Rotunda Archive

August 14, 2008

The Nebraska Hospital Association – Nebraska's influential voice for health care.

The Unicameral Web site has been redesigned and includes comprehensive information about the senators, bill status, legislative calendar and news.

If you have questions or concerns about any state legislation, please contact Bruce Rieker, Vice President, Advocacy, at 402/742-8146 or brieker@nhanet.org; or Cora Micek, Advocacy Coordinator, at 402/742-8153 or cmicek@nhanet.org. 

Second Session of the 100th Legislature

• 60-day session convened on January 9, 2008.
• 59 “bills of interest” were carried forward from 2007.
• 471 new legislative bills were introduced.
• 100 new “bills of interest” to NHA members. 
• The NHA testified 49 times before 9 of the 14 standing committees.
  • Of those 100 new bills, the NHA initially: 
    • Supported 42
    • Opposed 7
    • Monitored 51
  • Of the combined 159 bills of interest from 2007 and 2008:
  • 18 were indefinitely postponed.
  • 89 failed to advance.
  • 18 were amended into other bills that became law.
  • 34 were signed into law.
• The second session adjourned on April 17, 2008

2008 Legislative Interim

• 170 legislative interim study resolutions (ISRs) were introduced.
• 21 ISRs “of interest” to NHA members.

Composition of the 101st Legislature: January 2009 – January 2011

• 49 senators –
  • 23 new senators took office in 2007.
  • At least 15 more (possibly 20) will be elected in 2008.

• Average legislative experience will be less than 2.4 years.
• More than 75 percent will have less than 2 years of experience.
   

Legislative bills signed into law this session
The following bills of interest to NHA members were signed into law during the 2008 legislative session:
 

Appropriations Committee

LB 959: Provide for deficit appropriations
Sponsor: Speaker Mike Flood
NHA Position: Monitored and supported several provisions
Effective Date: April 3, 2008

In part, LB 959 funded several programs of interest to NHA’s members.

• $500,000 in 2008-09 for the Rural Health Provider Incentive Program (RHPIP).
• $900,000 in General Funds and $1,350,000 in Federal Funds for an additional rate increase of 1.5 percent for behavioral health providers in 2008-09.
• Requires the state to pay pharmacy dispensing fees to reimburse retail pharmacies for the costs of multiple-source drugs at the average manufacturer’s price.
• A one-time appropriation of $250,000 for Nebraska’s five community health centers.
• $87,500 to prepare planning documents for the UNMC College of Nursing Lincoln facility.
• $193,873 for 2007-09 for the Long-Term Care Savings Program.
• $3 million for 2007-09 for cost of maintenance and treatment of persons in emergency protective custody.

LB 961: Provides state funds to support Nebraska Regional Poison Center
Sponsor: Speaker Mike Flood
NHA Position: Support
Effective Date: April 3, 2008

LB 961 incorporated portions of LB 1075 and appropriates $200,000 annually to support the Nebraska Regional Poison Center. The Center provides 24-hour emergency telephone service staffed by nationally certified registered nurses with physician toxicologists available 24 hours per day for clinical consultations.

Banking, Commerce and Insurance Committee

LB 855: Change insurance provisions including the adoption of the Discount Medical Plan Organization Act
Sponsor: Banking, Commerce and Insurance Committee
NHA Position: Support
Effective Date: July 18, 2008

LB 855 requires that after January 1, 2009 all group policies of accident or health insurance, health services plans or health maintenance organizations include, for an additional premium, coverage for the reasonable and necessary medical treatment of temporo-mandibular joint disorder and craniomandibular disorder. LB 855 also creates the Discount Medical Plan Organization Act to promote the public interest of establishing standards for discount medical plan organizations; to protect consumers from unfair or deceptive marketing, sales, or enrollment practices; and to facilitate consumer understanding of the role and function of discount medical plan organizations in providing access to medical or ancillary services.


Health and Human Services Committee

LB 308: Adopt the Automated Medication System Act
Sponsor: Sen. Arnie Stuthman
NHA Position: Support
Effective Date: April 22, 2008

LB 308 allows, but does not require, the use of automated medication systems and telepharmacy to aid in improving patient safety and eliminating waste. Automated medication system refers to a mechanical system that performs operations or activities – other than compounding, administration or other technologies relative to storage and packaging for dispensing or distribution of medications – that collects, controls and maintains all transaction information. Those using this system must develop and maintain policies and procedures that meet or exceed the standards set forth in LB 308.


LB 395: Adopt a new Nebraska Clean Indoor Air Act (statewide smoking ban)
Sponsor: Sen. Joel Johnson
NHA Position: Support
Operative Date: June 1, 2009

LB 395 makes it unlawful for any person to smoke in public areas and places of employment. Those individuals in violation of Nebraska’s new state- wide smoking ban will be guilty of a Class V misdemeanor for the first offense and a Class IV misdemeanor for the second and any subsequent offenses. Exemptions exist for most private residences, up to 20 percent of rooms and suites rented to guests, and indoor areas used in connection with research related to the effects of smoking.


