Greg Hubbard and AJ Wilson of Hubbard, Wilson & Zelenkova
June 17, 2021

It has been a busy few months in the State Capitol. The legislature has continued to meet regularly and the Joint Finance Committee wrapped up deliberations on the biennial state budget on June 18. The document now will head to the full legislature for approval and then to the Governor’s desk where he will use his powerful partial veto authority to make numerous changes but, more likely than not, sign the document into law.

Below is a status summary on budget efforts as well as recently circulated legislation of concern to WACEP.

I. BIENNIAL BUDGET
We are pleased to report that per the Governor’s recommendation, the Joint Finance Committee adopted an increase to Emergency Physician MA reimbursement rates. The increase, beginning on January 1, 2022 will increase reimbursement by $4.4 million annually, which is the first of its kind in nearly 30 years. Thanks to all of you who contacted your legislators to assist in advocacy efforts. MA increase was the top priority for WACEP this budget cycle.

Also on WACEP’s behalf, a great deal of work went into goals of the Emergency Psych Taskforce. The Joint Finance Committee approved funding for regional crisis service grants, a concept supported by the Taskforce. There is much more to be done on this front but willingness to address the shortfalls in the current system is improving.

Finally, the Governor’s proposed budget originally included an out-of-network “surprise billing” prohibition. This proposal was substantially similar to the compromise “No Surprises Act” passed by Congress late last year but would have left more room for state customization. The proposal however was removed from the budget as non-fiscal policy and the State will instead focus on implementing the “No Surprises Act” this summer until its effective date of January 1, 2022.

II. LEGISLATION
HWZ is presently monitoring two proposals of concerns.

• SB 394/AB 396 authored by Senator Testin, Rep. Cabral Guerra, and Rep. Magnafici is an Advanced Practice Registered Nurse designation/licensure and scope expansion bill that was recently introduced. SB 394/AB396 is similar to a bill introduced last session but goes further in terms of scope. The bill proposes to designate and license nurse practitioners, certified nurse-midwives, certified registered nurse anesthetists, and clinical nurse specialists as APRN. It proposes to eliminate requirements for these APRNs to collaborate with physicians; codifies in state statute, the ability for an APRN to assess, diagnose and treat patients, including prescribing most drugs independently from a physician; mandates that the state "opt out" of federal certified registered nurse anesthetist supervision requirements; and eliminates current law requiring certified nurse midwives to have a collaborative arrangement with a physician who has experience with obstetrics.
• AB 407 authored by Senator Darling and Rep. Zimmerman removes the exemption under current law that allows physicians to prescribe opioids without checking the ePDMP. As a result, providers will need to consult the ePDMP even when prescribing opioids in quantities of three days or less. The WMS Council on Legislation voted to oppose the bill.