Nurse Practitioner Council by L. Siegle 2/1/2015

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1 Week two of the 2015 Legislative Session ended with afternoon House committees cancelling bill hearings due to the snow storm. The Senate must have anticipated the storm because they went home on Thursday afternoon. The political environment is tense because of divided government with the House controlled by Republicans and the Senate controlled by Democrats. Each have a political strategy which may impede the movement of nonpartisan bills. The House Appropriations Committee is meeting as usual to prepare HB2 (state budget). They hear presentations from each department of state government accepting the lowest recommendation in anticipation of the new consensus revenue projection due early in February. Word continues to be there will be little if any new money. HB0029 DUTY TO REPORT CHILD ABUSE OR NEGLECT No Updated Egolf, Brian F. Scheduled: 1/29/2015 in: HCAT House Pre-filed Legislation [3] HSCAC/House Judiciary Committee-HSCAC- w/drn-house Judiciary Committee [4] DP/a-T NMNPC NM Nurse Practitioner Position: Priority: House Bill 29 (HB 29) amends language detailing persons whose duty it is to report known or suspected child abuse or neglect. House Bill 29 (HB 29) amends language describing the duty to report known or suspected child abuse or neglect. Section 1 (Section 32A-4-3 NMSA 1978 (being Laws 1993, Chapter 77, Section 97, as amended)), Subsection 1 is amended to strike language which removes licensed physician; a resident or an intern examining, attending or treating a child; a law enforcement officer; a judge presiding during a proceeding; a registered nurse; a visiting nurse; a school teacher; a school official; a social worker acting in an official capacity; or a member of the clergy from the list of those that must report known or suspected child abuse or neglect, and who has information that is not privileged as a matter of law and who knows or has a reasonable suspicion that a child is an abused or a neglected child. Further, in section 1.E, language is stricken ( any of the persons enumerated in is stricken) and replaced (with a person who makes a report pursuant to ) so that it now reads, A law enforcement agency or the department shall have access to any of the records pertaining to a child abuse or neglect case maintained by a person who makes a report pursuant to Subsection A of this section, except as otherwise provided in the Abuse and Neglect Act. Section 2 states and requests that The effective date of the provisions of this act be July 1, HB0054 ANESTHESIOLOGY ASSISTANT DEFINITIONS No No Espinoza, Nora Scheduled: 2/5/2015 in: HHC 8:30 AM House Pre-filed Legislation [3] HHC/HBEC-HHC NMNPC NM Nurse Practitioner Position: Oppose Priority: High The CRNAs have asked us to oppose this bill. House Bill 54 (HB 54) changes the definitions of anesthesiologist and anesthesiology assistant. House Bill 54 (HB 54) changes the definition of anesthesiologist to remove the requirement of being an Created by LegisTrax 1

2 employee of a department of anesthesiology of a medical school in NM. It also removes the requirement that an anesthesiology assistant be currently employed or to be employed by a university in New Mexico with a medical school. HB0122 SCOPE OF PRACTICE ACT No No McMillan, Terry H. House Pre-filed Legislation [3] HHC/House Judiciary Committee-HHC NMNPC NM Nurse Practitioner Position: Oppose Priority: This is the latest version of the bill we have helped to kill every year. It put a process into place that no other issue requires. House Bill 122 (HB 122) provides for a process to evaluate proposed changes to the scope of practice act House Bill 122 (HB 122) creates a new act called the scope of practice act which provides for a process to evaluate proposed changes to the scope of practice of health professions. Legislative committees or subcommittees will be assigned by the Legislative Council to review and make recommendations regarding proposed changes to the scope of practice. HB122 allows a member or licensee of a licensing board to make written request to the respective board for a hearing concerning a proposed change. The board upon receipt of the request shall notify the Legislative Council, collect data, including information from the proponent, conduct a technical assessment with the assistance of a technical advisory group established for that purpose, provide its analysis, conclusion and any recommendations to the legislative council. The Legislative Council shall assign a committee to review the proposed change of scope of practice. The committee shall also consider the analysis, conclusions, and recommendations of the licensing board. HB122 also requires the committee to ensure appropriate public notice of the committee s proceedings, invite testimony of persons with special knowledge of the field. Assess the proposal using the criteria that includes potential harm or benefit to the health welfare and safety of the consumer, the impact on cost, the impact on access, and quality of health care. Finally, the committee will summarize its assessment, analysis, and recommendations in a final report to the legislature. HB0122 SCOPE OF PRACTICE ACT No No McMillan, Terry H. House Pre-filed Legislation [3] HHC/House Judiciary Committee-HHC NMNPC NM Nurse Practitioner Position: Oppose Priority: House Bill 122 (HB 122) provides for a process to evaluate proposed changes to the scope of practice act House Bill 122 (HB 122) creates a new act called the scope of practice act which provides for a process to evaluate proposed changes to the scope of practice of health professions. Created by LegisTrax 2

