Legislative News & Alerts

LB 891

Legislative Bill 891 requires that a health care practitioner who receives a test result that indicates a high likelihood or the definite presence of Down syndrome to deliver to the parents the information sheet provided by the Nebraska Department of Health and Human Services.

The Down syndrome website with a downloadable fact sheet is up and running at the URLs below.
Website: http://dhhs.ne.gov/publichealth/Pages/DownSyndrome.aspx
Fact Sheet only:  http://dhhs.ne.gov/publichealth/Documents/DownSyndromeFlyer.pdf
The link to the legislative bill is: http://nebraskalegislature.gov/FloorDocs/Current/PDF/Final/LB891.pdf

Important Announcement: Open Payments Physician and Teaching Hospital CMS Registration Begins June 1

Phase 1 of provider registration for Open Payments begins June 1, 2014. Physicians and teaching hopsitals that want to participate in Open Payments need to register in CMS' Enterprise Portal. The benefit of registration, although voluntary, is that it allows providers to review data that industry has reported and dispute any inaccuracies. Phase 2 of provider registration begins in July and physicians and teaching hospitals cacn also begin to review and dispute the data at this time. The review and dispute period will last 45 days. 

For more information see this Open Payments article. CMS' Open Payments Physician website can be accessed here and the Fact Sheet here. Dr. Shantanu Agrawal's blog entry on the CMS website can be found here.

Gov. Heineman vetoes bill to ease restrictions on nurse practitioners

LINCOLN (http://bit.ly/1hdUqU5 ) — Gov. Dave Heineman vetoed a bill Tuesday that would have allowed nurse practitioners more autonomy in their practices.

Legislative Bill 916 would have eliminated the requirement that nurse practitioners have a practice agreement with a doctor.

Backers said the requirement limits the number of nurse practitioners in Nebraska, adding to a shortage of primary care in rural areas.

Heineman said in his veto message that he expects there will be a shift toward more independence for nurse practitioners in the future.

But he said LB 916 goes "too far, too quickly."

Heineman said he had discussed the issue at length with the state's chief medical officer, who opposed the independent practice idea.

The governor said he was concerned about whether the bill adequately addressed patient safety. He said he would have signed the bill if it had required nurse practitioners to have about 4,000 hours of clinical experience.

Two state review panels had endorsed the proposal to give nurse practitioners their independence.

But Dr. Joseph Acierno, the state's chief medical officer, said the practice agreements should stay in place. In a December report, he said the current system "has not worked as intended, "but he expressed concern about a lack of experience by new nurse practitioner graduates.

Physician groups opposed LB 916, arguing the agreements are needed for patient safety.

They said doctors have more years of education and clinical training than nurse practitioners, who have master's or doctoral degrees in nursing.

LB 916 passed on a 43-0 vote, but lawmakers will not have a chance to override the governor's veto because the session has adjourned.

New AAFP Policy on Electronic Cigarettes

The American Academy of Family Physicians (AAFP) recognizes the increased use of electronic cigarettes (i.e., e-cigarettes) especially among youth and those attempting to quit smoking tobacco. Electronic cigarettes are unregulated, battery-operated devices that contain nicotine-filled cartridges. The resulting vapor is inhaled as a mist that contains flavorings and various levels of nicotine and other toxic substances. Although e-cigarettes may be less toxic than smoking combustible tobacco cigarettes, there is no empirical evidence supporting the efficacy of e-cigarettes as a smoking cessation device. However, some physicians and public health groups consider the use of said devices as a viable harm-reduction strategy. Anecdotal accounts of people using e-cigarettes as a cessation device have led some to believe that these products have the potential to help them quit – especially the long-term, highly addicted smoker. Others are concerned that e-cigarettes may contribute to nicotine dependence, promote dual use of both products, and encourage nicotine consumption. E-cigarettes may also introduce children to nicotine and potential addiction.

There are concerns about the lack of any regulatory oversight by the Food and Drug Administration’s Center for Tobacco Products (FDA CTP) on the manufacture, distribution and safety of e-cigarettes. Therefore, the AAFP calls for rigorous research in the form of randomized controlled trials of e-cigarettes to assess their safety, quality, and efficacy as a potential cessation device. The AAFP also recommends that the marketing and advertising of e-cigarettes, especially to children and youth, should cease immediately until e-cigarette’s safety, toxicity, and efficacy are established. (January 2014 Board Chair)

Nebraska Academy of Family Physicians Leadership Has Hand in Patient-Centered Medical Home Agreement

After five years of hard work, an idea that started at a Nebraska Academy of Family Physicians (NAFP) board meeting in November 2008 is now being achieved!  During that November 2008 meeting, several NAFP board members including Drs. Ivan Abdouch, Bob Rauner, Bob Wergin, Tom Werner, and Kevin Wycoff decided to work on bringing Nebraska farther along the path toward Patient-Centered Medical Home (PCMH). The first step was a legislative bill the group worked on sponsored by Senator Mike Gloor, LB 396, which was passed unanimously in the Nebraska Unicameral and signed in to law on April 22, 2009.  Many were surprised that a bill like this could go from conception to unanimous passage by the legislature in the span of four months, but the combination of a well-organized lobbying effort and a strong case made by a state senator with a health care background led to its success.  The result was a definition of PCMH for Nebraska and two state Medicaid PCMH pilots that ensued at Kearney Clinic in Kearney, Nebraska and Plum Creek Medical Group in Lexington, Nebraska.  View the full article here.

News Release: Healthier, Happier Nebraskans is the Goal of an Agreement between Insurance Companies and Primary Care Physicians

An agreement brokered by Senators Mike Gloor, District 35, and John Wightman, District 36, rests on the premise that a healthy Nebraskan requires less costly health care. Through a concept called Patient Centered Medical Home (PCMH) Nebraska physicians and insurance companies are betting on it, too, with an agreement starting in January 2014. This agreement will be announced by the stakeholder group and Senators who crafted it at a press conference and document signing on Wednesday, December 18, 2013 at 11 a.m. in Room 1524 of the Nebraska State Capitol in Lincoln, Nebraska. View the official State of Nebraska Legislature News Release here.

NDHHS Releases Recommended Method For Newborn Screening For Critical Congenital Heart Disease

Effective September 6, 2013, LB 225, as passed in the 2013 Legislative Session, requires screening of all Nebraska newborns for critical congenital heart disease.

Nebraska DHHS has released the approved screening methods. The methods and protocol recommended by Nebraska DHHS are consistent with those endorsed by the American Academy of Pediatrics Committee on Congenital Heart Defects, Children's National Hospital and Children's Hospital Omaha, Nebraska's expert panel on Critical Congenital Heart Disease, and Nebraska's Newborn Screening Advisory Committee.

For additional information contact Julie Luedtke, Julie.Luedtke@nebraska.gov or (402) 471-6733.