New laws include mandates for physicians

New laws include mandates for physicians

 

Several laws passed in the 2017 legislative session will create new requirements for physicians when they take effect July 1. 

The ISMA Government Relations team worked hard during the session to ensure that physicians are still the primary medical decision-makers. The new laws outlined below create a couple of new mandates, but ISMA worked to make sure exceptions remained for physicians’ use of professional judgment. As these laws are implemented, ISMA will continue to monitor any unintended consequences. If you have any questions on these new laws, please contact Mike Brady or Scott Gartenman for further explanation. 

Here is what physicians should know about laws taking effect July 1. 

Opioid prescribing 
Senate Enrolled Act (SEA) 226, which establishes seven-day opioid prescribing limitations for a first patient-physician encounter, is the most significant change for medical practitioners. This law, as well as statutory exceptions and new exceptions being considered by the Medical Licensing Board of Indiana, are detailed in a separate article in the ISMA Updates publication.

Surprise billing 
House Enrolled Act (HEA) 1273 imposes a new notice requirement on physicians referring patients for services. Referring physicians must now notify their patients when they are discharged that their insurance may not cover the services for which they are being referred and that patients should check whether a provider to which they are being referred is in their network. Primary-care providers will be most affected, since they most often refer patients for services. 

Immunizations 
HEA 1069 requires all college students to be immunized against meningitis before they can attend any Indiana college or university. 

Stroke treatment protocols 
HEA 1145 requires emergency services personnel to be instructed about appropriate facilities for the treatment of possible stroke victims, to ensure patients are transported to the facility best-equipped to care for them. This law resulted directly from a 2016 ISMA resolution and will help save lives. 

Cannibidiol 
HEA 1148 creates a registry for epilepsy patients who can legally be treated using cannibidiol, a marijuana-based extract. The bill originally included protections for physicians who treat patients on the registry, but those provisions were removed. ISMA is studying the impact of these last-minute changes and recommends physicians not provide cannibidiol treatment at this time. 

Telemedicine 
HEA 1337 expands a physician’s ability to use telemedicine services. The law allows a physician to prescribe any drug except an opioid once a patient-physician relationship has been properly established. The law also requires Indiana’s Medicaid programs to cover telemedicine without distance restrictions. 

Syringe exchanges
HEA 1438 shifts the decision-making on whether to establish a syringe exchange from the state to municipal or county health offices. This will allow a more nimble reaction to area-specific health crises and put the treatment of individuals in the hands of county and municipal health officers and leadership. 

Prior authorization
SEA 73 mandates the future availability of electronic prior authorization capabilities for prescriptions. The systems utilized will be available to physicians for their prescriptions without additional cost to the physician. This should help streamline the process. ISMA will share additional information and training from the vendor involved when it becomes available. 

Health care consent 
SEA 175 grants health care consent to new parties. An adult grandchild may now provide consent for an incapacitated adult grandparent if no one else is available to do so. A grandparent will now have the same right, where no other legally responsible party is available for consent in cases of incapacitated or minor grandchildren. 

HIV prophylaxis 
SEA 279 authorizes reimbursement for HIV-prevention drugs in rape cases, removing a possible impediment to treatment.

Direct primary care
SEA 303 establishes guidelines for direct primary care agreements between physicians and patients. In short, it requires such agreements to outline the expected care and states physicians may never bill a patient’s insurance for care included in the agreement. The law also states that direct primary care agreements are not insurance and that no physician insurance certification is needed in such an arrangement. 

To read a description of how new bills become laws, go to www.ismanet.org/legislation/bills.htm