KMS Newsletters

As 2024 comes to a close and with it the results of the recent national and statewide elections, healthcare issues will most likely continue to be front and center, both nationally and here in Kansas. While the new Congress remains closely divided, the general election once again yielded Republican supermajorities in both the Kansas House of Representatives and Senate. The House bolstered their number, growing from 85 to 88 Republicans, while the Senate gained two new seats bringing the total number of Republican Senators to 31 out of 40 total members. 

Maintaining a supermajority was a critical goal of Republican leadership, giving them the ability to potentially override any veto issued by Democrat Governor Laura Kelly. Legislators are already at work drafting legislation to introduce when the 2025 session begins on January 13. Bills from the previous year do not carry forward on election years, but rather, expire every two years. Even so, we expect to see many of the same issues resurface in hopes of finding newfound support. Among those are the bills expanding the scope of practice for advanced practice nurses and other providers.

Nurse anesthetists (CRNAs) are planning to renew their push to allow them to practice without any restrictions on their scope of practice. They argue that CRNAs are the only advanced practice registered nurses that weren’t included in the changes enacted in 2022 which allowed other APRNs to prescribe without a written protocol with a physician. While that sentiment may be understandable, their bid for statutory expansion of practice privileges actually goes much further and would even allow for the performance by CRNAs of surgery and other invasive procedures. It appears that since the passage of the APRNs bill allowing for prescribing, along with a confusing (and incorrect) interpretation by the Board of Nursing and other nursing advocacy groups about its application, some argue that APRNs do not have any limitations on their scope of practice. This interpretation defies a plain reading of the law, which does not provide such authority and is in violation of the Healing Arts and Nurse Practice Acts. 

Optometrists are also seeking an expanded scope and intend to introduce legislation that mirrors their prior effort, which would allow for multiple procedures that overlap into the practice of medicine. KMS will continue its opposition to these practice expansions by both the CRNAs and optometrists.  

Outside of scope issues, we also expect some controversial ideological issues to re-emerge as they do each year, but even more so after the recent election results. In particular, the debate over gender-affirming healthcare for minors is almost certainly going to receive legislative attention again. 

The KMS Legislative Committee is comprised of physicians from many specialties and geographic areas of the state, and it meets bi-weekly to review and advise our Board of Trustees on all legislation impacting the practice of medicine, patient access, reimbursement and the legal climate.

There is no doubt that the session will be busy by the time KMS Advocacy Day occurs on January 29th. We expect to hear from leaders from both the House and Senate, including newly elected Senate Majority Leader Chase Blasi, returning House Speaker Dan Hawkins, the health committee vice chairs and members of the “Doc Caucus” and a panel of physicians serving on the KMS Legislative Committee. If you haven’t already, please register to join us today.

Advocacy Day also gives us the opportunity to hear directly from you about issues directly affecting your practice. We have invited all state specialty societies to participate, identify their advocacy objectives, and work with a collective voice under the dome to ensure the practice of medicine remains in physicians’ hands. There are many issues affecting medical practice and we serve as your advocate at the Statehouse. We will continue to push for increases in Medicaid reimbursement, prior authorization reform, improved access to physician-led care, reforms that improve the legal climate, and incentives that encourage newly-trained physicians to establish their practices in the rural and other underserved areas of our state.

Your KMS staff has grown to include a few new faces while maintaining the long-term service of several dedicated employees, in some cases extending over decades. To a person, both new and long-tenured, we consider it a privilege to work as advocates for each of you and your patients. Thank you for your engagement in promoting and protecting your profession to ensure that Kansans receive the very best care. As a (sometimes reluctant) patient myself, I can attest to the excellence and warmth delivered by your hands.

As always, do not hesitate to reach out if you have questions or concerns about legislation or any other matters. It’s my pleasure and privilege to work on your behalf. Wishing you the best in 2025, with hope and optimism for what lies ahead.

It's time to renew your KMS membership for 2025! Kansas physicians are uniquely positioned to serve as both a patient advocate and an advocate for the profession. Your membership enables the Kansas Medical Society to:

• Continue focusing on our mission of advocacy for physicians of all specialties statewide.
• Ensure the physician's voice is well-represented in the legislative & regulatory arenas.
• Improve the practice environment in our state.
• Keep you informed as a member of the state's largest physician association.

Your continued membership is critical to the success of the Kansas Medical Society and the future of the profession. We will continue to focus on our mission and provide unparalleled support to each of you.

We appreciate your consideration in supporting KMS through your renewed membership. Click HERE to pay your dues TODAY!

Elections are open for 2025-2026 KMS Offices. Scan the QR code below to vote online before January 23, 2025.    

