722, as misguided. "Hospitals have a mission to treat everyone who walks through their doors," said Tom Nickels, AHA senior vice president of federal relations. "Hospitals are not the border patrol. They care for the patient first and ask other questions later."

20. Bush calls for medical liability reform during visit to Arkansashospital
   During a visit last week to BaptistHealthMedicalCenterin Little Rock, AR, President Bush called for an end to frivolous lawsuits that dramatically increase the cost of medical liability premiums. A spokesman for the Arkansas Hospital Association who attended said Bush strongly urged Congress to support medical liability reform, noting that such lawsuits were damaging to access of care since high premiums force doctors into early retirement and out of the community. Prior to the speech, Bush met with state hospital executives and examined various case studies on the affects of liability lawsuits on the community. The Arkansaslegislature recently passed a $1 million cap on punitive damages in medical liability lawsuits.

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