Legislative Update: House Prepares for Budget Debate as Conference Committee Tackles Medical Liability Reforms

House to debate proposed budget next week

The House Appropriations Committee completed its work on Wednesday giving a favorable report to a $19.3 billion budget proposal.  The bill is scheduled to be debated on the House floor next Tuesday and Wednesday.  As promised, Republicans did not continue the one-cent sales tax, which led to additional cuts totaling nearly $1.5 billion, from the Governor’s budget proposal.  Extensive cuts in education as well as health and human services account for the majority of the savings. 

Health and human services are reduced by an additional $462 million.  One-tenth of that savings would be achieved through a 2% across-the-board reduction to all Medicaid Provider Rates.  To date, the House has protected physicians from this additional rate reduction.  It is unclear whether this exception will remain in the budget as it moves through the Senate.

Even while avoiding a direct rate cut, physicians working through Community Care of NC (CCNC) must save the State an additional $90 million through Medicaid care management or face a rate reduction during the fiscal year to achieve those savings.  NCMS continues to work closely with CCNC, NCHA, the NC Academy of Family Physicians, DHHS Sec. Cansler and the Appropriation Chairs to successfully achieve and account for these savings in order to avoid any such cut.

Once the House approves its budget, the Senate will begin debate on its version. That process will likely end in a conference committee with representation from both chambers. The General Assembly is aiming to send its final budget legislation to the Governor by June 1, 2011. NCMS will continue to aggressively advocate for physician interests throughout the budget debate.

Medical malpractice bill begins negotiation process

Now that the NC Senate and House have each passed their version of medical liability reform legislation, a conference committee will address the differences between the two versions. Click here for a comparison of the two versions. Conferees for SB 33 – Medical Liability Reform were named this week.  They are as follows:

Rep. Johnathan Rhyne (R-Lincoln)

Rep. Danny McComas (R-New Hanover)

Rep. Paul Stam (R-Wake)

Rep. Tom Murry (R-Wake)

Rep. James Crawford (D-Granville)

Rep. William Brisson (D-Bladen)

Rep. Chuck McGrady (R-Henderson)

Sen. Peter Brunstetter (R-Forsyth)

Sen. Tom Apodaca (R-Henderson)

Sen. Harry Brown (R-Onlsow)

Sen. Bob Rucho (R-Mecklenburg)

Sen. Eric Mansfield (D-Cumberland)

There is no clear timeline as to when the conferees would meet or when a conference report would be presented for another vote.  Both the House and the Senate will be required to approve the conference report once completed.  It is important that physicians continue to ask for the support of their legislators. 

Meanwhile, H542 – Tort Reforms for Citizens & Business is expected to be reported to the House floor for debate in the coming week.  This bill includes a very important provision to allow for actual damages to be admitted into evidence during a medical malpractice trial.  Actual medicals are the real dollars paid to settle a medical bill.  Currently, only the billed charges are allowed into evidence.  Anyone that has ever looked at an explanation of benefits statement can tell you that the bill is settled for a fraction of the charges outlined on the statement.  This significant improvement in evidentiary rules would allow for the jury to have a more honest understanding of the damages incurred by the injured party.  NCMS supports this bill along with an extensive coalition of business partners.

NCMS views this year’s debate on medical liability reform as a landmark first step toward addressing the long standing deficiencies in the medical malpractice system. NCMS has devoted unprecedented resources to the lobbying and public relations effort supporting medical liability reform legislation. The success of this project is a top priority of the NCMS and its coalition partners.  

A very busy year at the NC General Assembly

This month marked the filing deadline for public bills for the 2011 session of the General Assembly. The NCMS is tracking over 200 bills relating to health care and the practice of medicine in North Carolina. Below is a listing of those bills by broad category which will most greatly affect you and your patients.

Tort and Medical Liability Reforms

HB 154 –Reform Medical Malpractice Evidentiary Rules, Faison (D-Orange)

HB 155 – Medical Malpractice Insurance Coverage, Faison (D-Orange)

HB 542 – Tort Reform For Citizens and Businesses, Rhyne (R-Lincoln)

HB 551 –Discovery/Medical Peer Review, Faison (D-Orange)

HB 599 – Patients Rights/Notice of Professional Liability Insurance, Insko (D-Orange)

HB 732 – Tort Reform Act of 2011, Blust (R-Guilford)

SB 33 – Medical Liability Reforms, Apodaca (R-Henderson)

SB 642 – Med Mal Review Board, Hartsell (R-Cabarrus)

SB 674 – Civil Justice System Reforms, Brunstetter (R-Forsyth)

State Budget

HB 200 – Appropriations Act of 2011,  Brubaker (R-Randolph)

HB 341 – Tobacco Products Tax Increase, Weiss (D-Wake), also see SB 338

SB 32 – Hospital Medicaid Assessment/Payment Program, Brunstetter (R-Forsyth)