Registration is OPEN for KMS Advocacy Day on Wednesday, January 29, 2025, in Topeka, Kansas!

Kansas Medical Society’s Advocacy Day offers a unique opportunity to connect directly with your legislative leaders. You will join physicians from across the state, regardless of specialty to ask the hard questions that impact the house of medicine. Please plan to meet with your specialty society, KMS leadership & your peers to inform lawmakers, guide decision-making, and generate support for policies on critical issues that impact physicians, patients, and the healthcare environment for our great state of Kansas. Whether you view advocacy as a responsibility or an option, your community participation, leadership, and collective voices are essential to the House of Medicine’s continued leadership in health care.

The Kansas Legislature convened for the 2025 Regular legislative session on Monday, January 13th. Leaders have announced a twelve-week legislative calendar with final adjournment in early April. While the first week was largely dominated by the swearing-in of all House and Senate members and other procedural events, committees were in full swing by week two with hearings and bill introductions vying for priority in the shortened timeline. 

Of note for Kansas physicians are the perennial bids for increased scope of practice by non-physicians. SB 67 establishing independent practice for certified registered nurse anesthetists was introduced late last week with language that is nearly identical to bills sought in 2023 and 2024. Under the proposal, CRNAs would be allowed “full practice authority,” only prohibiting surgery to place a medical reservoir and perform or prescribing for an abortion. As written, the bill would not further limit CRNA practice or distinguish it from the practice of medicine in any other way. The Board of Nursing would continue to license and regulate CRNAs. The Kansas Medical Society has strongly opposed this legislation since its original introduction in 2023. Proponents have stated they want the same statutory authority as APRNs who were successful in their push for prescribing authority and the ability to order durable medical equipment. However, SB 67 is far broader and essentially equates independent “full practice authority” with the unlimited and independent practice of medicine.

Optometrists are also seeking an expanded scope and have signaled their intent to re-introduce language that would allow them authority to perform certain surgical and other procedures with additional training. The optometry bill failed to make it out of committee last year, but optometrists have redoubled their efforts this year and, in the Capitol, meeting with legislators daily to push for action on the issue this year.  

Other bills of interest include SB 41 which was proposed at the recommendation of the Health Care Stabilization Fund Oversight Committee. The bill would add APRNs to the Fund, requiring all nurse practitioners to comply with the mandatory insurance provisions and purchase a minimum of $ 1 million in coverage as a condition of licensure, as physicians, CRNAs, physician assistants, and other participating providers do.  

Finally, both House and Senate leaders have indicated strong support for advancing legislation to ban certain procedures and treatments around gender-affirming care for minors. Identical bills were introduced in the House and Senate health committees (SB 63 and HB 2071) which prohibit healthcare providers from treating gender dysphoria with the intent of altering a minor child’s physical sex. The bills provide that a physician performing such services to minors will lose their license, and the legislation creates a new private (civil) cause of action against physicians for providing such care. The addition of new civil causes of action is a growing trend around the country and has been added to several ideological bills as a harsh deterrent. The Kansas Medical Society does not support creating new private causes of action against physicians in addition to and outside of malpractice. Both the House and Senate have scheduled hearings on this issue next Tuesday, January 28th, and have indicated the bill will be among the very first policy debates before each body, with passage very likely.

KMS does not advocate for or against those social or ideological issues predominantly characterized by a conflict or clash of deeply held personal beliefs, values, or principles. 

By the end of this month, the legislature will be a quarter of the way through its planned schedule, leaving very little time for additional bills to move through the full process without strong support in both chambers. Nonetheless, your team is at the Statehouse every day to monitor emerging issues and advocate on behalf of you, your practice, and your patients.  

If you’d like to learn more about the legislative process, I urge you to register today for our annual Advocacy Day this coming Wednesday, January 29. It’s a great opportunity to meet with your legislators and colleagues of all specialties from around the state to discuss current legislative issues.  We’ve had a tremendous registration response once again but would love to have you join us. Registration information is below.

Last day to register for KMS Advocacy Day is Monday, January 27 by 5 PM. Advocacy day is on Wednesday, January 29, 2025, in Topeka, Kansas!

Kansas Medical Society’s Advocacy Day offers a unique opportunity to connect directly with your legislative leaders. You will join physicians from across the state, regardless of specialty to ask the hard questions that impact the house of medicine. Please plan to meet with your specialty society, KMS leadership & your peers to inform lawmakers, guide decision-making, and generate support for policies on critical issues that impact physicians, patients, and the healthcare environment for our great state of Kansas. Whether you view advocacy as a responsibility or an option, your community participation, leadership, and collective voices are essential to the House of Medicine’s continued leadership in health care.

