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1 2013 HAT Legislativee Agenda HAT Legislation SB997 / HB343 Decisions and reporting concerning hospitals. Sponsors Sen. Randy McNally / Rep. Michael Harrison Description Establishes that within sixty days, instead off within forty-five days, the attorney general and reporter must notify the public benefit hospital entity in writing of their decision to object to the proposed public benefit hospital conveyance transaction or take no action. Allows the attorney general and reporter to extend this period for an additional forty-five days, instead of thirty days, if the extension is necessary to obtain information. Requires the report of hospital statistics to include a report on community benefits provided by hospitalss required to make a report. Comment Caption bill introduced on behalf of HAT. THA Legislation SB103 Retaining medical records. Sponsors Sen. Becky Duncan Massey Description Requires mammography records to be retained for 10 years following the patient's discharge from a hospital or death. Authorizes the board of medical examiners to promulgate rules and regulations in retaining medical records. Senate Status 02/07/ Set for Senate Health & Welfare Committee 02/13/13. Comment HAT supports this legislation introduced on behalf of THA. SB104 / HB83 Change of ownership of hospital - filing requirements. Sponsors Sen. Becky Duncan Massey / Rep. Mark White Description Requires the owner of a hospital that closes during the fiscal year to file a joint annual report with the department of health for the period of time that the hospital was owned or operated. Requires the owner of a hospital that changes ownership to file a joint annual report with the department of health for the period of time that the hospital was owned or provide a notarized statement to the department of health indicating that the required data for the period of time that the hospital was owned or operated has been providedd to the purchaser who shall submit a report for the full year. SB257 / HB1019 Replaces current universal do not resuscitate order statute. Sponsors Sen. Rusty Crowe / Rep. Cameron Sexton Description Replaces current do not resuscitate order withh a new provision authorizing physician orders for scope of treatment (POST). Defines POSTT as written orders on an approved form that specifies whether in the event of cardiac or respiratory arrest, cardiopulmonary resuscitation should or should not be attempted and specifies other medical interventions that are to be provided or withheld. Authorizes nurse practitioners or clinical nurse specialists to issue a POST under certain circumstances. Establishes a POST to be valid and in effect until revoked. Requires health care facilities to communicate the existence of the POST. Empowers the

2 board for licensing health care facilities to promulgate rules and create forms regarding procedures for withholding resuscitative services. Removes civil and criminal liability for health care providers acting in good faith for decisions regarding a POST. SB258 / HB344 Adds "computed tomography" to healthcare services-con. Sponsors Sen. Rusty Crowe / Rep. Michael Harrison Description Adds "computed tomography" to the list of healthcare services requiring a certificate of need before the service is initiated. SB441 / HB544 Annual Coverage Assessment Act of Sponsors Sen. Doug Overbey / Rep. Michael Harrison Description Creates the Annual Coverage Assessment Act of Establishes process for annual coverage assessments to be applied on covered hospitals. Requires such assessment to not be used to reduce or eliminate state funding to the TennCare program. Establishes procedure to impose and collect the assessment. Specifies the amount of the assessment. (15 pp.) Comment This legislation extends the hospital coverage assessment for one additional year to continue to provide the critical dollars necessary to avoid reductions in TennCare reimbursement for providers. SB963 / HB319 Revises tamper resistant prescription requirements. Sponsors Sen. Randy McNally / Rep. David Shepard Description Broadens tamper resistant prescription requirements by allowing prescriptions printed utilizing a technology that results in a tamper-resistant prescription that meets current regulatory guidelines and requirements. Allows a pharmacist to fill a prescription issued on tamperresistant prescription paper or a prescription printed utilizing a technology that results in a tamper-resistant prescription. Allows unique serial numbers to be included on all tamperresistant prescriptions, written or printed. CERTIFICATE OF NEED Legislation SB336 / HB806 Sunset-health services and development agency. Category Government Organization Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Extends the health services and development agency to June 30, Establishes qualifications for each of the agency's six members. Comment HAT supports this legislative to extend the HSDA and preserve the CON program. PRIVATE ACT HOSPITAL Legislation SB1024 / HB737 Tax exemptions of private act hospital authorities. Category Taxes Business Sponsors Sen. Doug Overbey / Rep. Bob Ramsey Description Revises the provisions governing the tax exemptions of private act hospital authorities. Removes starting dates beginning with 2001 tax year for payments, and January 1, 2002 for claims for exemptions. Comment HAT supports this bill introduced to clarify provisions pertaining to property tax exemptions for private act hospitals. 2

3 TMA Legislation SB459 / HB277 Safe Harbor Act of Category Family Law Sponsors Sen. Ken Yager / Rep. Bill Dunn Description Creates the Safe Harbor Act of Establishes a procedure for pregnant women referred to drug addiction treatment that receives public funding to be a priority user of available treatment. Requires department of mental health and substance abuse services to ensure that certain treatment is available. Prohibits certain treatment centers from refusing treatment solely because the person is pregnant. Requires certain medical providers to encourage pregnant women to seek drug addiction treatment. Prohibits DCS from petitioning for the newborn's protection solely because of the patient's use of prescription drugs for non-medical purposes during the term of her pregnancy. Provides civil immunity for certain health care providers. Broadly captioned. Comment HAT supports this bill introduced on behalf of TMA. SB743 Collection of certain charges permitted if forwarded to sponsor. Category Professions & Licensure Sponsors Sen. Steven Dickerson Description Authorizes collection of certain charges by health care providers for voluntary provision of health care services when forwarded to a sponsoring organization. Comment HAT supports this bill introduced on behalf of the TMA. SB882 / HB867 Concussion policies for youth athletic programs. Category Education Sponsors Sen. Jim Tracy / Rep. Cameron Sexton Description Requires schools and community-based youth athletic organizations to adopt guidelines and policies concerning the nature, risk and symptoms of concussion and head injury. Requires coaches to complete an annual concussion recognition and head injury safety program. Requires the creation of a concussion and head injury information sheet. Establish procedures for the immediate removal of any youth athlete who shows signs and symptoms of concussion. Comment HAT supports this bill introduced on behalf of TMA. 3