HB 58 – Modify FMAP Cuts, Brunstetter (R-Forsyth)

Scope of Practice

HB 331 – Allow PAs and NPs to Sign Death Certificates, Hollo (R-Alexander), also see SB 191

HB 412 – Study Use of Alternative Medicine, Farmer-Butterfield (D-Wilson)

HB 429 – Establish Music Therapy Practice Act, Insko (D-Orange)

HB 496 – Insurance Co-Pays for Chiropractic Services, Moore (R-Clevelend)

HB 522 – Midwifery Practice Act, Wilkins (D-Person), also see SB 662

HB 619 – Update/Modernize Physical Therapy Act, Howard (R-Davie)

HB 639 – Clinical Exercise Physiologist Licensure, Alexander (D-Mecklenberg)

HB 753 – Establish Radiologic Technicians Licensure, Insko (D-Orange)

HB 847 – Naturopathic Doctors Licensing Act, Barnhart (R – Cabarrus), also see SB 467

SB 31 – Clarify Penalty for the Unauthorized Practice of Medicine, Mansfield (D-Cumberland)

SB 230 – Pedorthist Licensure, Hartsell (R-Cabarrus)

SB 246 – Expand Pharmacists’ Immunizing Authority, Hartsell (R-Cabarrus), also see HB 444

SB 349 – Confidentiality/Investigative Info/Optometry, Purcell (D-Scotland)

SB 437 – Enact First Evaluation Program, Hartsell (R-Cabarrus), also see HB 423

SB 656 – Right to Choose Physical Therapist, Davis (R-Macon)

SB 672 – Study Radiologist Assistant Licensure, Purcell (D-Scotland)

Insurance Regulation

HB 2 – Protect Health Care Freedom, Stam (R-Wake)

HB 115 – North Carolina Health Benefit Exchange, Dockham (R-Davidson)

HB 238 – State Health Plan/Repeal Penalties, Dollar (R-Wake)

HB 578 – Health Care Sharing Organizations, Murry (R-Wake), also see SB 608

HB 709 – Protect and Put NC Back To Work, Folwell (R –Forsyth), also see HB 544

HB 826 – Coverage for Treatment of Autism Disorders, Parfitt (D-Cumberland) also see SB 115

SB 265 – State Health Plan/Appropriations and Transfer, Apodaca (R-Henderson) also see SB 323

SB 517 – Freedom to Negotiate Health Care Rates, Apodaca (R-Henderson)

SB 744 – Transparency in the Cost of Health Care, Goolsby (R-New Hanover)


HB 347 – Notification to Treat Minors/12 or Younger, Randleman (R – Wilkes)

HB 540 – Remove Adult Care Homes From CON Review, Cook (R-Beaufort)

HB 606 – Sheriff/Inspect Prescription Drug Records, Hurley (R-Randolph)

HB 618 – Streamline/Oversight DHHS Service Providers, Lewis (R-Harnett), also see SB 525

HB 666 – Facilitate Locum Tenens Physicians, Hollo (R-Alexander), also see SB 609

HB 683 – Born Alive Infant Protection Act, Blust (R-Guilford)

HB 726 – Mandate Use of Controlled Substance Reporting System, Rapp (D-Madison)

HB 795 – Patient Access to Pathological Materials, Steen (R-Rowan)

HB 809 – Model Health Care-Associated Infections Law, Burr (R-Stanly)

HB 812 – Hospital Authority Territorial Jurisdiction, Torbett (R-Gaston)

HB 854 – Abortion-Woman’s Right To Know Act, Samuelson (R-Mecklenburg), also see SB 769

SB 337 – Allow Expansion of Capitated Waiver, Nesbitt (D-Buncombe), also see HB 127

SB 357 –DNR Form Signatures, Kinnaird (D-Orange)

SB 375 – Facilitate Statewide Health Information Exchange, Stein (D-Wake)

SB 471 – Youth Skin Cancer Prevention Act, Purcell (D-Scotland)

SB 474 – Photo ID for Certain Controlled Substances, Apodaca (R-Henderson), also see HB 656

SB 496 – PPACA/Required Fraud and Abuse Provisions, Pate (R-Wayne)

SB 607 – Conform Medical Records Law, Stein (D-Wake)

SB 697 – Patient Advocacy and Protection Act, Stein (D-Wake)

SB 718 – Prescription Integrity Act, Mansfield (D-Cumberland)

SB 723 – Strengthen Controlled Substance Reporting System, Hise (R-Mitchell)

SB 743 – Encourage Volunteer Health Care Providers, Goolsby (R-New Hanover)

SB 765 – No Firearms Questions During Medical Exams, Brock (R-Davie)

SB 766 – Notarized Consent for Minor’s Abortion, Brock (R-Davie)

SB 774 – Update Electronic Prescription Rules, Brock (R-Davie)

SB 775 – Regulate Abortion Facilities, Brock (R-Davie)


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