Debrief: New Health Laws Address Addiction, Breast Cancer

Jun 25, 2014

Another legislative session has wrapped up. Health care reporter Kristin Gourlay joins host Dave Fallon in the studio to talk about how health care fared on Smith Hill.

Here's a transcript of their discussion.

KRISTIN: The University of Rhode Island and Rhode Island College will be getting a shared nursing school. It’ll be in an old power plant that’s been sitting empty in Providence’s historic jewelry district. This school has been a dream of many for a while, and with the stroke of his pen the governor made that dream a reality in this year’s budget. It’s also official that lawmakers kind of kicked the can down the road on funding Health Source RI, Rhode Island’s online health insurance marketplace. There’s some federal funding to keep it going this year, but it’ll be up to the next administration to figure out what to do with it after that.

DAVE: Kristin, there was also a lot of attention this session on substance abuse and mental illness in the General Assembly. That’s partly because of this huge spike in the number of overdose deaths. And Rhode Islanders continue to struggle with heroin and prescription painkillers. How did lawmakers deal with those issues?

KRISTIN: Most importantly, I think they’re certainly paying more attention and learning about the problem. They learned, for instance, that insurers don’t always cover treatment for substance abuse. So both the House and Senate passed – unanimously – a measure that requires insurers to cover substance abuse and mental illness conditions. That goes beyond a federal so-called “mental health parity” law that only requires this kind of coverage – if an insurer offers it – to be comparable to the medical coverage they offer. In Rhode Island, it will have to be part of every health plan. Insurers must now cover medications that treat opioid addiction. And this law also directs hospitals and other health care providers to follow up with people they’ve seen for drug and alcohol problems, to help make sure they’re getting into treatment.

DAVE: Kristin, what about prescription drugs in particular? Part of the problem is just the sheer amount of painkillers like OxyContin that get sold or stolen, or how easy it’s it is for someone who may be addicted to get multiple prescriptions from different doctors and pharmacies.

KRISTIN: Right. Well, Rhode Island has a prescription drug monitoring program. That’s supposed to help doctors and pharmacists track a patient’s prescriptions. The idea is that you would be able to spot whether someone is doing something called “doctor shopping,” going from doctor to doctor to get new prescriptions to feed an addiction. But it’s not a perfect system. First, fewer than 20 percent of Rhode Island doctors are using it. What’s more, doctors – and pharmacists – have said it’s time consuming to look up each patient’s record before prescribing something. So the governor has just signed a law that lets a doctor or pharmacist designate someone on staff who can check those records. It sounds minor, but it could help boost participation in the system.

DAVE: Kristin, the House and Senate health committees always introduce a lot of bills. But of course they don’t all make it to the governor’s desk. Was there a particular measure they were really putting a lot of energy into that just didn’t pass?

KRISTIN: Yes. Several senators were behind a bill that would have established something called the Rhode Island Health Care Authority. This was a massive piece of legislation, and the idea behind it, according to Senator Josh Miller, one of the co-sponsors, was to kind of bring all of the various efforts to reform health care under one umbrella. It would have made HealthSource RI, the state’s online health benefits exchange, the main portal for everyone to buy health insurance. And it would have established this single agency that incorporated everything having to do with health insurance and health care in the state under one umbrella. But the measure just didn’t make it. I’m told the thinking was to leave that kind of big structural change to the next governor.

DAVE: Kristin, we have just a minute or so. Anything else catch your eye this session?

KRISTIN: Well, the governor's signature means Rhode Island has just joined several other states with laws that require health care providers to let women know if a mammogram shows they have dense breasts. Here’s why that’s important: dense breast tissue can make it more difficult to pick up any possible cancers on a mammogram. So sometimes doctors will refer women with dense breasts for an MRI or an ultrasound, which can potentially pick up what a mammogram may have missed.

And…if you’re worried about those high co-pays and deductibles you might be seeing in your new health insurance plan, so are lawmakers. It’s not a bill they passed, but they did create a commission to study the impact that’s having.

More health laws passed this session:

- Changes to the state's medical marijuana law, including requiring anyone wanting to register as a primary caregiver to undergo a criminal background check, allowing landlords to refuse to rent to someone who plans to cultivate marijuana, and ensuring that cultivators adhere to city safety codes, in particular because of the large electricity requirements of "grow lights."

- Efforts to legalize marijuana, and to regulate and tax it like alcohol, failed again this year.

- A new "medical tourism" bill, designed to address a situation last year with a company that tried to get state approval to provide home-based pain medication (by refilling a kind of pump) but was unable to, makes the approval process easier.

- Hospitals must now provide a list of the 25 most commonly performed procedures and what they cost, annually, to the health department. Bear in mind: what hospitals charge is almost never what they actually get paid, by insurance companies, by you, by public payors. Also, prices vary between hospitals for many reasons.