tennessean.com
Written by
Richard Cowart
2:27 AM, Jan. 10, 2012

The Tennessee General Assembly convenes its 2012 session today, and several key health-care subjects are on the table. Among them:

Health-care exchange: Gov. Bill Haslam has indicated he wants to move forward in setting up a health-care exchange system, as set forth in the federal health-care reform act. Lt. Gov. Ron Ramsey and Speaker Beth Harwell have indicated that they want to move forward more slowly and cautiously, perhaps indicating a conflict between the administration and legislative leadership.

Ramsey has signaled that he’d like to delay further legislation pending the U.S. Supreme Court’s ruling on the constitutionality of the federal health plan. Failure to act may default Tennessee to the federal exchange.

What will happen: Expect preparatory action despite political headwinds.

Tort reform: Although tort reform was successfully passed in the 2011 legislative session, the issue is expected to be revisited this year. Several Republican members have been discussing a possible “Loser Pays” bill, under which the unsuccessful party in a malpractice suit would be responsible for paying attorneys’ fees and court costs. What will happen: Texas did it. Tennessee will try.

Workers’ compensation: A large coalition of employers has been meeting to discuss reform of the current workers’ compensation system, including items such as creating a commission-based system and the ability of certain employers to opt out of the system with limitations.

What to expect: Any major changes to workers’ compensation will likely be put on hold until 2013. A recently proposed bill requiring drug testing for recipients of both workers’ compensation and unemployment benefits became a precursor of 2013.

Immigration: Many Tennessee health-care facilities utilize health workers with visas. The upcoming legislative session is expected to focus on tighter immigration controls, including a possible Alabama-type bill.

Last year there were three major pieces of immigration legislation: E-Verify, legal status for entitlements, and provisions for increased police authority to detain suspected illegal immigrants. Only a watered-down version of E-Verify passed. The sponsors have already announced that they are coming back for more and are hoping to pass stricter immigration controls.

What’s ahead: The implementation issues in Alabama and other states are significant. Despite political support, Tennessee should pause and learn from other states.

Medicaid: The largest health-care issue in the upcoming session is the state budget. While tax collections have started to meet projections, the collections still lag behind the growth in government. As such, Haslam has requested an overall 5 percent cut from all state departments. State Medicaid cuts in services and provider reimbursements loom as significant concerns in the year ahead.

By all accounts, lobbyists and legislators alike are expecting a short and intense session, with an adjournment goal of early to mid-May. As the presidential nominees and the U.S. Supreme Court debate health-care issues on a national scale, expect the 2012 Tennessee General Assembly to have its share of health-care hoopla, too.

Dick Cowart is chairman of the health law and public policy departments of the Baker Donelson law firm. Reach him at dcowart@bakerdonelson.com.

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