The pace at the capitol slowed considerably this week as legislators shift to closed-door negotiations on the budget and end-of-session policy deals. The two chambers still have a substantial budget divide to close and several notable issues left unresolved before they can adjourn for the year.
Just one week remains until the scheduled adjournment of the legislative session on Friday, April 30. This deadline obviously has important ramifications for our ongoing push for a hard cap on noneconomic damages, however, it is important to note that this is not a hard and fast deadline. April 30 simply marks the last day legislators receive their daily per diem for their annual work in Des Moines. The legislature frequent works past this deadline and is expected to do so again this session.
HF 592 and SF 557 – the companion bills to enact a $1 million hard cap on noneconomic damages – remain eligible for consideration through the end of session. IMS continues to work closely with legislative leadership and our legislative champions to push our final holdout votes to a position of support on this critical reform. You have an important role to play in the final days of session. Continued contact with your local legislators is crucial to ensure they know the importance of tort reform to their local physician community and are prioritizing this bill as one of the end-of-session deals. If you haven’t already, please contact your legislators immediately. If you haven’t contacted them within the past few days, please follow up to ask them for an update on the effort. These contacts matter. Please use your voice.
We got our first look at the Health and Human Services (HHS) budget this week with the Senate introducing SSB 1297, its initial budget proposal and the House introducing its initial budget proposal as an unnumbered bill draft. This budget, which funds the Department of Public Health, the Department of Human Services, and the myriad of health-related programs they administer, is the largest section of the state’s annual budget. The Senate is proposing a $2.03 billion HHS budget for FY22 and the House is proposing a larger $2.05 billion FY22 budget. Of note, SSB 1297 does not include additional funding for the state’s mental health system, which is instead included as a $68 million appropriation in SF 587 – the bill to restructure mental health funding by shifting funding from county property taxes to state General Fund appropriations. The House HHS budget contains approximately $36 million in new mental health funding across a host of programs.
Both proposals include several notable new funding proposals, including funding for three additional staff members to help ease the backlog of autopsies at the State Medical Examiner’s Office; additional funding to continue state grant funding for four rural psychiatric residency slots; funding to establish at least one regional center of excellence as proposed by the governor in her Condition of the State Address; funding from the sports waging tax receipts to fund additional gambling addiction and SUD treatment; and funding to increase PMIC reimbursement rates – a proposal the IMS Policy Forum endorsed in adopting PRS 19-2-05. The Senate also seeks to resurrect a controversial DHS eligibility verification proposal that died earlier this year and the House seeks to again push for telehealth behavioral health commercial payment parity. IMS has prepared a summary comparing the notable provisions of the two HHS budget proposal.
Telehealth Payment Parity
On Tuesday, the House debated SF 524 – a bill we told you about a few weeks ago, which create a new workgroup to study improvements to the inpatient psychiatric bed tracking system. As we noted at the time, the House Human Resources Committee passed the bill with an amendment to resurrect the telehealth behavioral health commercial payment parity proposal that had previously overwhelmingly passed the House as a standalone measure, but stalled in the Senate. On Tuesday, the House again overwhelmingly supported the telehealth parity measure, passing both it and the bed tracking workgroup as a now-bundled SF 524 back to the Senate for consideration. The Senate has indicated that it will not support advancing the telehealth insurance mandate, which is now also included in the House’s proposed HHS budget bill.