Final Legislative Deadline Looms Next Week

April 11, 2024

April 19 marks the final committee deadline for this year’s legislative session. By this date, committees must act favorably on major appropriation and finance bills, which means committee omnibus bills must be passed by their relative committees before next Friday. 

The MMA is tracking two omnibus bills, the first involving several scope of practice provisions. The MMA shared concerns with two items in the Senate version of the bill. The first would lift existing statutory caps on optometric prescribing of oral antiviral drugs, steroids, and oral carbonic anhydrase inhibitors, and expand optometrists’ authority to provide intravitreal injections. The second would create a separate pathway for international medical graduates who do not qualify for licensure in Minnesota under current state requirements. The MMA agrees that there is a need to find ways to allow well-qualified physicians to achieve licensure to address physician workforce shortages in the state but contends that the current language needs additional guardrails to ensure a minimum standard of care. 

Another item that is concerning to physicians, especially psychiatrists, would allow physician assistants (PAs) to provide ongoing psychiatric treatment for children with emotional disturbances and adults with serious mental illness without coordinating with a psychiatrist when diagnosing and treating patients with mental illnesses. This item is opposed by the Minnesota Psychiatric Society and the National Alliance on Mental Illness (NAMI), who have argued that PAs are not qualified to adequately monitor prescribe, and treat these patients independently. The bill is supported by the Minnesota Association of Physician Assistants (MAPA).  

A provision in the bill would establish a new certified midwife licensure by the Board of Nursing. In the legislation, the scope of certified midwives allows them to manage, diagnose, and treat women's primary healthcare, including pregnancy, childbirth, the postpartum period, care of the newborn, family planning, partner care management relating to sexual health, and gynecological care of women across the life span.  

Lastly, the scope of practice omnibus bill includes an item authorizing pharmacists to prescribe, dispense, and administer drugs to prevent the acquisition of human immunodeficiency virus (HIV). 

A second omnibus bill, the health budget and policy omnibus bill, must also be acted on favorably by the relevant House and Senate committees before the April 19 deadline. The details of either the House or Senate omnibus bill have not been released yet, but the MMA is optimistic that two priority bills will be included in the budget and policy omnibus bill. 

The top legislative priority for the MMA has been prior authorization reform. The MMA has advocated for legislation prohibiting prior authorization for services where a delay poses an immediate danger to patient health. These include treatments for substance use disorder, outpatient mental health, cancer, and chronic conditions, among others. The bill also requires health plans to submit data on prior authorization to the Department of Health (MDH), which in turn will submit a legislative recommendation to improve the prior authorization process, including a recommendation for a prior authorization exemption process for providers. The MMA is hopeful this will be included in the omnibus bill. 

The MMA is also advocating for the inclusion of its physician wellness legislation, which creates a program through which physicians can confidentially seek and obtain professional help to address career fatigue and wellness without fear that this will be shared with employers or licensing agencies. The legislation prohibits health system credentialing applications from inquiring about an applicant’s past health conditions. The bill allocates funds to create a statewide wellness recognition program to publicly recognize Minnesota healthcare institutions that have committed to improving physician mental health and burnout, and one-time funds to initiate a statewide campaign to educate the healthcare workforce about the importance of clinician well-being. 

The contents of the proposed health budget and policy omnibus bill are expected before next week.