3 Legislative committees or subcommittees will be assigned by the Legislative Council to review and make recommendations regarding proposed changes to the scope of practice. HB122 allows a member or licensee of a licensing board to make written request to the respective board for a hearing concerning a proposed change. The board upon receipt of the request shall notify the Legislative Council, collect data, including information from the proponent, conduct a technical assessment with the assistance of a technical advisory group established for that purpose, provide its analysis, conclusion and any recommendations to the legislative council. The Legislative Council shall assign a committee to review the proposed change of scope of practice. The committee shall also consider the analysis, conclusions, and recommendations of the licensing board. HB122 also requires the committee to ensure appropriate public notice of the committee s proceedings, invite testimony of persons with special knowledge of the field. Assess the proposal using the criteria that includes potential harm or benefit to the health welfare and safety of the consumer, the impact on cost, the impact on access, and quality of health care. Finally, the committee will summarize its assessment, analysis, and recommendations in a final report to the legislature. HB0259 CERTAIN PHYSICIAN SERVICES GROSS RECEIPTS No No Trujillo, Jim R. [4] HHC/HWMC/House Appropriations & Finance Committee-HHC NMNPC NM Nurse Practitioner Position: Priority: watch RELATING TO TAXATION; EXPANDING THE TYPES OF RECEIPTS THAT MAY BE DEDUCTED FROM GROSS RECEIPTS FOR COMMERCIAL CONTRACT AND MEDICARE PART C SERVICES PROVIDED BY A PHYSICIAN, OSTEOPATHIC PHYSICIAN OR PODIATRIST; PROVIDING FOR DELAYED REPEAL. SB0048 NMSU MENTAL HEALTH NURSES STAYING IN NM No No Papen, Mary Kay Senate Pre-filed Legislation [1] Senate Education Committee/Senate Finance Committee-Senate Education Committee NMNPC NM Nurse Practitioner Position: Priority: Senate Bill 48 (SB 48) makes an appropriation to New Mexico State University (NMSU) to increase the number of psychiatric mental health practitioners that graduate from NMSU and remain in New Mexico for at least three years following graduation. Senate Bill 48 (SB 48) appropriates three hundred ninety-five thousand dollars ($395,000) from the General Fund to the Board of Regents of New Mexico State University (NMSU) for expenditure in Fiscal Year 2016 to increase the number of psychiatric mental health practitioners that graduate from NMSU and remain in New Mexico for at least three years following graduation. Any unexpended or unencumbered balance reaming at the end of Fiscal Year 2016 shall revert to the General Fund. SB0121 VACCINE PURCHASING ACT No No O'Neill, Bill B. Scheduled: 1/29/2015 in: SPAC 1:30 PM Senate Pre-filed Legislation [3] Senate Public Affairs Committee/Senate Judiciary Committee/Senate Finance Committee-Senate Public Affairs Committee NMNPC NM Nurse Practitioner Position: Support Priority: Created by LegisTrax 3

4 This is a bill that some of your members have requested we support. Senate Bill 121 (SB 121) relates to public health and children; enacts the Vaccine Purchasing Act, establishes a Universal Vaccine Purchasing Program, creates the Vaccine Purchasing Fund; requires reporting of the number of insured children; authorizes assessments to be levied on health insurers for costs of vaccines for insured children; providing for penalties for failure to report number of insured children; makes an appropriation; declares an emergency. Authorized recipients and those not edible for the program are identified; applicability provision criteria established. Program only includes insured children who are not eligible for the vaccines for children program. Senate Bill 121 (SB 121) - Vaccine Purchasing Act Sponsors: Bill B. O Neill and Terry H. McMillan *Declares An Emergency **For The Legislative Health And Human Services Committee SB 121 relates to public health and children; enacts the Vaccine Purchasing Act, establishes a Universal Vaccine Purchasing Program, creates the Vaccine Purchasing Fund; requires reporting of the number of insured children; authorizes assessments to be levied on health insurers for costs of vaccines for insured children; providing for penalties for failure to report number of insured children; makes an appropriation; declares an emergency. Authorized recipients and those not edible for the program are identified; applicability provision criteria established. Program