State Rep. Bashore requests AG opinion on out-of-state prescribers

Bashore Requests AG Opinion on out-of-State Prescribers

OKLAHOMA CITY (Sept. 20th) – Rep. Steve Bashore, R-Miami, has requested an opinion from Oklahoma Attorney General Gentner Drummond concerning Oklahoma residents' ability to fill prescriptions at an Oklahoma pharmacy when prescribed by an out-of-state medical provider.

Sen. Dahm files legislation to fight destructive woke gender ideology

Sen. Dahm files legislation to fight destructive woke gender ideology

OKLAHOMA CITY – Sen. Nathan Dahm, R-Broken Arrow, has filed legislation to fight the dangerous and destructive woke gender ideology of the left.

“For years, Senate leadership has dismissed the threat that the left’s gender ideology poses to our state,” Dahm said. “However, with instances of ‘family friendly’ drag shows, drag queen story hours, and the discovery of the gender transition program at OU Medical, it’s past time we stop this craziness. The following bills will provide Senate leadership with a way to fulfill the promises made during special session and end the practice of gender destruction in our state.”

Bullard files bill prohibiting genital mutilation (aka "gender transition") of anyone under the age of 26

Bullard files bill prohibiting genital mutilation of youth under 26

OKLAHOMA CITY (Jan. 10th) - Sen. David Bullard, R-Durant, recently filed Senate Bill 129, also known as the Millstone Act, to prohibit Oklahoma doctors from providing gender transition procedures or referral services relating to such procedures to anyone under the age of 26. The bill would further authorize the state’s attorney general to enforce the act and those found guilty of violating it would be guilty of a felony and subject to license revocation.

Stitt signs bill ensuring firefighters can provide limited emergency medical transport

Legislation signed ensuring firefighters can provide emergency medical transport in limited situations

OKLAHOMA CITY (May 17th) – Legislation giving firefighters statutory authority to transport patients to the hospital in emergency situations has been signed into law.  Senate Bill 1515, by Sen. Darrell Weaver, R-Moore, and Rep. Mike Osburn, R-Edmond, was signed by Gov. Kevin Stitt on Monday.

Weaver filed the legislation in response to a situation where an Oklahoma City firefighter was disciplined for his decision to drive a 3-year-old burn victim to the hospital in his fire truck after waiting 20 minutes for an ambulance to arrive.

Joint Committee on Pandemic Relief Funding approves $60M to address nursing shortage

Relief Working Group Recommends Funding to Increase Nurses

OKLAHOMA CITY – The Joint Committee on Pandemic Relief Funding – Health and Human Services Working Group today unanimously approved a number of projects to send to the full committee that would substantially increase the number of nurses in the state.

Funding for the total projects requested equals roughly $60 million.

The working group is chaired by Oklahoma House Speaker Pro Tempore Kyle Hilbert, R-Bristow, and Sen. John Haste, R-Broken Arrow. Reps. Jon Echols, R-Oklahoma City, Cyndi Munson, D-Oklahoma City, and Sens. John Michael Montgomery, R-Lawton, and Julia Kirt, D-Oklahoma City, serve as members of the working group.

The lawmakers issued the following joint statement after today's action:

OCPA column: Lives and livelihoods are decimated by surgery bans

Lives and livelihoods are decimated by surgery bans

By Jonathan Small

The U.S. health care system is starting to collapse, and lives and livelihoods are being endangered and lost. The cause of this malady is easy to diagnose: excessive government restrictions imposed in the name of fighting COVID-19. The cure is simple: Lift the government restrictions on society, including those impacting provisions of much-needed medical care.

Due to COVID-19, many states imposed bans on “elective” surgeries in response, which were even labelled “non-critical luxuries.”

This was done to save beds for COVID-19 patients and preserve personal protective equipment.

Sadly, these onerous government orders put many medical providers on the verge of bankruptcy and caused real harm, including death, for patients nationwide. And it turned out the COVID-19 hospitalizations never appeared in the numbers projected, so those extra hospital beds were not needed.

One local cardiologist, Dwayne A. Schmidt, recently noted Oklahoma’s ban included patients with large, high-risk aneurysms. One of Schmidt’s patients suffered a life-changing heart attack at home after his surgery was delayed.

