The 2012 North Carolina General Assembly seems to be accelerating toward adjournment. This past week, a Senate adjournment resolution was introduced with a June 19 end date. While many think this is a great goal, most believe that it will take until the end of June for the General Assembly to wrap up its business. Here is a quick summary of bills pertaining to medicine that are currently pending before the legislature.

BUDGET / Medicaid

HB 950 – Modify 2011 Appropriations Act 
As previously reported, HB 950 will make some significant changes to the Medicaid budget but it does not currently include any additional across the board cuts to providers. The Senate spent the late afternoon yesterday reviewing the House proposals and is anticipated to move quickly next week to release their own version. Once the Senate has completed its work, the two chambers will go into a negotiation process referred to as conference. The conference process is expected to proceed quickly this session.

Scope of Practice

SB 467 / HB 847 – Naturopathic Licensure Act
This bill would grant licensure status to graduate-level trained naturopaths. Currently, about 30 such naturopaths practice in North Carolina illegally.  A far greater number of lesser trained naturopaths claim licensure status and practice in North Carolina as well.  As previously reported, the NCMS opposes the bill in its current form. 

HB 522 / SB 662 – Midwifery Licensure Act
This bill proposes to license certified professional midwives to practice independently, without physician supervision. The NCMS has strongly opposed this legislation for years because of its regressive nature. At a time when education and training are most important, this bill would seek to lower the educational requirements for a group that seeks to practice in one of the riskiest areas of medicine. The NCMS continues to support the currently licensed nurse midwives that practice under the supervision of a physician and provide an alternative for expecting mothers.

SB 246 / HB 444 – Expand Pharmacists’ Immunizing Authority
This bill would seek to allow “immunizing pharmacists” to deliver any CDC-approved vaccine to customers at the pharmacy. After many rounds of discussion during the 2011 long session, an agreement was made to extend the immunizing pharmacist existing ability to deliver the flu vaccine. That change was made in the 2011 Budget Act. HB 444 was discussed in House Health Committee and sent to a subcommittee for additional review regarding safety, continuity of care and prescription order. The subcommittee consists of Rep. Burr (R-Rowan), Rep. Jackson (D-Wake) and Rep. Murry (R-Wake). The bill has not yet been scheduled for a hearing in either chamber.

HB 1157 – Behavior Analysis Practice Act
A recently introduced bill, proposed by the House Select Committee on Military Affairs, would create a new licensure category under the psychology practice act. The legislation was proposed in response to the greater number of military personnel returning from deployment with counseling needs. The bill currently prohibits the practice of medicine, optometry and psychiatry by these newly licensed practitioners. The NCMS staff is still analyzing this bill at this time.

HB 1081 / SB 832 – Provisional Licensure Changes Medicaid
This bill eliminates the use of incident-to billing for psychologists, licensed clinical social workers and clinical addiction specialists by changing their provisionally licensed status. It does not appear to make any changes that would affect physician assistants at this time. The NCMS will continue to watch this bill closely and ensure that incident-to practices currently in place are not hampered until the dispute about direct enrollment issues is addressed with the NC DHHS.

Workers’ Compensation changes

HB 237 – 2012 Workers’ Compensation Amendments
The proposal would require the Industrial Commission to follow rulemaking procedures for adopting the fee schedule in the same way that they are required by the 2011 act to adopt rules for the rest of their business. This requirement will allow for public input during the adoption process of a new fee schedule. The bill from 2007 requires that the fee schedule be readopted by the end of the year. A draft proposal has been put together by the Industrial Commission to make adjustments to the fee schedule, but the NCMS has not yet been able to review the proposal.

Public Health

HB 438 / SB 433 – Local Human Services Administration
This bill would allow local county commissions the option of dissolving local boards of health and restructure local administration of health services. The bill is an extension of existing law that allows such changes for counties with a population greater than 500,000. The NCMS opposes this legislation. In response to NCMS concerns, the bill has been amended to include the requirement of a health advisory board for counties that choose to dissolve their local health board.