only includes insured children who are not eligible for the Vaccines for Children Program. Provisions of the Vaccine Purchasing Act Apply to policies, plans, contracts and certificates delivered or issued for delivery or renewed, extended or amended in this state on or after January 1, Universal Vaccine Purchasing Program: Creation [New Material] The Department of Health (DOH) shall establish and administer a Statewide Universal Vaccine Purchasing Program Vaccine Purchasing Fund: Creation, Funding, Approval and Vouchers, Balances [New Material] A. The "Vaccine Purchasing Fund" is created in the State Treasury. The fund consists of assessments paid by health insurers pursuant to the Vaccine Purchasing Act and appropriations and transfers made to the fund. Money in the fund shall be expended only for the purposes specified in the Vaccine Purchasing Act, by warrant issued by the Secretary of Finance and Administration pursuant to vouchers approved by the Secretary of Health. subsections (B)(C) follow. D. Any balance remaining in the fund shall not revert or be transferred to any other fund at the end of a fiscal year, and that balance shall be taken into consideration in the determination of the department's succeeding fiscal year's budget. E. Money in the fund shall be invested by the State Investment Officer in accordance with the limitations in Article 12, Section 7 of the constitution of New Mexico. Income from investment of the fund shall be credited to the fund. Authorized Uses Of The Vaccine Purchasing Fund [New Material] A. The fund shall be used for the purchase, storage and distribution of vaccines, as recommended by the advisory committee on immunization practices, for insured children who are not eligible for the vaccines for children program. B. The fund shall not be used for: (1) the purchase, storage and distribution of vaccines for children who are Created by LegisTrax 4

5 eligible for the vaccines for children program; or (2) administrative expenses associated with the Statewide Universal Vaccine-Purchasing Program. Reporting and Assessments [New Material] A. The office of superintendent shall require each health insurer to annually reimburse the state for the cost of vaccines for childhood immunizations for each insured child according to each health insurer's policy obligations and in accordance with state and federal laws. Key reporting and assessment dates for all parties are listed under Section 6, subsection (B) through (F). G. The payment of an assessment pursuant to the Vaccine Purchasing Act shall be deemed payment for clinical services and activities to promote health care quality for the purpose of calculating a health insurer's medical loss ratio. Appeal and Penalties [New Material] A. A health insurer aggrieved by an assessment levied under Section 6 of the Vaccine Purchasing Act may appeal as provided in Section 59A-4-20 NMSA B. A health insurer that fails to file the report required under Subsection B of Section 6 of the Vaccine Purchasing Act shall pay a late filing fee of five hundred dollars ($500) per day for each day from the date the report was due. Subsection (C) through (E) detail additional penalties and guidelines for this section. Powers and Authority [New Material] The Department of Health (DOH) and the office of superintendent shall promulgate and enforce such rules as may be necessary to carry out the provisions of the Vaccine Purchasing Act. Applicability: Provisions [New Material] The provisions of the Vaccine Purchasing Act: A. do not apply to an entity that only issues policies, certificates or subscriber contracts within New Mexico that are limited to a specific disease; hospital confinement; indemnity; accident-only; credit; dental; vision; Medicare Supplement; long-term care; disability income insurance; student health benefits-only coverage issued as a supplement to liability insurance; workers' compensation or similar insurance; automobile medical payment insurance; nonrenewable short-term coverage issued for a period of twelve months or less; Medicaid; or any medical assistance program administered by the Department or the Human Services Department; and B. Apply to policies, plans, contracts and certificates delivered or issued for delivery or renewed, extended or amended in this state on or after January 1, SB0190 DISCRIMINATION AGAINST HEALTH PROVIDERS No No Papen, Mary Kay Senate Pre-filed Legislation [3] Senate Public Affairs Committee/Senate Judiciary Committee-Senate Public Affairs Committee NMNPC NM Nurse Practitioner Position: Support Priority: Medium Theoretically this will prevent insurance companies from discrimination based of type of license so long as work is in your scope. Senate Bill 190 (SB190) enacts sections of the healthcare purchasing act and other statutes and laws of New Mexico. These include the New Mexico insurance code, the nonprofit health care plan law and the health maintenance organization law to provide that carriers may not discriminate against providers who work within their legal scope of practice Senate Bill 190 (SB 190) modifies multiple statutes to restrict carriers from providing care if the provider Created by LegisTrax 5