I personally know stories of a young man whose body suffered and weakened because he could not get the surgery he needed. I also know personally of a woman who faced the danger of not having a timely aortic valve replacement.

The ban has also destroyed the finances of many health care providers. Now mass layoffs and furloughs are underway. Becker’s Hospital CFO Report says 256 hospitals across the nation have furloughed employees. The providers laying off medical workers include Mercy, which is furloughing employees across a four-state system that includes Oklahoma, Poteau-based Eastern Oklahoma Medical Center, Integris Health in Oklahoma City, and HillCrest HealthCare System in Tulsa.

A report by the American Academy of Family Physicians has predicted most counties in the country could face a shortage of family medicine providers if coronavirus restrictions continue through June because doctors will be forced to permanently close their doors.

Even so, Oklahomans are fortunate that our state’s “elective” surgery ban has been lifted. People in other states are not so lucky. For the sake of lives and livelihoods, the Mackinac Center Legal Foundation has been forced to file a lawsuit on behalf of three medical practices to challenge Michigan Gov. Gretchen Whitmer’s executive order that continues to ban “elective” procedures in that state.

The announcement of the lawsuit noted one Michigan patient forced to postpone gallbladder surgery has now developed gangrene. Michigan physician Jordan Warnsholz warned the government shutdown “has put my patients directly at risk.”

A policy that causes the collapse of health care infrastructure while increasing the lethality of non-COVID-19 medical conditions is a policy that should be abandoned; let’s pray that happens immediately.

Jonathan Small serves as president of the Oklahoma Council of Public Affairs.

OSDH issues guidance for resuming elective surgical procedures

OSDH Issues Guidance for Resuming Elective Surgical Procedures in Oklahoma April 24

In preparation for elective surgeries resuming in Oklahoma on April 24, the Oklahoma State Department of Health (OSDH) today issued the following guidelines for elective surgery centers and hospitals:

Testing guidelines:

• Elective surgery centers and hospitals must administer COVID-19 tests in partnership with private labs to test all patients prior to surgery. 
• Patients should receive a negative COVID-19 test result within 48 hours of the scheduled procedure.
• Elective surgery centers and hospitals should not perform an operation on a patient with a medical history of COVID-19 until that patient has received two negative COVID-19 test results. 

Governor Stitt amends Executive Order to allow for elective surgeries to resume

Governor Stitt amends Executive Order to allow for elective surgeries to resume

OKLAHOMA CITY (April 16, 2020) – Governor Stitt today issued an amendment to Executive Order (EO) 2020-13, which sets guidelines for medical providers to determine which elective surgeries that can resume April 24.

Additionally, Gov. Stitt signed Executive Memorandum 2020-02 outlining an Elective Surgery Acuity Scale (ESAS) for medical providers to follow regarding when elective surgeries can be performed during the COVID-19 state of emergency.

OSU lab on Stillwater campus to assist state with COVID-19 test analysis

OSU lab on Stillwater campus to assist state with COVID-19 test analysis

(STILLWATER, Oklahoma - March 27, 2020) – Oklahoma State University is helping Oklahoma ramp up its COVID-19 testing capability after procuring supplies sufficient to analyze approximately 10,000 COVID-19 test samples being taken by health care professionals across the state.

Through coordination with partners from the OSU Center for Health Sciences, the lab has been certified by the Center for Medicare and Medicaid Services to run the tests for COVID-19. In partnership with the Oklahoma State Department of Health (OSDH), OSU’s certified diagnostic laboratory has the personnel and equipment to begin testing next week.

“Oklahoma State University has done incredible work to quickly find innovative ways to help our state significantly increase its COVID-19 testing capacity,” said Governor Kevin Stitt. “Secretary Shrum has been an invaluable member of my Governor’s Solution Task Force, and I commend President Hargis and her for answering the call to help their fellow Oklahomans.”

Individuals will need to get the initial swab administered by a medical professional. Health care providers will be notified by the OSDH next week regarding how to submit sample test samples.

“We are pleased to support the state’s extensive efforts to blunt the spread of this virus. I commend the innovation of our researchers and administrators to find ways we can use our experts and resources to overcome the challenges we face as this crisis evolves, ” said OSU President Burns Hargis. “Both OSU and OSU Center for Health Sciences experts are committed to doing our part to protect Oklahomans during this public health crisis.”

