IHA Vice President of Government Relations Trent Fox took time to sit down with Harmony editor Natalie Russell to discuss priority legislation for hospitals in the 2022 session, beginning in January. Below is a preview of some legislative issues that IHA and other industry leaders plan to address next session.
Q: What will be the top legislative agenda items for Indiana hospitals next session?
A:
- Workforce: The COVID-19 pandemic has shed light on, and even exacerbated, Indiana's health care professional shortage. The physical and mental toll of this pandemic has overwhelmed our workforce. IHA will advocate for policies to support Indiana's health care heroes. A few examples of such policies include:
- Licensure: Under the executive orders of the Governor, many barriers to providers were lifted through regulatory waivers. IHA will advocate to make permanent certain waivers. Additionally, the Professional Licensing Agency (PLA) implemented the registry for out-of-state health care providers who wish to practice in Indiana. The registry allows them to do so, as long as they hold the same license type in another state and are in good standing. This registry will be terminated once the Public Health Emergency (PHE) ends. If the Governor decides not to renew the PHE, we contend this type of registry, or similar reciprocity measures, should continue permanently.
- Student Loan Repayment: Another way to support Indiana's health care workforce is to provide financial relief associated with their training and education. IHA will support legislation to establish such a program for health care providers in the state who have committed to serving Hoosiers.
- Health Care Cost Transparency: It is undeniable that affordability remains a top concern, therefore IHA has been a proponent of increased transparency of health care costs. Hospitals have committed to transparency through various measures in recent years, but there are several other contributing factors to the cost of health care for Hoosiers, such as insurance premiums and costs associated with the pharmaceutical industry. IHA will support the next phase in transparency, providing consumers with meaningful information concerning their increasing health insurance premiums and what they are paying for drugs.
- Employers of all sizes are dealing with the devastating costs of health insurance. IHA has worked proactively in the market to resolve such issues with innovative and tailored solutions. This type of market solution will play a large role in the future of health care delivery. Employers have made it clear they want help, and hospitals are answering that call throughout the state.
Q: Will there be more legislation surrounding COVID-19 policies, including vaccination mandates?
A: Due to the developments over the last two years, we presume there will be legislative proposals concerning vaccinations, specifically dealing with an employer's ability to require its staff to be vaccinated.
- The legislature considered a few pieces of legislation in the 2021 session dealing with vaccinations, ultimately resulting in what has been called the “vaccine passport" provision included in House Enrolled Act (HEA) 1405. The new law prohibits government entities from requiring documented proof of the COVID-19 vaccination as a condition of employment.
- Since that law went into effect, there have been many developments on this front. The FDA elevated the Pfizer vaccine from its status under Emergency Use Authorization (EUA) and granted it full approval. Additionally, President Biden and his administration have been gradually pushing for vaccine requirements throughout the federal government and even asking for regulations to require certain larger employers to require it as a condition of employment.
- As this issue evolves, state legislatures will undoubtedly react in various ways. IHA will advocate for policies that support hospitals, and all health care providers, in their mission to serve patients safely. Several industries outside of health care delivery are strongly encouraging, and even requiring, vaccination for their workforce. Increasing Indiana's vaccination rate is the most effective way to get out of the pandemic, and IHA will continue to support ways to accomplish that goal.
Q: Recommendations were made at the end of the 2021 legislative session regarding “white bagging." How will IHA expand on this issue next session?
A: During the 2021 session, the legislature passed a bill that required the Indiana Department of Health (IDOH) to research and report on specialty drug management, generally known as “white bagging." This legislation was in response to insurance companies mandating new policies regarding the distribution of specialty drugs that have jeopardized patient safety. Indiana hospitals were previously able to utilize in-house pharmacies to source specialty drugs such as chemotherapy treatment and other infusion medications, to assure quality and patient access. With the policy change, insurance companies are now requiring hospitals to use only designated specialty pharmacies that are often owned by or affiliated with the insurance company. Following the change, hospitals have faced ongoing difficulty acquiring the drugs needed to treat patients, or have received incorrect or unusable doses, which has caused delays to patient care and poses risks to patient safety. Though the legislature did not have extra lead time to consider the bill due to the late release of these policy changes, state lawmakers quickly realized the gravity of the safety concerns and passed legislation requiring a report to yield further information. The IDOH report was released in July of 2021 and contained multiple recommendations for the practice of white bagging, which were directed toward both health care providers and insurance companies for implementation. IHA's goal for the 2022 session is to advocate for the recommendations made in the report to be operationalized through legislation. The report emphasizes the safety issues white bagging poses and encourages best practice guidelines for handling specialty drugs throughout the supply chain.