6 is duly licensed or certified. Hospitals may accept insured individuals even if they are not contracted with a carrier and carriers may not restrict hospitals from accepting insured as long as that hospital is licensed by the department of health. This section is referred to as hospital freedom of choice. SB190 does not define convalescent or nursing homes as hospitals. Of other significance are the sections that modify various laws and statutes (listed above in the summary) that prohibit discrimination by carriers to providers who are acting within their scope of their license, certification or authority under the law. However, this is not a bill that allows any willing provider to contract with a carrier. Carrier may also make distinctions on reimbursement related to quality and performance measures. SB0220 HMO CREDENTIALING REQUIREMENTS No No Pirtle, Cliff R. [3] Senate Corporations Committee/Senate Judiciary Committee-Senate Corporations Committee NMNPC NM Nurse Practitioner Position: Priority: Senate Bill 220 (SB 220) related to managed health care; amending and enacting sections of the health maintenance organization law to establish provider credentialing requirements and define credentialing ; repealing a section of the New Mexico insurance code Senate Bill 220 (SB 220) modifies the health maintenance organization law with new definitions for credentialing and the credentialing process affecting carriers and providers. Also, the definitions for pharmacist including a clinical pharmacist are relocated for numbering purposes. The state superintendent of insurance is empowered and directed to develop a standardized credentialing application for medicaid plans in New Mexico. Credentialing in SB220 means the process of obtaining and verifying information about a provider and evaluation of that provider when that provider seeks to become a participating provider. The original definitions for pharmacist and pharmacist clinician are stricken for number purposes and reinserted for that same purpose. Pharmacist is a person licensed as a pharmacist pursuant to the Pharmacy Act and a pharmacist clinician means a pharmacist who exercises prescriptive authority pursuant to the Pharmacist Prescriptive Authority Act. A new section referencing Medicaid credentialing and setting deadlines is provided in SB 220. This new section requires the superintendent to adopt a uniform credentialing process, the rules of which shall adopt a single credentialing application form for the credentialing of providers. A carrier shall not require a provider to submit information not required in the uniform credentialing application. Recredentialling shall be held to the same standard. Initial credentialing shall not be required more than every three years. The carrier shall complete its review in forty five days and notify the provider within ten days of receipt of the application if it is incomplete in writing with an identifiable contact person. A carrier shall reimburse a provider for covered health care services, in accordance with the provider's contracted reimbursement rate, for any claims from the provider that the carrier receives more than forty-five calendar days after the date on which the carrier received a credentialing application for that provider; provided that the provider has submitted a credentialing application and any supporting documentation that the carrier has requested in writing within the time frame established earlier in this section. Also, if the carrier has failed to approve or deny the applicant's credentialing application within the time frame Created by LegisTrax 6

7 established in SB220, and the provider has no past or current license sanctions or limitations, as reported by the New Mexico medical board or another pertinent licensing and regulatory agency, or by a similar out-ofstate licensing and regulatory entity for a provider licensed in another state. A dispute regarding credentialing or recredentialling shall be governed by statute (Section 59A SB 220 repeals section 59A NMSA This repealed section has to do with the superintendent s establishment of licensing and credentialing rules following certain national standards. SB0299 NURSE PRACTITIONER SCOPE OF PRACTICE No No Morales, Howie C. [3] Senate Public Affairs Committee/Senate Judiciary Committee-Senate Public Affairs Committee NMNPC NM Nurse Practitioner Position: Support Priority: High Senate Bill 299 (SB 299) updates certain sections of the law to include an advanced practice registered nurse, a certified nurse midwife or a physician assistant working within that person s scope of practice, expanding certain provisions of the Uniform Health-Care Decisions Act to include non-physician primary care practitioners, requiring state agencies and political subdivisions to update their rules to include the practitioners where appropriate Senate Bill 299 (SB 299) modifies numerous sections of law by expanding the definition of primary care practitioner to now include an advanced practice registered