Dr. Kenneth Sewell, vice president for research at OSU, said the university is uniquely prepared to take part in the statewide effort to accelerate testing.

“We will be able to test hundreds of samples in an eight-hour shift,” he said. “If necessary, our lab can increase our capability to additional shifts.

“All of our universities in the state play different roles, but only a few of us are research universities and have this kind of equipment, have the faculty that are trained up in this with staff and graduate assistants. Everything they do at a research level is meant to have a positive impact on the public, but it’s a rare time when we can put that impact in play almost in real time. This is going to matter today and tomorrow, and we think that’s why we’re here.”

Muskogee Hospital sets up triage tent adjacent to ER to process potential COVID-19 patients

Saint Francis Hospital Muskogee Update to COVID-19 Response

(Muskogee, Oklahoma) As a part of the ongoing preparation and response to COVID-19 in the area, Saint Francis Hospital Muskogee has set up a triage tent adjacent to its emergency department in order to assess patients presenting with emergent COVID-19 symptoms or acute respiratory illness. By doing this, the hospital aims to minimize the number of potentially infectious patients entering the facility without appropriate personal protective equipment.

“We want to keep all of our patients and staff safe and reduce their exposure to COVID-19,” said Michele Keeling, senior vice president and administrator of Saint Francis Hospital Muskogee. “In order to do this we are directing all patients seeking emergency treatment to proceed directly to the tent.” This process will start at 7:00 a.m. on Thursday, March 26.

The external triage area provides the hospital the ability to physically distance patients with confirmed or suspected COVID-19 symptoms from those coming to the emergency room for other serious medical issues such as stroke, chest pain and trauma. As patients are assessed in the triage area and their level of severity is determined, they will be appropriately masked and escorted into the facility in a manner that minimizes exposure to others.

“I want to make sure that I’m clear, this tent is not a walk-in clinic or public testing site—it is an extension of the emergency department. If you do not need emergency care, please do not come to the hospital. Instead, call your primary care physician first for guidance,” said Keeling. “The presence of this tent should not cause any unnecessary anxiety. It does not mean that we are unable to handle the volume of patients coming to the hospital. It is only a sign that we are doing everything within our power to keep our patients and staff safe.”

The hospital continues to respond to the needs of the community during this time of increased public concern. “Our role in this pandemic is to be prepared and ready to care for our community,” said Kim Walton, RN, director of acute care services.

Saint Francis Hospital Muskogee has posted information via www.saintfrancis.com/muskogee which includes important links to the Oklahoma State Department of Health and the Centers for Disease Control and Prevention.

OCPA column: Oklahomans deserve protection from scam medical bills

Oklahomans deserve protection from scam medical bills

By Jonathan Small

Because hospitals operate in a system with little pricing transparency, many patient bills are more fiction than fact, yet patients can face financial devastation if they don’t pony up.

At the same time, the cost of medical bills would have been much, much lower if the market allowed for competitive pricing through up-front information.

This happens nowhere else in American society. Can you imagine purchasing anything—from goods at Walmart or Amazon to a car or home—without advance knowledge of price while facing a legal obligation to pay whatever a provider demands? Of course not, yet that scenario plays out in health care every day—even though most health care procedures are neither new nor emergencies.

Oklahomans deserve protection from these exploitive practices, and it’s to their credit that some lawmakers have filed legislation this year to protect consumers from “surprise” medical bills.

The proposed law would prohibit medical providers from reporting a healthcare debt to a credit bureau or pursuing collection activities unless the patient “was presented with and agreed to the total cost of all healthcare services” prior to receiving services.

Prior authorization is crucial, because many hospitals do much to keep patients in the dark. Even at medical facilities listed as “in network” on an individual’s insurance policy, specific doctors at that same facility can be considered “out of network,” such as an anesthesiologist. That’s often done deliberately and allows issuance of wildly inflated bills to patients given no forewarning.

Hospitals respond by quibbling over the definition of “surprise medical bill.” But I have a news flash: Any bill where a consumer is not provided an advance cost estimate is a surprise bill.

