Communications: News

Legislative Update

Friday, April 21, 2017   (0 Comments)
Posted by: Dave Renner, CAE, MAFP Legislative Representative
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Sprint to the Session's End Begins

The one task the 2017 legislature must complete this year - passage of bills to fund state government for the next two years – is now  the main focus of legislators.  They returned from their Easter/Passover break on April 18 to begin the final push towards adjournment.  The Minnesota Constitution requires that the legislature adjourn no later than midnight on May 22. 

The end game for how the session end, however, remains cloudy. There are large differences between the proposals put forward by the House and the Senate, with even more difference with the approach sought by Governor Dayton.  Dayton has indicated that he is not interested in negotiating a final outcome before the House and Senate have reached agreement on a single legislative spending and tax target.

Given the stark difference between legislators and the Governor, it remains unclear whether legislative leaders will work to put forward bills that he will sign, or, put forward bills certain to be vetoed and then enter negotiations after that.  Further muddying the picture for the final days of the session is the single vote majority of the Senate Republicans; any  single GOP member holds enormous sway in the final action .  

Another factor making predictions more difficult is gubernatorial politics. Governor Dayton has announced that he will not seek re-election in 2018, and a number of legislative leaders – including the Speaker and chair of the House HHS Finance Committee – are possible candidates for Governor.  That dynamic amplifies the urgency of decisions made as potential candidates seek to score political points and gain support for future bids for higher office.

Health Care Spending Bills Negotiations Begin

Efforts to reconcile significant differences in the House and Senate bills that fund health and human service programs began on April 19.   While both bills include reductions in the growth of overall HHS spending, they do so via different means, and there are dozens of policy provisions that are included in only one bodies’ proposal.  

The Senate proposal reduces forecast spending in 2017-2018 by $335 million.  It does so primarily by shifting some spending from this biennium into the future one.  Such tools are often used in times of fiscal distress, but the move is unusual in that the state is anticipating a surplus of  $1.65 billion for the next biennium.  In addition to the accounting shift, the Senate proposal calls for cuts in physician reimbursement of 2.3% on July 1, 2017 and 3% on July 1, 2019.  

The House bill contains an even larger cut, totaling $599 million.  It, too, includes accounting shifts, as well as banking savings of $150 million by excluding the cost of inflation in its forecast.  The bill includes a number of provisions that are projected to save the state hundreds of millions of dollars by requiring better eligibility verification for public program recipients and reducing hospital readmissions.  Should these savings not appear as intended, the House bill includes contingent language cutting $204 million from reimbursement for health care providers.  If this cut is applied equally to all providers it equates to a 7.3 percent reimbursement cut for physician services.

The bills, totaling over 700 pages in total, contain dozens of policy provisions. Physician groups are monitoring proposals relating to many of these items, including opioid abuse, alignment of state-mandated quality measure reporting, reform of the medication prior authorization process, and others.  

Earlier in the legislative session Governor Dayton unveiled his own budget proposal.   A centerpiece of his budget package was the creation of a “public option” to allow individuals to purchase MinnesotaCare.  His bill has been strongly endorsed by DFL legislators, though the Republican lead legislature has rejected the approach.  Dayton’s budget proposal also included a reinstatement of the provider tax, another proposal that has not received Republican support.  The provider tax is set to be repealed on December 31, 2019.

Conference committee members from the House include Reps. Matt Dean (R - Dellwood), Joe Schomacker (R - Luverne), Tony Albright (R - Prior Lake), Debra Kiel (R - Crookston), and Jennifer Schultz (DFL - Duluth). Senate members include Sens. Michelle Benson (R - Ham Lake), Jim Abeler (R - Anoka), Karin Housely (R - Stillwater), Mark Utke (R - Park Rapids), and Tony Lourey (DFL - Kerrick). 

Bill Extends Medical Faculty Licensure Exception Process 

An effort to make permanent an alternate route to physician licensure for certain foreign-trained physicians was passed by the Senate Finance Committee on April 19. The language of the bill is also moving via the House's HHS Finance bill. 

In an effort to offer physician licensure in certain unique and narrow circumstances, the 2016 legislature established a Medical Faculty License. The statute only applies to physicians who practice at teaching institutions and have practiced in another state for at least five years. 

The original bill was sought by Mayo Clinic to allow them to recruit physicians that do not have conventional training. That legislation was passed late in the legislative session and included a sunset for July 1, 2018.  The Board of Medical Practice reported to the Legislature that the exception had been used three times since its passage in 2016. 

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