Ohio Coalition of Primary Care Physicians Meets

Immediate Past President Tom Houston, MD; Executive Vice President Ann Spicer; Deputy Executive Vice President Kate Mahler, CAE; and Lobbyist David Paragas, JD; represented The Ohio Academy of Family Physicians at the Ohio Coalition of Primary Care Physicians meeting on September 30 at the Ohio Association of Community Health Centers.

Groups participating in the meeting included the OAFP; the Ohio Osteopathic Association, the Ohio Society of the American College of Osteopathic Family Physicians; the Ohio Chapter, American Academy of Pediatrics; the Ohio Chapter, American College of Physicians/American Society of Internal Medicine: the Ohio Psychiatric Physicians Association; the Ohio Section, American College of OB/GYNs; and the Ohio Association of Community Health Centers.

• Maureen M. Corcoran, president of Vorys Health Care Advisors, presented an analysis of a proposed Ohio-initiated statute to regulate state prescription drug pricing. It is anticipated that the initiated statute will appear on Ohio’s 2017 general election ballot. Known as the Ohio Drug Price Relief Act, the proposed initiated statute, offered by the California-based AIDS Healthcare Foundation, would prohibit the state from agreeing to pay, directly or indirectly, for the purchase of a prescribed drug unless the net cost of the drug, inclusive of rebate discounts and other price concessions, is the same as or less than the lowest price paid for the same drug by the U.S. Department of Veterans Affairs. The analysis concludes that it is unlikely that the statute could be implemented; that the statute would create additional administrative burdens without much cost savings; and that additional, unintended consequences would likely occur in programs that became involved indirectly as collateral damage. The OAFP has not taken a position on the Ohio Drug Price Relief Act.
• Susan Jagers, of Initiative Consulting, presented on Senate Bill 243 and House Bill 443, proposals currently under consideration by the Ohio General Assembly, to improve the step therapy process used by insurers to limit how much they spend covering patients’ medications. Both bills would require that an insurer’s process for requesting a step therapy override is transparent and available to the physician and the patient; would set terms under which an exception to step therapy requirements would be automatic; and would ensure that step therapy programs are based on clinical guidelines developed by independent experts. The OAFP strongly supports step therapy legislation and has testified as to that support.
• Kim Welter, of Equality Ohio, spoke in support of Senate Bill 74 and House Bill 247, proposals that would forbid use of “conversion” or “reparative” therapy that seeks to change a minor’s sexual orientation or gender identity. The American Academy of Family Physicians opposes the use of “reparative” or “conversion” therapy of lesbian, gay, bisexual, or transsexual individuals.
• Alan Levy, MD, of the Ohio Psychiatric Physicians Association (OPPA), discussed a project that their association is conducting relative to resident depression and depression of persons in medical training. The OPPA annual meeting, to be held on Sunday, March 12, 2017, will focus on depression of those in medical training and physician suicide. The OAFP will promote that meeting to its members.

• House Bill (HB) 216 – a proposal that originally would have given advanced practice registered nurses independent practice. The independent practice provisions of the bill have been removed and as a result, most physician organizations have changed their position on HB 216 from one of strong opposition to a position of neutral. The OAFP Public Policy Committee will consider this change at its meeting on Saturday, October 22.
• House Bill 248 – a proposal that mandates coverage of abuse deterrent opioids. It looks as though the bill is unlikely to pass as a standalone bill but might be amended into another piece of legislation such as the mid-biennium review legislation dealing with opioids.
• House Bill 523 – medical marijuana legislation which, of course, has passed but is a long way from implementation as the Ohio Department of Commerce, the State of Ohio Board of Pharmacy, and the State Medical Board of Ohio all have to develop administrative rules to regulate how a physician would recommend medical marijuana to a patient, how pharmacies would distribute medical marijuana, and how the product itself would be cultivated, processed, and tested prior to distribution.
• Senate Bill 169 – a proposal that authorizes a physician or other specified health care professionals, with the consent of the patient, to issue medical orders regarding life-sustaining treatment (MOLST) for that patient. The bill passed the Ohio Senate but because several Right-to-Life chapters in the state oppose (they see it physician-assisted suicide legislation), the bill is unlikely to pass the House.
• Senate Bill 300 – a proposal to authorize psychologists to prescribe psychotropic drugs. The OAFP has participated in interested parties meetings on the bill. The OAFP is strongly opposed to the bill because of the lack of training psychologists have for prescribing and the extremely dangerous nature of the drugs they are seeking to prescribe.
• Senate Bill 332 – a comprehensive infant mortality bill that implements many recommendations of the Infant Morality Commission. The provision that the OAFP objected to relative to mandating cultural competency continuing medical education as a condition of state licensure has been removed.

Also discussed was Resolution 2 passed at the 2016 OAFP Members Assembly which called for the Ohio Department of Health to modernize the state’s immunization registry so that adult immunization records can be integrated seamlessly into the registry. The resolution calls for the Ohio Department of Health to allow patients to have read-only access to their immunization record.