Oklahoma Watch has reported that dozens of Oklahoma hospitals filed at least 22,250 lawsuits against former patients over unpaid medical bills in recent years. Many of those bills fall into the “surprise” category, and those being sued include people from all parts of society, including people with insurance and those on government-funded Medicaid.

Some hospital officials suggest inflated bills are caused by “uncompensated care.” Yet that category itself is rife with bogus figures, as can be seen by hospitals’ actual profit margin. Oklahoma Watch found the Saint Francis Health System accounted for 22 percent of all state hospital lawsuits against patients. But when the 1889 Institute reviewed hospitals’ publicly available reported financial data in 2017, it found Saint Francis enjoyed a 17.5-percent profit margin.

U.S. House Speaker Nancy Pelosi famously said Congress had to pass Obamacare so citizens could find out what’s in it. For too long, Oklahoma’s big-box hospitals have operated on the Pelosi principle when it comes to medical bills. Lawmakers should put an end to that.

Jonathan Small serves as president of the Oklahoma Council of Public Affairs.

'Transparency in Health Prices Act' passes State House 93-0

Transparency in Health Prices Act Passes House

OKLAHOMA CITY – State Rep. Carol Bush (R-Tulsa) today secured unanimous passage of a bill that ensures price transparency to the public for common health care treatment options.

House Bill 3029 creates the Transparency in Health Care Prices Act and would require health care providers, groups and facilities to make health care prices available to the public for their 20 most commonly provided inpatient and outpatient services. The measure passed the House with a vote of 93-0.

“Someone needing health care services deserves to know the price they will pay for such treatment,” Bush said. “This bill is an effort to provide more transparency in our health care treatment system and to set up a basic structure for supplying such cost information to the Oklahoma consumer.”

Bush said the legislation is supported by the Oklahoma State Medical Association and was a request bill from three doctors that live in her district.

Health care price referenced in this measure means the cash price a provider, group or facility will charge a patient for standard services to be rendered. This pricing list shall be made available to the consumer by the provider, group or facility via their website or other conspicuous posting and must be updated annually. The health care cash price would not include any amount in the case of complications or exceptional treatment.

HB 3029 was co-authored in the House by State Reps. Lewis Moore (R-Arcadia), Andy Fugate (D-Oklahoma City), Robert Manger (R-Oklahoma City), Melissa Provenzano (D-Tulsa) and Dr. Randy Randleman (R-Eufaula).

The bill now moves to the State Senate where it is authored by Adam Pugh (R-Edmond).

Carol Bush represents District 70 in the Oklahoma House of Representatives, which includes parts of Tulsa County.

OK Rural Association asks Congressional delegation to act on surprise medical billing

The Oklahoma Rural Association weighed in this week on the issue of surprise medical billing by sending the following letter to Oklahoma's Congressional delegation. Oklahoma state legislators are discussing the issue as well, which you can read about here.

January 20, 2020

As a nation, we continue to grapple with the rising cost of health care and health insurance. As you know, one of the most troubling aspects of this trend is the prevalence of hidden costs that are passed onto patients by insurance companies after they deny an out-of-network claim. As you and other members of Congress seek to remedy this, I urge you to use the wisdom and foresight you have lent to other policy issues to mitigate unintended consequences that make the solution further complicate, rather than solve, the original problem.

Some states, like California, have sought to resolve surprise billing through cost controls, but such plans have proved short-sighted. Setting low rates for medical care might sound like an appealing option to keep costs low, but it creates another problem: access. These caps could put doctors out of business. In fact, California is currently experiencing a doctor shortage that leaves many communities underserved, particularly rural farming communities. Rural communities across the country already face doctor shortages and other hurdles to accessing healthcare services. Additional and more severe shortages caused by government rate-setting would unquestionably harm these communities.

New York, on the other hand, has instituted an arbitration system, which empowers a third party to resolve billing disputes between doctors and insurance companies. This system has shown promise, maintaining patient access to vital (and potentially life-saving) care while reducing out-of-network billing by 34% and lowering emergency room fees by 9%.

Any legislation that addresses this problem must recognize that surprise medical bills usually emerge from a dispute between a patient’s insurance and that patient’s doctor. Patients themselves should not be in the middle of these disputes. As you look at potential solutions that protect patients and remove them from the middle of this process, please tread carefully to ensure that high costs are not slashed at the expense of access.

