SUMMARY OF SIGNIFICANT LEGISLATION RELATING TO
MEDICAL PRACTICE OR PUBLIC HEALTH
INTRODUCED IN THE 2018 REGULAR SESSION OF
THE WEST VIRGINIA LEGISLATURE
The West Virginia State Medical Association ("WVSMA") was actively involved in advocating certain legislation relating to medical practice and public health. At times, that advocacy took the form of providing significant support for or input to policy decisions made by legislators. At other times, WVSMA opposed legislation and played a critical role in its defeat.
A. The following bills were enacted by the West Virginia Legislature during the 2018 regular session.
Do note that Governor Justice must act on these bills by or before midnight on March 28, 2018.
A failure to act does not result in a "pocket veto"; the only way to disapprove a bill is to veto it. Thus, a bill can become law without the Governor's signature.
The Opioid Reduction Act of 2018. This is the Governor’s bill on opioid reduction. The bill limits initial prescriptions of controlled substances to certain patients, with subsequent prescriptions also limited. It does not apply to certain patients such as those under cancer treatment, in palliative care, or in nursing homes, nor does it apply to patients who have been in an existing physician-patient relationship and under an opioid treatment plan prior to January 1, 2018. The bill requires narcotics contracts for any prescriptions exceeding 7 days whereby the patient is limited to receiving Schedule II drugs from one physician and pharmacy. A breach of the contract may be a basis for termination of the relationship. Finally, SB 273 strengthens existing law by requiring the Board of Pharmacy, upon consultation with affected professionals, to promulgate emergency rules which define abnormal prescribing practices and to report such on a quarterly basis to the appropriate licensing boards. WVSMA supported this bill and provided significant direction for policy makers relating to limitations on initial prescriptions for opioids. Also, language in the bill which appeared to expand the prescriptive authority for physician's assistants and APRNs was removed at the request of WVSMA.
-Relating to prior authorizations. The original purpose of this bill was to establish universal forms and deadlines when a prior authorization is submitted. However, the bill was amended such that payers are now required to post on their websites by October 2018 those particular forms they require for submission of requests for prior authorizations. Further, as of July 2019, payers must respond to electronic prior authorization requests within 48 hours for urgent and within 7 days for non-urgent matters. WVSMA supported this bill and engaged with lawmakers and their staff in the development of the underlying public policy for this legislation.
Relating to the clarification of prescribing guidelines for biological products. The purpose of the bill was to provide definitions of biological and biosimilar products and to permit a pharmacist to substitute a biosimilar for a prescribed biological product only if permitted by the prescribing physician and if that biosimilar had been recognized by the FDA as interchangeable. However, if a physician expressly indicates on the prescription that the biological is medically necessary, there may be no such substitution. Pharmacists must report any permitted substitution to the physician within 5 business days. This bill was originally drafted by WVSMA and supported throughout the legislative process.
-Updating the schedule of controlled substances. This bill amended certain schedules of controlled substances and, among other things, added Gabapentin as a Schedule V controlled substance. WVSMA supported this bill and engaged with lawmakers and their staff in the development of the underlying public policy for this legislation
Requiring specified coverage in health benefit plans for outpatient and inpatient treatment for substance abuse disorders. Language in the bill which appeared to expand the prescriptive authority for psychologists was removed at the request of WVSMA.
Relating to Patient Injury Compensation Fund. The purpose of this bill is to continue the collection of fees from hospital trauma centers, plaintiff's attorneys, and physicians for deposit in the Patient Injury Compensation Fund. Those moneys would then be used to pay out compensation to the closed class of qualified plaintiffs. Once those claims have been satisfied, the Fund would close on December 31, 2021. Together with the other participants, WVSMA supported the continuation of this Fund.
Relating generally to drug control introduced by request of Governor Justice. The purpose of the bill is to require hospital emergency rooms and departments, as well as certain other law enforcement and medical care providers, to report suspected or confirmed drug overdoses to the Office of Drug Control Policy. This bill permits counties experiencing drug overdoses higher than the national average to establish certain community-based recognition and response efforts and seek federal and private funding to implement these programs. The bill requires all first responders, regardless of frequency of drug overdoses in their communities, to carry naloxone and be trained in its use.
Relating to hospitals as a designation for stroke treatment. The purpose of this bill adds a designation as a thrombectomy-capable stroke center. The bill also modifies the composition of the advisory committee promoting stroke awareness and treatment and also prohibits inspections of such hospitals by DHHR as a result of their designation. The American Heart Association supported this bill, as did the WVSMA. It passed both chambers unanimously.
Specifying documents not subject to discovery. The purpose of this bill is to identify in law those documents generated during the peer review process that are not subject to civil discovery in subsequent proceedings, such as medical malpractice actions. The bill codified case law in that regard, providing continuity and clarity in those areas.