LB 765: Changes provisions relating to certificates of need
Sponsor: Sen. Tim Gay
NHA Position: Monitor
Effective Date: July 18, 2008

LB 765 modifies current certificate of need statutes as they apply to long-term care and rehabilitation beds. The new statutes prohibit health care facilities from increasing their long-term care beds by more than ten percent of their total long-term care bed capacity or ten beds, whichever is less, over a two-year period without a certificate of need. The same rules apply to rehabilitation beds. In cases of initial establishment of long-term care beds or rehabilitation beds, the 10-10-2 rule applies to the total number of beds of that facility.

An additional exception to the certificate of need provisions is created in LB 765. The exception states: “If the average occupancy for all rehabilitation beds within a health planning region exceeds 80 percent occupancy during the most recent three consecutive calendar quarters as reported at the time of the filing of the application and no other comparable services are otherwise available in the health planning region, the department shall grant an exception to the moratorium and issue a certificate of need for up to three rehabilitation beds.”


LB 797: Change provisions relating to health and human services
Sponsor: Health and Human Services Committee
NHA Position: Supported certain provisions
Effective Date: April 1, 2008

As part of a much larger bill, LB 797 reinserted language into Nebraska’s statutes that defines rural area for the purposes of critical access hospital as a county with a population of less than 100,000 residents. LB 797 also added nurse practitioners as a profession that may receive financial assistance pursuant to the Rural Health Systems and Professional Incentive Act.


LB 830: Adopt the Prescription Drug Cost Savings Act
Sponsor: Sen. Steve Lathrop
NHA Position: Monitor
Effective Date: July 18, 2008

The purpose of LB 830 is to provide appropriate pharmaceutical care to Medicaid recipients in a cost-effective manner by requiring the establishment of a preferred drug list by July 1, 2010. The Nebraska Department of Health and Human Services is required to establish a pharmaceutical and therapeutics committee to advise the department on all matters relating to the establishment and maintenance of such list. The department is required to enter into multistate purchasing pools; negotiate directly with manufacturers and labelers; or contract with a pharmacy benefit manager for negotiated discounts or rebates in order to achieve the lowest available price for such drugs under this program.


LB 928: Health and Human Services Committee Omnibus Bill
Sponsor: Sen. Joel Johnson
NHA Position: Monitored and supported several provisions
Effective Date: April 22, 2008

Originally, LB 928 was intended to repeal the Hepatitis C Education and Prevention Act. By the time it was passed by the Legislature, provisions from at least nine bills of interest were amended into it. Portions of bills amended into LB 928 include:

• LB 48 – Allows certified registered nurse anesthetists (CRNAs) to use fluoroscopy.
• LB 738 – Creates the Brain Injury Registry Act. If a person with a brain or head injury is admitted to or treated at a hospital or rehabilitation center located within a hospital, such hospital or rehabilitation center shall provide a report of such injury to the Nebraska Department of Health and Human Services within 30 days after the discharge of such person. Within 30 days after receiving a report of brain or head injury, the department shall provide relevant and timely information to the person with such injury to assist such person in accessing necessary and appropriate services relating to such injury.
• LB 796 – The “cap” on the annual fee that the Department of Health and Human Services may charge for the registration and inspection of radiation generating equipment was raised from $70 to $400. No fee shall exceed the actual cost to the department for such registration and inspection.
• LB 906 – For each laboratory in Nebraska applying for certification, fees shall include: (a) An annual fee not to exceed $1,800. (b) An inspection fee not to exceed $3,000 per certification period.
• LB 994 – Extends the termination date of the Behavioral Health Oversight Commission from June 30, 2008 to June 30, 2009.
• LB 1120 – A certificate of need is not required if a federally recognized Indian tribe has a self- determination agreement in place with the Indian Health Service of the United States Department of Health and Human Services stating that payment for enrolled members of a federally recognized Indian tribe who are served at such facility will be made with 100 percent federal reimbursement.
• LB 1121 – The Department of Health and Human Services shall develop recommendations for the provision of medical assistance to persons with disabilities who are employed to enhance and replace current eligibility provisions.
• LB 1123 – Changes the composition of the Children’s Behavioral Health Task Force beginning on July 1, 2008.
• LB 1176 – Requires the Department of Health and Human Services to provide a report to the Governor, the Legislature and the Medicaid Reform Council no later than December 1 before the next regular session of the Legislature, summarizing the purpose and content of proposed rules and regulations that relate to Medicaid benefits and the impact of such proposed rules and regulations on recipients of those benefits.
   