Thank you.
Monica Collison
President
Oklahoma Rural Association

OCPA column: Medicaid won't reduce inflated hospital bills

Medicaid won’t reduce inflated hospital bills

By Jonathan Small

Most of us have heard of someone who received a wildly implausible bill from a hospital. Among the examples compiled by the website, thehealthy.com, were hospitals that charged $15 per Tylenol tablet, $8 for a “mucus recovery system” (better known as a box of tissues), $53 per non-sterile pair of gloves, $10 for the little plastic cup that holds a patient’s pills, and $23 per alcohol swab.

The retail cost of a Tylenol tablet runs less than 30 cents, meaning the $15 price is a markup of more than 5000 percent. If hospitals are overcharging that much on small items, one wonders how much the markup is on the big-ticket items.

Those prices are the result of a medical system with no price transparency and, therefore, little direct competition. And the lack of transparency leads to “surprise” medical bills that people struggle to pay, and then to lawsuits.

Oklahoma Watch recently reported that Oklahoma hospitals have filed at least 22,250 lawsuits against former patients over unpaid medical bills since 2016.

How did some hospital officials’ respond to that report? Just expand Medicaid.

But experts familiar with the lawsuit issue note that many people being sued are already insured, including some on Medicaid. This problem isn’t caused by lack of coverage; it’s caused by a lack of transparency. Even for routine procedures, it is extremely difficult to get an up-front estimate, and hidden costs are the norm.

However, where price transparency exists at places like the Surgery Center of Oklahoma, it demonstrates conclusively that many other hospitals are dramatically overcharging patients. Comparisons have shown the Surgery Center’s prices are often one-sixth to one-eighth the amount charged elsewhere.

So why is it that the facilities charging the far-higher prices are the ones claiming to be on the verge of insolvency, and not the Surgery Center? One answer is that many of the figures touted by supposedly “broke” hospitals are as bogus as a $15 aspirin pill. Martin Makary, a professor of surgery with the Johns Hopkins University School of Medicine, recently noted that one hospital was caught charging $70,000 for a hip replacement when the commercial reference-based price was $29,000 and the Medicare-allowable amount was $20,000. That means that hospital could claim to have provided $30,000 in “uncompensated” care if it collected “just” $40,000 on a hip replacement, even though that price may represent $10,000 to $20,000 in pure profit.

Expanding Medicaid won’t suddenly cause hospitals to stop inflating bills. In fact, knowing that taxpayers are on the hook may encourage some providers to further boost their charges, and patients will continue to be sued.

If policymakers are serious about reducing health costs and protecting consumers, they need to focus on increasing up-front price transparency and competition in medicine, not expanding government welfare.

Jonathan Small serves as president of the Oklahoma Council of Public Affairs.

Op-Ed: Real health care solutions available

Real health care solutions available

Let us start talking about health care by getting a few things out of the way.

First, looking for government solutions to health care is a lost cause. We can quibble, but in the end, any plans coming out of D.C. are going to be based on special interests and political advantage. The second is the error of conflating health care with insurance. Health care insurance is not health care, any more than car insurance is car maintenance. To fix our system’s problems, we have to move away from treating health insurance as a cost-sharing plan for non-catastrophic, non-major medical care.

Real solutions are happening right now across Oklahoma and the U.S. as providers in several areas of care are stepping away from the fantasy pricing of the insurance-based system. A growing number of providers are offering transparent pricing and bundled care for their goods and services.Would you like to get effectively unlimited care as needed from your physician for $50-$100 a month? There is a growing number of physicians doing just this. It is a model called Direct Primary Care.

In this model, clients pay a monthly subscription fee. Routine care, even for things like stitches, are covered by the subscription. Most include the ability to contact the physician digitally or by phone with questions or concerns, which becomes a great convenience for clients. Many also include the ability to get needed medications, labs, and imaging without the normally bloated pricing, often for pennies on the dollar.

These savings alone, in a great many cases, are more than enough to cover the cost of the monthly subscription.

Honest and competitive pricing is being realized in other areas as well. Not long ago, I was looking to get X-rays for a client. A certain nonprofit quoted a $350 price tag, which included the radiologist’s report. At an imaging center not taking insurance, I was able to get the same service for $56. You see similar differences in pricing for MRI, CT, and other imaging.

