Submitted by: Betty Dickson, MANA Lobbyist

Report to the Mississippi Nurses Association
Health Affairs Committee

The legislature voted today to go home over the weekend after all general bills have been signed. They will come back April 20 to finalize the budget. By that time, they are hoping to know what funds are coming from the federal government for Medicaid. They will also have revenue figures for all of March and much of April.

A review of the bills that MNA is supporting or following follows:

HB 32 - School nurses; require school districts to grant same leave allowances as allowed teachers. Died in Committee

HB 212 - Advanced practice registered nurses; extend repealer on Nurse Practice Act. This bill passed the House with language that extended the repealer until 2015. This bill does not include removal of ‘reverter’ language. This bill is alive and on the Senate calendar. It should pass next week but will likely die on the calendar because SB 2557 removes both the reverter language and extends the repealer. We do not need HB 212. SB 2557 has been signed by the governor.

HB 664 – MS Silver Alert System act of 2010. MNA worked to get this bill passed. It will set up an activation should a senior adult with dementia goes missing. This bill is similar to the Amber Alert activation plan for children. This bill passed the House, went to the Senate where it was amended and has now gone back to the House where Chairman Willie Bailey has assured us that he will concur with the Senate language. That bill has been signed by the governor

HB 694 – Require applications for nursing licensure to undergo criminal background checks. This bill came from the Board of Nursing and is related to requirements in the licensure compact with other states. The Board will conduct the checks. This bill has passed the House, was transmitted to the Senate and is now on the Senate calendar. Bill has passed and sent to the governor.

HB 695 – Midwifery; Board of Nursing shall regulate and only allow certified nurse midwives to practice. The bill was amended in the House Public Health Committee to allow for registration of lay midwives with the Board of Nursing and be allowed to practice for five years before being phased out. There was a lot of misinformation about the bill among those who wished to deliver their own babies at home and legislators began receiving phones calls from those opposing the bill. Board of Nursing Executive Director Melinda Rush said she will begin dialogue with those who opposed the bill. I predict that the bill will be introduced again next week and we will push to have a hearing to dispel any wrong information. The bill was only aimed at those midwives who were hanging out a shingle and charging for their services.

HB 728 – Increase the number of school nurses who are eligible for certification salary supplement. The cap is currently at 30. This bill died early in committee. It was difficult to argue for this bill in light of the fact that many teachers and counselors are facing possible cuts in this program. There was certainly no mood to increase the numbers. While the legislature is trying to provide enough funding to pay the existing certification staff, there was a bill to cap teachers and counselors due to budget restraints. This will remain a contentious issue as long as the current economic downfall exists.

HB 954 and SB 2579 – Both bills died early in the session when opposition came from several hospital administrators in spite of the fact that the MS Hospital Association agreed earlier not to fight the bill. The bill was also opposed by several ambulatory surgical centers. The bill would have required that an RN (circulating nurse) be present for operating and invasive procedures. Many states have passed similar legislation. According to the Hospital Association, all hospitals follow this standard, but since the opposition arose, it was decided it was better to give this issue another year to continue dialogue with all parties and try to resolve the issue prior to the legislative session 2011.

The midwife bill and the circulating nurse bill are great examples of flushing out your opposition. Seasoned lobbyists will tell you that it takes up to three years to get a bill through to final passage. These two bills introduced for the first time, now are ‘out there’ and we now know where the opposition is. Work can be done prior to the 2011 session to work with the opposition to hopefully resolve some of the questions.

HB 1067 - Nurse-Family Partnership program; State Department of Health shall establish in MS. This program provides for a nurse to follow a first-time mother from the 28 th week of pregnancy through childbirth and until the child is age two. MNA joined with the Nurse-Family Partnership to get this bill passed. The bill passed both houses and was sent to conference. Conference bill entered and passed both houses today (March 25) and now goes to the governor for his signature. There is $1.5 billion in the recently passed Health Care Reform bill for home visit programs. We have been in touch with Dr. Mary Currier, State Health Officer and MNA member Margaret Morton at the State Health Department and are looking forward to working with them on this program.

HB 1192 - Board of Health will adopt guidelines incorporating principles of patient-centered medical home. MS State Medical Association was behind this bill. It passed the House where it was amended to include nurse practitioners. The bill has been signed by the governor.

HB 941 – Sets up the Mississippi Health Information Network. The governor’s office received $10.3 million to be used to set up a statewide network to facilitate communication of patient clinical and financial information. MNA Executive Director Ricki Garrett served on the governor’s task force to make recommendations as to how this would be done. The bill calls for a governing board to oversee this work. The original bill did not include a registered nurse so we had it amended to do so. The amended bill from the House had a 21-member board. The Senate PH committee did a strike-all to HB 941and made several changes. The strike-all set up a nine-member board. In the changes, MNA continues to have a representative on the board. The bill calls for oversight of all parties who will participate so as to avoid duplication, to insure interconnectivity, a seamless flow of information and complete security of data. Parties currently involved in initiating programs include providers, University Medical Center, IQH, Medicaid, Delta Health Alliance, hospitals and the Federally Qualified Health Centers (FQHCs). The House bill and the Senate bill are very different. This bill went to conference, where the conferees removed all association appointments. Nursing was left out of the bill in spite of the fact that over 1800 NPs and scores of nurses will be using the electronic patient record system.

SB 2744 - State Health Insurance Management Board; authorize to assess active employees a portion of premium under health plan. This bill is now on the House calendar. If you are a state employee and are covered on the state plan, you can expect your premiums to increase.

SB 2127 - Health insurance; provide for reciprocal limitations on claim filing and claim audits. This bill will be of interest to nurse practitioners. It sets out that the health insurance issuer or other health insurance benefit payer shall have the same time limit following payment of the claim to perform any review or audit for reconsidering the validity of the claim and requesting reimbursement for payment of an invalid claim or overpayment of a claim. This bill is on the House calendar. I recommend that NPs who are billing might have their billing clerks follow this bill. It has been signed by the governor.

There were hundreds of health care bills filed this year and many died during the session. Others passed. Interested parties should access the legislative website at www.ls.state.ms.us and look under bill status. If you have questions regarding a bill, please direct them to me at bettyrdickson@gmail.com .

Another piece of information important to nurse practitioners follows:

21% Medicare Payment Cut Postponed until April 1

The U.S. Senate passed H.R. 4691, the "Temporary Extension Act of 2010," by a vote of 78-19 on Tuesday night. The bill included provisions that resulted in a one month delay of the 21% physician payment cut that was scheduled to take place on March 1. The cut is now extended until April 1st.


The bill, which was passed by the House of Representatives on February 25th, encountered opposition on the Senate floor from Senator Jim Bunning (R-KY). The Senator repeatedly objected to unanimous consent votes on the legislation because he wanted to find ways to finance the bill, so that it wouldn't add to the deficit. Additionally, the bill extends the therapy cap exceptions process through March 31, 2010, retroactive to January 1, 2010. Outpatient therapy service providers may now submit claims with the KX modifier, when an exception is appropriate, for services furnished on or after January 1, 2010
through March 31, 2010


Although another short term fix is now in affect, there are other proposals in the works that would implement other short-term patches to the sustainable growth rate (SGR) formula. Some proposals would postpone cuts for 90 days, 7 months, or through the end of 2010. Senate Majority Leader Harry Reid (D-NV), has a measure to provide full-year extension of Medicare payments to physicians as well as extensions to other expired benefits.