Insight Matters
Summer 2005

Update on the Legislative Outlook
Kenneth Miller, M.D., Chair, Government Relations Committee

The members of the Government Relations Committee have been very busy over this last quarter along with our Executive Director, Janet Shaw, and our lobbyists, Dan Jones and Tracy Intihar with Capital Consulting Group, Inc. Multiple issues have challenged us at the state and federal level, including the state budget bill, Medicaid "step-therapy"; expanded scope of practice for APN admissions; PA prescription privilege; other scope of practice issues; mental health parity, telemedicine, single payor system; patient/physician privacy legislation. Following are the highlights of activities on several bills (for a complete listing of activities currently being addressed by the OPA, visit the Web site at www.ohiopsych.org):

At the state level:

HB 66 - The Biennial Budget Bill: Included in various versions of the budget bill, were several provisions, which could have had a dramatic impact on psychiatry and the patients for whom we care, including Medicaid reforms, which at one point, called for a "step therapy" provision - this was subsequently deleted from the bill by the Senate Finance Committee; at one point, there was language to correct a discrepancy in the expanded scope of practice for marriage and family therapists, which occurred as an oversight in the last legislative session; and included in the final version of the budget bill is plan for Medicaid managed care; however, there will be carve-outs for behavioral health services.

HB 5/SB 5 - Mandate Lite & HSAs: This bill permits small employers to offer health care plans that do not provide benefits otherwise required by law (known as "mandate lite") and provides for the operation of health savings accounts in a manner that is consistent with federal law. The OPA has expressed its concerns with the bill as it relates to "mandate lite" in a letter to members of the Senate Finance Committee.

HB 180/SB 116 - Mental Health Parity: The OPA, along with other members of the Coalition for Healthy Communities, continues to work with Rep. Peterson (sponsor of HB 180) and Senator Spada (sponsor of SB 116) in order to advance mental health parity legislation for Ohio. Policymakers continue to express concern related to increased costs to small businesses; however evidence of the effects of mental health parity laws in the form of actual experience, economic forecasting and actuarial projects shows that their costs are minimal. Members are encouraged to download an excellent document from the OPA Web site, entitled: "Mental Health Parity Research Summary - Does Parity Make Sense for Ohio?" for use in communicating with your legislators to garner their support for parity.

HB 144 - Waive Doctor/Patient and Attorney/Client Privilege in Probate Cases: During the last legislative session, the OPA worked with the Ohio Bar Association and Ohio Legal Rights, to ensure that language was included to protect the patient confidentiality. This bill, which includes the corrective language has passed the House and is moving on to the Senate.

At the federal level:

HR 1402, the Paul Wellstone Mental Health Equitable Treatment Act: Representatives Patrick Kennedy (D-RI), Jim Ramstad (R-MN), John Sullivan (R-OK), and Grace Napolitano (D-CA) are seeking cosponsors of their legislation, H.R. 1402, the Paul Wellstone Mental Health Equitable Treatment Act, which would end discrimination in coverage of mental illness treatment. Scheduled to sunset at the end of this year, the Mental Health Parity Act (MHPA) of 1996 prohibits discriminatory annual and lifetime dollar caps for mental health benefits as compared to medical and surgical benefits. Members are encouraged to visit the APA advocacy website at www.capwiz.com/psych and utilizing the easy-to-follow steps for communicating directly with their legislators.

HR 525 - Association Health Plan Legislation: On July 26, 2005, the House passed legislation (by a vote of 263 to 165) to expand multi-employer association health plans (AHPs), which has the potential to undermine state laws to cover treatment for certain services, including mental health parity. This proposal would significantly expand the scope of federal law (known as ERISA) that exempts self-insured employers from state law. The legislation now moves on to the Senate. Members are encouraged to visit the APA advocacy website at www.capwiz.com/psych to communicate directly with their legislators.

Members of the Government Relations Committee have worked diligently to be available to various other OPA committees (Executive, Psychiatric Practice, Public Mental Health and OPPAC) to assist them with their legislative and government relations concerns. Of particular, and growing concern, are issues related to managed care and access/medical necessity determinations. The government relations committee will continue to monitor these concerns and work with our outside lobbyists to determine a course of action.

Finally, we are pushing forth with our summer advocacy efforts and have made contacts with several key members of the General Assembly, including Rep. John White (R-Kettering), Chair of the House Health Committee, and Rep. Geoffry Smith (R-Columbus), Chair of the House Insurance Committee. We plan to increase our connections with the local Chapters by encouraging members at the local level to schedule meetings with their key legislators and assisting the Chapters with inviting local legislators to attend a Chapter meeting.

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