May 3, 2019: State Advocacy Update

The AMA and Arkansas Medical Society (AMS) applauded Arkansas Governor Asa Hutchinson and the Arkansas General Assembly last week for putting an end to senseless administrative barriers to evidence-based treatment for opioid use disorder (OUD).

Arkansas Act 964 requires all health insurers and the Arkansas Medicaid program to remove prior authorization to FDA-approved medications—including buprenorphine, methadone and naltrexone—that have been shown to support recovery, reduce health care costs and save lives. These medications are part of what is commonly referred to as medication-assisted treatment (MAT), considered the gold standard for treating OUD, according to the U.S. Surgeon General.

The new law also requires that these medications must be on the lowest cost-sharing tier, which the AMA believes is critical to increase availability and affordability of MAT. “I commend Governor Hutchinson, Representative Deborah Ferguson and Senator Cecile Bledsoe for their leadership on this critical issue,” said AMA President-elect Patrice A. Harris, MD, MA, chair of the AMA Opioid Task Force.

“The Arkansas Medical Society championed this bill because we’ve seen firsthand how delays and denials of care because of prior authorization harm our patients,” said Gene Shelby, MD, an addiction medicine physician who represents AMS on the AMA Opioid Task Force. “This bill received unanimous support because all stakeholders came to see that the status quo has to change if the epidemic is to end. Removing prior authorization for MAT is an important step in that direction.” Arkansas, which saw a 10% increase in the opioid-related overdose death rate from 2016 to 2017, is the first state this year to enact this type of legislation, based in part, on AMA model legislation.

For more information about the AMA model bill, please contact Daniel Blaney-Koen of the AMA.

Georgia, Kentucky, North Dakota and Oklahoma have adopted legislation this year to join the Interstate Medical Licensure Compact, bringing the total number of states in the Compact to 29, plus DC and Guam. The IMLC is a pathway to expedite the licensure of physicians already licensed to practice medicine in one state who wish to practice in multiple states. The AMA supports the compact as a means to modernize the state licensure system, provide uniformity in requirements for state licensure and offer pluralistic approaches to verification of credentials for licensure.

The Indiana State Medical Association (ISMA) defeated bill S.B. 394 that would have allowed advance practice registered nurses to practice independently. ISMA worked closely with fellow members of organized medicine including the AMA and Indiana Osteopathic Association to defeat this legislation.

The Montana Medical Association (MMA) defeated several scope of practice bills this session. Due to MMA’s strong lobbying efforts, they successfully defeated a psychologist prescribing bill (S.B. 106), as well as prevented a bill that would have allowed physician assistants to practice independently from moving beyond the drafting stage.

MMA was also instrumental in securing an important amendment to H.B. 231, which as drafted, would have allowed pharmacists to administer vaccines to children as young as seven years of age. As a result of MMA’s strong advocacy efforts, an amendment was added to only allow this practice within a collaborative practice agreement with a physician.

The AMA Scope of Practice Partnership was proud to award MMA with a grant to support their efforts to defeat these bills and protect the health and safety of patients in Montana.

• May 3, 2019: Advocacy spotlight on Physician proposals inspire new HHS payment models for primary care 
• May 3, 2019: National Advocacy Update 
• May 3, 2019: Judicial Advocacy Update