Judiciary Committee

LB 157: Provide safe havens for children
Sponsor: Sen. Arnie Stuthman
NHA Position: Monitor
Effective Date: July 18, 2008

LB 157 states in its entirety that “No person shall be prosecuted for any crime based solely upon the act of leaving a child in the custody of an employee on duty at a hospital licensed by the State of Nebraska. The hospital shall promptly contact appropriate authorities to take custody of the child.” The NHA has developed a model safe haven policy that has been distributed to its members.


LB 586: Changes medical lien provisions
Sponsor: Sen. Abbie Cornett
NHA Position: Opposed but agreed to final compromise
Effective Date: March 11, 2008

LB 586 applies to third party injury claims and states “For persons covered under private medical insurance or another private health benefit plan, the amount of the lien shall be reduced by the contracted discount or other limitation which would have been applied had the claim been submitted for reimbursement to the medical insurer or administrator of such other health benefit plan. The measure of damages for medical expenses in personal injury claims shall be the private party rate, not the discounted amount.” LB 586 incorporates the provisions of LB 220 that provides chiropractors with the authority to assert a medical lien just as other health care providers would be permitted to do.  


Revenue Committee

LB 575: Exempt non-profit, assisted living facilities from sales and use taxes
Sponsor: Sen. Lowen Kruse
NHA Position: Support
Operative Date: October 1, 2008

Current law only provides nursing homes and intermediate care facilities with a sales tax exemption. By definition, assisted living facilities have replaced intermediate-care facilities. The statutory revisions made by LB 575 make the necessary adjustments to provide that tax exempt status to non-profit, licensed assisted living facilities.


Urban Affairs Committee

LB 1096: Adopt the Volunteer Emergency Responders Job Protection Act
Sponsor: Sen. Mike Friend
NHA Position: Support
Effective Date: July 18, 2008

AAmended into LB 1096 was LB 948, introduced by Sen. Russ Karpisek, which creates the Volunteer Emergency Responders Job Protection Act. This prohibits employers of ten or more people from terminating or taking any other disciplinary action against any employee who is a volunteer emergency responder if such employee, when acting as a volunteer emergency responder, is absent from or reports late to his or her place of employment in order to respond to an emergency prior to the time such employee is to report to his or her place of employment. An employer may subtract from an employee’s earned wages any time such employee is away from his or her place of employment because of such employee’s response to an emergency.


Interim Study Resolutions
Over 170 interim study resolutions (ISRs) were adopted by the Legislature; 21 of them are “of interest” to NHA members. Several of those ISRs of interest and the committee they were referred to are listed below:

Banking, Commerce and Insurance Committee

LR 299: Explore changes being implemented by insurance companies to reduce private insurance benefits covering prosthetic limbs.

LR 301: Examine issues regarding the Comprehensive Insurance Pool.

LR 305: Examination of requiring issuers of group health benefit plans to provide information regarding claims paid and the amount of premiums collected by line of insurance.


Business and Labor Committee

LR 334: Examination of the effects of LB 588 on workers’ compensation premium costs and hospital fee schedules. LB 588 became law in 2007. It modified the workers’ compensation inpatient hospital fee schedule.

LR 370: Study issues relating to the effect of mandatory overtime at 24-hour care facilities. LR 370 was also referred to the Health and Human Services Committee.


Education Committee

LR 292: Review services available for at-risk children age birth to five years.


Health and Human Services Committee

LR 221: Explore the implementation of a statewide stroke registry. LR 303 Examine the establishment of a laboratory at the University of Nebraska Medical Center to conduct medical research on umbilical cord blood and tissue.

LR 337: Examine the needs of Nebraska to develop a plan to provide behavioral health workers the support personnel necessary for community-based behavioral health services and funding for that plan.

LR 338: Study to conduct research and develop recommendations relating to the implementation of the Nebraska Behavioral Health Services Act. LR 338 was also referred to the Appropriations Committee.

LR 340: Examination of transparency in health care pricing and billing.


Judiciary Committee

LR 276: Study the standards and oversight of death investigations in Nebraska.

For more information about these or any other bills or resolutions, contact: Bruce Rieker, Vice President of Advocacy at (402) 742-8146 or brieker@nhanet.org.

The NHA staff thanks everyone who participated in the development of public policy during the 2009 legislative session. Your efforts of attending NHA meetings, participating in conference calls, and contacting policymakers to advocate a position on behalf of Nebraska’s hospitals are invaluable. Together we are the influential voice for health care.

Throughout the 2010 legislative session, hospitals will need “champions” in the Legislature to deal with Medicaid, workers’ compensation, behavioral health reform, and all other issues that impact the operations and success of hospitals. Hospitals must be prepared for discussions vital to the communities they serve and to the mission of hospitals across the state. For more information, contact the Nebraska Hospital Association at (402) 742-8140.

NHA Rotunda Review is published by the Nebraska Hospital Association, 3255 Salt Creek Circle, Suite 100, Lincoln, NE 68504. Phone 402/742-8140, Fax 402/742-8191. Contact Kelley Porter, Director of Communications, at 402/742-8151, or email, kporter@nhanet.org.