March 7, 2019: State Advocacy Update

Following outbreaks of measles in Washington and Oregon that have, to date, sickened 74 individuals, lawmakers in many states are considering bills to change childhood vaccination laws. The AMA is very concerned about the action in some states to allow nonmedical exemptions and is working to change these laws.

All states require certain vaccines for children attending school. All but three states (California, Mississippi and West Virginia) allow parents to opt out of vaccines for their children for personal, philosophical or religious reasons, though specific exemptions vary by state. This year state legislatures across the country are considering bills that would either expand or eliminate nonmedical exemptions.

Nonmedical exemptions are a barrier to the high immunization rates necessary for herd immunity and work against the establishment of a successful vaccination program. The AMA supports eliminating all non-medical exemptions from required childhood vaccines and has submitted testimony on legislation in Arizona (PDF), Maine (PDF), Oregon (PDF) and Washington (PDF). Similar legislation is currently pending in several other states and the AMA continues to work with state medical associations on those bills.

For assistance with immunization laws in your state, contact the AMA Advocacy Resource Center.

Life insurance carriers need to be more careful in underwriting when there is a prescription for naloxone or other medications not relevant to an individual's health condition, the Massachusetts Insurance Commissioner said in a recent bulletin (PDF). The bulletin was issued after widespread concerns were sparked by a recent story where a nurse employed by an addiction treatment program at Boston Medical Center had a standing order for naloxone and was denied life insurance as a result. "It would defeat the Commonwealth's important public health efforts if applications for individual accident and sickness insurance policies, life insurance policies and annuity contracts, were unfavorably impacted solely because the applicant had obtained naloxone or some other opioid antagonist to address opioid overdoses of other persons or had a prescription to prevent illness or disease," said the Feb. 1 bulletin The Massachusetts Medical Society was among many in the Commonwealth urging the commissioner to issue the bulletin.

Medical societies in Kentucky, Montana and Vermont are among the first states in 2019 working to enact legislation that would remove prior authorization requirements for medication-assisted treatment (MAT) for opioid use disorder. The state societies, AMA and American Society of Addiction Medicine are working closely to help legislators understand that the best time for patients to receive treatment is when the patient expresses the desire to receive treatment—and that any delay or denial of care due to a prior authorization requirement could have fatal consequences. In Kentucky, HB 121 unanimously passed the House but has not yet been scheduled for a hearing. In Montana, SB 280 did not move out of committee but may be attached to legislation going to the Senate. And in Vermont, S. 43 passed out of the Senate and is awaiting a hearing in the House.

For more information, please contact the AMA's Daniel Blaney-Koen.

The diversion of pharmaceutical controlled substances is a growing problem. To help registered practitioners in identifying and preventing diversion activity, the Drug Enforcement Administration (DEA) will be hosting two regional free one-day Practitioner Diversion Awareness Conferences (PDAC) March 18 and 19 in Cleveland. There is no registration fee and the conference is open to all DEA Registered Practitioners in Ohio. The same program will be held both days; participants can attend either day. Attendees will receive a certificate from the Federation of State Medical Boards which they can present to their appropriate boards/associations for possible continuing educational credits. The Federation of State Medical Boards designates this live activity for a maximum of 6.5 AMA PRA Category 1 Credits™.

Topics covered include:

• The Ohio Automated RX Reporting System (OARRS)
• Prescriptions for controlled substances
• Methods of diversion and effective controls for controlled substances
• Telemedicine
• Disposal, return of patient medications and options for patients

The conferences will be held in at the Renaissance Cleveland Hotel. Learn more and register now.

• March 7, 2019: Advocacy spotlight on AMA and other health groups strongly object to Title X Family Planning Rule
• March 7, 2019: National Advocacy Update