Legislative deadline approaches
Rachelle Colombo; KMS Director of Government Affairs
Just two days remain for committees to take action on their assigned bills before both the House and Senate will debate and vote on those proposals which will advance beyond the first major deadline of the legislative session, the so-called "turnaround" deadline. By this Friday, most bills having failed to pass out of committee and pass the entire body of origin will be considered dead for the remainder of the session.
Though the majority of the bills focused on APRN collaborative practice agreements are exempt from the coming deadline, the Senate Health committee has held hearings on both sides of the issue, most recently considering KMS proposal SB 218. KMS testified in support of SB 218, underscoring the need for a new approach to APRN regulation and oversight that reflects the evolving nature of nursing practice in varying clinical settings while still ensuring physician collaboration, particularly when the practice of medicine is involved. Several APRNs testified in opposition to the bill's proposal for a joint advisory committee of the Board of Healing Arts and Board of Nursing, stating concerns that the promulgation of jointly-adopted regulations could result in disruptive restrictions to advanced nursing practice. The consensus of the Senate Health Committee following the most recent hearing was that the APRN and physician communities need to continue talking and searching for an approach that is acceptable to both professions. No further committee action is currently scheduled on any of the initiatives related to APRNs, though the bills are exempt from deadlines and may come up in the second part of the session.
HB 2319, the Kansas Hospital Association's bill directing the Brownback administration to expand Medicaid in a budget-neutral way, is not subject to the normal legislative deadlines and will remain alive for legislative consideration later this session. KMS continues to encourage legislators to begin the dialogue about expanding Medicaid in a financially responsible, sustainable manner, such as that contained in HB 2319.
SB 123 allows for restrictions to be placed on psychotropic medications prescribed to Medicaid participants. State Medicaid officials, who are the main proponents of the measure, cite concerns over high costs and disproportionately high utilization of pyschotropics for this patient population. KMS opposed the bill, because the care of patients with severe mental illness is highly individualized, complex and not without risk. Further, subjecting psychotropic medications to the existing KanCare prior authorization requirements threatens to further increase time, cost and hassle for physicians treating the Medicaid population. KMS suggested that a committee of psychiatrists, primary care physicians and pharmacists should be established to consider cost and utilization prior to the development of new restrictions. The committee opted to pass the bill out of committee but noted their desire to see KDHE ensure such a structure will be established before the bill is acted upon by the full Senate.
The Senate Commerce committee heard SB 167, which amends the workers compensation statutes to require a return to the 4th edition of the AMA guides to the evaluation of permanent impairment from the 6th edition, which took effect January 1 this year. Mark Melhorn, MD, an orthopedic surgeon from Wichita, testified for KMS in support of using the 6th edition of the AMA Guides, and how the impairment ratings differ, most notably through the utilization of the most recent science to establish treatment and evaluate overall loss of function. The committee heard from a number of plaintiff's attorneys in support of the bill but it has not been scheduled for further action.
The House Corrections Committee held a hearing on HB 2313, which establishes higher criminal penalties for battery or assault of a health care provider, emergency medical respondent or firefighter. Because these professionals are exposed to heightened risk in the customary course of their duties, the bill would protect these professions with penalties equal to those of assaulting a police officer. The hearing centered on the frequency and severity of these types of situations and how lawmakers might best deter this kind of violence. The committee may take action this week on the bill.
There are several other issues affecting the practice of medicine that await action in the House and Senate. A full list of issues KMS has a position on can be found here. If you have further comments or questions pertaining to legislative matters, please contact KMS Director of Government Affairs, Rachelle Colombo.