Surgery is another area benefiting clients with price honesty and transparency.There are now state-of-the-art surgery centers in Oklahoma and across the U.S. that actually list their prices, and those prices are often 10-20 percent of the price charged in hospitals and other insurance-based systems. It isn’t rare for the prices at such centers to turn out to be less than the out-of-pocket portions for the same procedures done at locations playing the insurance game.

So, right now, there is a growing availability of care that costs less than many spend for coffee, internet, or a phone in a month. Honest, market-based pricing is bringing down costs, and making care more affordable and accessible. Though we have a long way to go, there is a health care revolution happening now, and it is being done by patients and providers.

For those interested, the Free Market Medical Association is a great source to find and reach out to the health care innovators and providers that are bringing real solutions to our communities.

Dr. Shannon Grimes is a chiropractor in Tahlequah, former chairman of the Cherokee County Republican Party, and current chairman of the Cherokee County Libertarian Party.

Lawmakers Vote to Ban Creation of Embryos for Experiments

Lawmakers Vote to Ban Creation of Embryos for Experiments

OKLAHOMA CITY (February 22, 2011) – Legislation that would make it illegal to create human embryos for experiments was approved by a House committee today.

"This legislation simply makes it illegal to create unborn children with the intent of killing them for research purposes," said state Rep. George Faught, R-Muskogee. "Oklahomans do not support treating unborn babies as ‘spare parts.’"

House Bill 1442, by Faught, creates the "Destructive Human Embryo Research Act." The proposed law would make it illegal to "intentionally or knowingly conduct destructive research on a human embryo" or to "buy, sell, receive, or otherwise transfer a human embryo with the knowledge that such embryo shall be subjected to destructive research."

Violations would result in misdemeanor charges.

The legislation states that the destruction of human embryos to obtain embryonic stem cells "raises grave moral, ethical, scientific, and medical issues that must be addressed," and that the moral justification for medical or scientific research "cannot be based upon the dehumanizing and utilitarian premise that the end justifies any means."

In spite of millions spent, Faught noted that embryonic stem cell research has not produced a single treatment and typically generates cancer tumors, not cures.

In fact, Dr. Kevin Donovan, director of the Oklahoma Bioethics Center at the University of Oklahoma College of Medicine in Tulsa, told the Tulsa World (April 24, 2009 edition) that "embryonic stem cell research so far and in the future is a dead end. There are no foreseeable cures in the next decade for certain."

In addition, embryonic stem cell research also has a supply problem.

A report by the RAND Corporation found that only 2.8 percent of so-called "leftover" embryos at fertility clinics have been specifically designated for research while 88.2 percent continue to be held for family planning. (link)

The RAND report also found that 11,000 embryos would generate just 275 new embryonic stem cell lines.

Locally, KOTV in Tulsa reported in 2009 that the Integris Fertility Clinic in Oklahoma City had 230 sets of embryos stored for later use, 20 sets for embryo adoption, and just two sets designated for research. The clinic indicated that each "set" can contain anywhere from two to 11 embryos each.

"It is clear that the only viable way to conduct embryonic stem cell research is to create thousands of new embryos specifically to harvest them for stem cells," Faught said. "Even if there were no moral problems, there simply are not enough ‘discard’ embryos at fertility clinics."

Faught said he does support adult stem cell research, which is already helping patients overcome more than 70 diseases and disorders and does not require embryo destruction.

"Why should we condone the killing of thousands or millions of unborn children when there are far better alternatives, and at a time when advances in adult stem cell research are allowing ‘reprogramming’ of cells to duplicate embryonic cells?" Faught said. "Oklahoma can be pro-life, pro-research and pro-cure without endorsing embryo destruction."

He noted Oklahoma has already dedicated millions to adult stem cell research. In 2009, the Oklahoma Tobacco Settlement Endowment Trust committed $500,000 for a year-long planning phase for adult stem cell research funding, followed by $1 million per year funding for the following five-year implementation phase, for a total of $5.5 million.

House Bill 1442 passed the House Public Health Committee today. It now proceeds to the floor of the Oklahoma House of Representatives.

NOTE: For accompanying video, go to this link.