4 OTHER Legislation SB290 / HB854 Removes medical imaging equipment from certificate of need. Sponsors Sen. Mark Green / Rep. Cameron Sexton Description Removes the requirement to have a certificate of need for magnetic resonance imaging and positron emission tomography. Redefines major medical major equipment to not include any medical imaging equipment, including but not limited to, magnetic resonance imaging, computed tomography, and positron emission tomography equipment. Comment HAT opposes this bill introduced on behalf of group practice physicians that would remove CON requirements from magnetic resonance imaging, computed tomography, and positron emission tomography equipment. This legislation would significantly weaken the certificate of need program by allowing unnecessary duplication of services that add to the cost of care and do not contribute to the orderly development of health care services. SB142 / HB118 Handgun carry permit holders to store firearms in cars. Category Criminal Law Sponsors Sen. Ron Ramsey / Rep. Jeremy Faison Description Allows the holder of a valid handgun carry permit recognized in Tennessee to transport and store a firearm or firearm ammunition in the permit holder's privately-owned vehicle while utilizing any public or private parking area, so long as the permit holder's vehicle is parked in a location where it is permitted to be and the firearm or ammunition being transported or stored in the vehicle is kept from ordinary observation while the owner is in the vehicle or kept from ordinary observation and locked within the trunk, glove box, or interior of the person's privately owned vehicle if the permit holder is not in the vehicle. Prohibits any business entity, public or private employer, or the owner, manager, or legal possessor of the property from being held liable in any civil action for damages, injuries, or death resulting from or arising out of another's actions involving a firearm or ammunition. Position Neutral Comment HAT is urging legislators to support a compromise on this legislation that would satisfy those who wish to protect the rights of private property owners that want to ban firearms. SB623 / HB615 Surgical technologists earn certain national certification. Sponsors Sen. Mark S. Norris / Rep. Tony Shipley Description Replaces LCC-ST with NBSTSA. Requires that persons employed as surgical technologists must earn 60 continuing education credits to meet national certification. Requires the continuing education credits be earned prior to the expiration of the four year cycle to renew the credential. Comment HAT opposes this bill because imposing new certification requirements could restrict the supply of surgical technologists and raise costs for hospitals. SB804 / HB937 Prohibits Medicaid expansion under new federal health care law. Sponsors Sen. Brian K. Kelsey / Rep. Jeremy Durham Description Prohibits the state from establishing, facilitating, implementing, or participating in any new expansion of the medical assistance program, also known as Medicaid, pursuant to the Patient Protection and Affordable Care Act. Comment HAT opposes this bill because failing to expand coverage through Medicaid to comply with the Affordable Care Act will diminish the resources available for community health improvement and leave community hospitals and Tennessean extremely vulnerable due to the lack of affordable, quality health care. Hospitals have agreed to accept a reduction in their Medicaid reimbursement rates in exchange for expanded coverage to reduce the amount of uncompensated care they provide each year. 4

5 SB275 Local government debt requires state funding board approval. Category Public Finance Sponsors Sen. Brian K. Kelsey Description Requires a local government to obtain approval from the state funding board when that local government on or after July 1, 2013 proposes an indebtedness that together with all other outstanding indebtedness of that local government exceeds the total amount of outstanding indebtedness of the state. Authorizes the state funding board to approve the issuance of any proposed indebtedness by a local government in excess of the limitation. Comment Due to concerns about limiting a community hospital's ability to secure financing or increasing the costs required for needed projects, HAT opposes this bill as proposed. SB548 / HB44 Helmet exemption for certain motorcycle operators. Category Transportation Vehicles Sponsors Sen. Mike Bell / Rep. Cameron Sexton Description Permits motorcycle operators to ride a motorcycle without a helmet if they have completed a department of safety approved motorcycle safety education course, they have been legally operating a motorcycle for at least two years, they are at least 21 years of age, and they have a minimum of $100,000 of liability insurance coverage and a minimum of $200,000 of medical insurance coverage. Comment HAT opposes this bill due to concerns about public safety and increased costs of unreimbursed care to the health care safety net system. SB1143 / HB894 Motorcyclist Liberty Restoration Act. Category Transportation Vehicles Sponsors Sen. Mark Green / Rep. Kelly Keisling Description Creates the "Motorcyclist Liberty Restoration Act". Requires the driver of a motorcycle under the age of 21 to wear a crash helmet. Requires the passenger of any motorcycle under the age of 21 to wear a crash helmet. Allows a driver or passenger who is over the age of 21 to wear a crash helmet, no helmet, or a helmet meeting certain requirements. Increase the licensing renewal cost for a Class M license from $17.50 to $ Allocates the $2.00 increase in funds to be earmarked to the bureau of TennCare. Directs the department of health and the department of safety to prepare a report on the number of motorcycle accidents on Tennessee roads and highways involving riders without helmets and the costs to TennCare to care for such riders. Requires the commissioner of health to report the findings on February 1, Comment HAT opposes this bill due to concerns about public safety and increased costs of unreimbursed care to the health care safety net system. 5