nurse, certified nurse-midwife or physician assistant working within the person s scope of practice. Multiple examples in SB 299 are provided in this analysis. The list is extensive but is not all inclusive in this analysis. For example SB 299 changes the determination of a disabled person, and who may certify a person who has a medically determinable physical or mental impairment from a licensed physician, to now include the expanded list of an advanced practice registered nurse, certified nurse-midwife or physician assistant working within the person s scope of practice. SB 299 also empowers an advanced practice registered nurse, certified nurse-midwife or physician assistant working within the person s scope of practice, just as a physician, to issue a certificate that states a minor physical condition may be endangered by a vaccination. Other areas where SB299 expands the scope of practice for the above mentioned midlevel providers include issuing certificates stating that bus drivers are free of all communicable diseases in a transmittable stage that may be dangerous to the health of students. Certificates for all education employees may be issued by an advanced practice registered nurse, certified nurse-midwife or physician assistant working within the person s scope of practice on a form prescribed by the Department of Health and approved by the Public Education Department. Under the definitions section of the original legislation the definition of primary care practitioner is now worded to mean a health-care practitioner designated by an individual or the individual's agent, guardian or surrogate to have primary responsibility for the individual's health care. Another definition, supervising health-care practitioner now means a primary practitioner, or if there is no primary care practitioner or if the primary care practitioner is not reasonably available, the health-care practitioner who has undertaken primary responsibility for an individual's health care. Primary physician is replaced by the expanded term primary care practitioner. SB 299 also expands the Optional Health Care Directive to include the newly defined primary care Created by LegisTrax 7

8 practitioners that include the expanded list of providers mentioned above. An extensive list of actions in the original Act now is expanded to include the expanded list of practitioners. Finally, SB299 provides a temporary provision that directs state agencies and political subdivision to update rules requiring an examination by or certificate or statement of a licensed physician to include advanced practice registered nurse, certified nurse-midwife or physician assistant working with that person s scope of practice. By January 1 st of 2016, every cabinet secretary, agency head, and head of political subdivision of the state shall update rules requiring an examination, by a certificate form, or a statement of a licensed physician to also accept such examination, certificate or statement from an advanced practice registered nurse, certified nurse-midwife or physician assistant working within that person's scope of practice. SB0341 USE OF NURSE EDUCATORS FUND FOR DEGREE No No Campos, Pete [3] Senate Education Committee/Senate Finance Committee-Senate Education Committee NMNPC NM Nurse Practitioner Position: Support Priority: Medium Senate Bill 341 (SB 341), relating to nursing education, seeks to allow any registered nurse who is, or will be, a nurse educator to use the Nurse Educators Fund to obtain a higher degree. Senate Bill 341 (SB 341), relating to nursing education, seeks to allow any registered nurse who is, or will be, a nurse educator to use the Nurse Educators Fund to obtain a higher degree. Section 1 sub-section A, wherein the creation of the Nurse Educators Fund in the State Treasury (rather than the Commission on Higher Education) is discussed, is amended to state that there is created in the state treasury the "nurse educators fund". The state treasurer shall deposit in the fund all amounts appropriated or credited to the fund. The fund shall be administered by the Higher Education Department, which shall charge not more than a five percent administrative fee. Earnings from investment of the fund shall accrue to the credit of the fund. Any balance in the fund at the end of any fiscal year shall remain in the fund for appropriation by the legislature. Sub-section 1.B strikes enhance[ing] the ability of college and university employed nurses as the purpose of the Nurse Educators Fund, and is amended to state that the purpose of the fund is to enable the attainment of bachelor of science, master of science and doctor of philosophy degrees in nursing programs by nursing educators employed by a public post-secondary educational institution and registered nurses seeking employment as nursing educators in a public post-secondary educational institution. Lastly, Sub-section 1.C is amended to stipulate that the Higher Education Department shall develop rules for continuing employment or pay-back provisions for current and future nursing educators who use the fund." Created by LegisTrax 8