HHHS0225 Converted WP Minutes

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MINUTES OF THE
HOUSE HEALTH AND HUMAN SERVICES STANDING COMMITTEE
Room 25, House Office Building
February 25, 2013

MEMBERS PRESENT:    Rep. Paul Ray, Chair
                Rep. LaVar Christensen, Vice Chair
                Rep. Stewart Barlow
                Rep. Rebecca Chavez-Houck
                Rep. Tim M. Cosgrove
                Rep. Brian M. Greene
                Rep. Michael S. Kennedy
                Rep. Ronda Rudd Menlove
                Rep. Edward H. Redd

STAFF PRESENT:        Mr. Mark D. Andrews, Policy Analyst
                Ms. Linda Black, House Secretary

Note:    A list of visitors and copy of handouts are filed with the committee minutes.

Chair Ray called the meeting to order at 4:35 p.m.

MOTION:    Rep. Cosgrove moved to approve the minutes of February 19, 2013, and the corrected minutes of February 21, 2013. The motion passed unanimously.

H.B. 315    Office of Inspector General of Medicaid Services Amendments (Rep. J. Dunnigan)

Rep. Dunnigan presented the bill to the committee.

MOTION:    Rep. Greene moved to replace H.B. 315 with 1st Substitute H.B. 315, "Office of Inspector General of Medicaid Services Amendments". The motion passed unanimously.

MOTION:    Rep. Greene moved to amend the bill as follows:

1.    Page 5, Lines 122 through 125 :

             122          (b) If there is a conflict between the Medicaid state plan, administrative rules,
             123      Medicaid provider manuals, or a Medicaid information bulletin issued by the department, a
             124      health care provider may rely on the policy interpretation included in a current

{ ~~Medicaid~~

125 provider manual or current } Medicaid information bulletin that is available to the public.

The motion passed unanimously.

MOTION:    Rep. Redd moved to further amend the bill as follows:

1.    Page 5, Lines 129 through 134 :

             129          63J-4a-204. Selection and review of claims.
             130          (1) (a) On an annual basis, the office shall select and review a representative sample of
             131      claims submitted for reimbursement under the state Medicaid program to determine whether
             132      fraud, waste, or abuse occurred.
             133          (b) The office shall limit its review for waste and abuse under Subsection (1)(a) to 36
             134      months prior to the date of the inception of the investigation

or 72 months if fraud is suspected .

The motion passed unanimously.

MOTION:    Rep. Christensen moved to further amend the bill as follows:

1.    Page 8, Line 232 through Page 9, Line 248 :

             232          Section 6. Section 63J-4a-501 is amended to read:
             233          63J-4a-501. Duty to report potential Medicaid fraud to the office or fraud unit.
             234          (1) [A] (a) Except as provided in Subsection (1)(b), a health care professional, a
             235      provider, or a state or local government official or employee who becomes aware of fraud,
             236      waste, or abuse shall report the fraud, waste, or abuse to the office or the fraud unit.
             237          (b) (i) If a person described in Subsection (1)(a) reasonably believes that the waste is a
             238      mistake and is not intentional or knowing, the person may first report the waste to the provider,
             239      health care professional, or compliance officer for the provider or health care professional.
             240          (ii) The person described in Subsection (1)(b) shall report the waste to the office or the
             241      fraud unit unless, within 30 days after the day on which the person reported the waste to the
             242      provider, health care professional, or compliance officer, the provider, health care

professional,
             243      or compliance officer demonstrates to the person that the waste has been corrected.
             244          (2) A person who makes a report under Subsection (1) may request that the person's
             245      name not be released in connection with the investigation.
             246          (3) If a request is made under Subsection (2), the person's identity may not be released
             247      to any person or entity other than the office, the fraud unit, or law enforcement, unless a court
             248      of competent jurisdiction orders that the person's identity be released.

(4) If fraud allegations are found to be untrue, the individual may recover reasonable attorneys fees and costs and the record may expunged;

Following committee discussion, Rep. Christensen withdrew the motion.

Spoke in favor of the bill:    Mr. Dave Gessell        Utah Hospital Association
                Mr Dave Davis        Utah Retail Merchants Association
                                Utah Food Industry Association
                Ms. Michelle McOmber    Utah Medical Association

Spoke in opposition
of the bill:            Mr. Lee Wyckoff        Office of the Inspector General (handout provided for the committee)

Spoke to the bill:        Mr. Frank Pignanelli        HMS

MOTION:    Rep. Christensen moved to pass the bill out favorably, as substituted and amended. The motion passed unanimously, with Rep. Greene absent for the vote.

H.B. 329    Medicaid Vision Amendments (Rep. R. Menlove)

Rep. Menlove presented the bill to the committee.

MOTION:    Rep. Cosgrove moved to pass the bill out favorably. The motion passed unanimously, with Rep. Greene absent for the vote.

MOTION:    Rep. Cosgrove moved to place H.B. 329 on the Consent Calendar. The motion passed unanimously, with Rep. Greene absent for the vote.

H.B. 120    Information on Pharmaceutical Products (Rep. P. Ray)

Rep. Ray presented the bill to the committee.

MOTION:    Rep. Ray moved to replace H.B. 120 with 1st Substitute 120, "Information On Pharmaceutical Products". The motion passed unanimously, with Rep. Greene absent for the vote.

MOTION:    Rep. Ray moved to amend the bill as follows:

1.    Page 2, Lines 37 through 39 :

             37          (B) employed by someone other than a pharmaceutical manufacturer
:

    (I) for the purpose of countering information provided in commercial detailing; and
    (II)

to disseminate

38 educational information about prescription drugs to other health care providers

{ ~~across a broad~~

             39      range of interventions } in an effort to better align clinical practice with scientific research; and

2.    Page 2, Lines 43 through 45 :

             43      higher education or through a medical residency program;

{ or }

             44          (B) is disseminating educational information about a prescription drug to a patient or a
             45      patient's representative
; or

    (C) is acting within the scope of practice for the health care provider regarding the prescribing or dispensing of a prescription drug

3. Page 2, Line 56 :

56 (i)

{ ~~labeling and~~ } false and misleading advertising in 21 C.F.R., Part 201 (2007);

4. Page 3, Line 61 :

61 against

{ ~~the person who violated this section~~ } a person engaged in academic detailing, if:

    (i) the actions of the person engaged in academic detailing, that are a violation of this section, are:
    (A) the result of gross negligence by the person; or
    (B) willful and wanton behavior by the person; and
    (ii) the damages to the person are proximately caused by the violations of this
section.

The motion passed unanimously, with Rep. Greene absent for the vote.

MOTION:    Rep. Ray moved to hold the bill. The motion passed unanimously, with Rep. Greene absent for the vote.

MOTION:    Rep. Cosgrove moved to adjourn the meeting. The motion passed unanimously, with Rep. Greene absent for the vote.

Chair Ray adjourned the meeting at 6:23 p.m.

                        _____________________________
                         Rep. Paul Ray, Chair