Legislature passes "turnaround" deadline
Rachelle Colombo
Today is "turnaround" day, the first major legislative deadline of the session and signifies the movement of bills from their originating chamber to the opposite body. Non-exempt bills which have not been worked out of committee, debated and passed on the floor of the chamber from which they originated will not move forward in the legislative process after turnaround day. Both the House and Senate spent two full days hearing and debating bills before concluding on Thursday evening in advance of the turnaround deadline.
After several weeks of contentious discussions, KMS negotiated a compromise on the physical therapy "direct access" bill which has been sought nearly annually by the Kansas Physical Therapy Association. For the most part, under current law, physical therapists can only begin treatment of patients upon the referral of a physician or certain other health care providers. However, there are some exceptions to this referral requirement. Kansas is one of about 35 states that has some form of limited or conditional "direct access." In 2007, the law was amended to allow PTs to treat patients without a referral if the patient had been previously referred for care within the last year for the same condition.
With the KMS amendments, HB2159 allows patients to self refer to a physical therapist and receive treatment for 15 business days before a physician referral is required. PTs will be required to notify patients in writing that a physical therapy diagnosis is not a medical diagnosis. Hospitals and outpatient medical facilities will still retain the right to require physician referral for physical therapy prior to treatment to ensure that care is not fragmented and that any PT services provided in a hospital are consistent with the physician's treatment plan. Physician referral will still be required for debridement and wound care. These provisions were included in the KMS amendments in exchange for a limited expansion of direct access for PTs. The bill passed the full house on a final action vote of 124-0 and now moves to the Senate.
Mammography reporting requirements
SB 407, mammography reporting requirements related to dense breast tissue, passed out of Senate Public Health and Welfare on Tuesday, after amendments proposed by KMS were added. As amended, the bill requires mammography reports to include additional information about breast density for women categorized as having heterogeneously or extremely dense breasts. The mammography report must state if the woman has dense breasts, and if so, it will encourage her to talk with her physician about her individual risk factors and whether further tests may be necessary. The bill, which is similar to bills being introduced throughout the country by breast cancer advocacy groups, was crafted to encourage more awareness about breast density, the limitations of mammography, and to promote further discussion between patients and physicians. The bill was debated by the full Senate and passed 40-0 on final action.
Prescription Monitoring Program
SB 327, the bill that makes some purely technical amendments to the state's Prescription Monitoring Program, is still alive and awaiting further consideration by the Senate Public Health and Welfare Committee. The PMP program is part of a national effort to help states combat the growing problem of illegal diversion and use/overuse of controlled substances. It is a secure database that contains every controlled substances prescription written and dispensed in the state. Prescribers and dispensers can obtain a profile of their patients' use of controlled substances, which will help them identify patients who seek, overuse or divert controlled substances for illegal purposes.
KMS offered an amendment that would establish a PMP peer review process to help the program with early identification of prescribing or dispensing patterns that result in patient harm, or are clearly unlawful or inconsistent with established professional standards of care. The amendment was developed by KMS to respond to a request by the Attorney General's office for a process to help them obtain more timely information on individuals who are clearly violating the law and diverting or abusing controlled substances. The state Board of Pharmacy, for reasons which are unclear, has been the most outspoken opponent of the peer review process amendment sought by KMS. In any event, KMS continues to work with the AG's office and other stakeholders on an approach that preserves the integrity of the program while also providing an additional measure of protection for patients, as well as prescribers whose professional practices are consistent with established standards of care.
If you have questions about legislative issues, contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it , KMS Director of Government Affairs.