While KMS members converged upon the state capitol this week, legislative work ramped up with several issues being introduced, hearings held and some issues advancing for votes.

SB 19 establishes the “conscientious right to refuse act” to prohibit discrimination against individuals who refuse medical care, and creating a civil cause of action based on such discrimination, and also revoking the authority of the Secretary of Health and Environment to quarantine individuals and impose associated penalties. The bill is scheduled for a hearing and vote next week. KMS opposes SB 19.

SB 41 follows the recommendation of the Health Care Stabilization Fund Oversight Committee to add two categories of APRNs to the Fund, requiring them to purchase $1M in malpractice coverage as a condition of licensure. The bill is scheduled for a hearing in the Senate Health committee next Thursday.  KMS supports SB 41.  (More on this topic below).

SB 63 bans the surgical and prescriptive treatment of gender dysphoria on minor children and establishes a new civil cause of action against healthcare providers engaging in such practice. The bill was heard in both health committees early in the week, was advanced to the Senate and then the House, and passed both chambers with large majorities. It now goes to the Governor who has vowed to veto it, which will most certainly trigger what is likely to be a successful effort by the legislature to override the veto.

SB 67 establishes independent practice for Certified Registered Nurse Anesthetists (CRNAs) and eliminates restrictions on their scope of practice with the exception of surgery for the purpose of placing medical reservoirs. The bill preserves the Board of Nursing as their licensing and regulatory agency, despite the Board’s inability to regulate the practice of the healing arts, which this bill clearly allows. KMS opposes SB 67.

HB 2157 expands pharmacist's scope of practice to include point-of-care testing for and treatment of COVID-19. KMS opposes HB 2157.

Bills allowing for expanded optometric scope of practice (KMS opposes) and the establishment of licensure for Anesthesiologist Assistants (KMS supports) were introduced, but the language of the bills is not yet available. If you have questions about these or other legislative issues, please contact Rachelle Colombo.  

KMS also testified before the House Social Service Budget Committee to report about the implementation of the legislature’s 9% across-the-board increase in the physician fee schedule for Medicaid. As many of you know, not all codes received an increase, including several global codes. The Kansas Department of Health and Environment reported that federal regulations prohibit any Medicaid codes from exceeding comparable codes in the Medicare fee schedule. Consequently, despite the legislature’s $30 million appropriation for a 9% increase to all codes, the following methodology was instead applied:

• Codes Currently > 91% of Medicare: increased to 100% of Medicare
• 9% Increase to all Codes < 91% of Medicare
• Codes with no Medicare Equivalent: increased by 9%
• Codes >= 65% of Medicare After 9% Increase: No increase above the 9%
• With additional funding, select Codes Under 65% of Medicare with High Utilization: Additional increase up to 65% of Medicare.

KMS reported this information back to the legislature and asked that the legislature direct KDHE to establish a new physician fee schedule for Medicaid that is not limited by the Medicare fee schedule and can be utilized by the Managed Care Organizations in KanCare. KDHE has not commented publicly on the request.

At the present time, of the four categories of advanced practice nurses licensed in Kansas, only two (nurse anesthetists and nurse midwives) are required by state law to comply with the provisions of the Health Care Stabilization Fund law. The largest category of APRNs (with ~7200 licensees), nurse practitioners, do not participate in the Fund, and neither does the last category, clinical nurse specialists (with ~370 licensees). 

A question that has arisen in conjunction with the legislature’s possible action with SB 41 to require the two remaining APRN groups to participate in the Fund is whether the premiums charged to these two APRN groups will be adequate to cover their losses, or will other providers (physicians, hospitals, PAs, nursing homes, etc.) in essence have to subsidize the nurse practitioner claim costs. It has been the longstanding policy of the Fund’s Board of Governors that each provider group is rated and should pay premiums sufficient to cover the claims and losses generated by that provider group. For example, currently, there are different rates for nurse anesthetists and nurse midwives, and the nurse practitioners and clinical nurse specialists will also be rated based on their risk profile and losses produced.

There are currently 30 separate risk classifications used by the Fund, including eleven risk categories for different physician specialties, for example. The Fund’s actuary does a detailed analysis every year of losses by risk classification, and the Board of Governors uses that to adjust premium surcharges accordingly.

Because some APRNs are now allowed to prescribe independently under their expanded statutory authority, adding the remaining two APRN groups to the Fund would make the minimum coverage requirement for all APRNs consistent with that which is required of all other healthcare providers participating in the Fund, at $1 million per claim. This makes sense from a patient protection and public policy perspective, as it will assure patients who are treated by these APRNs will have the same statutorily assured right of compensation for personal injury sustained due to negligence, as they would have for virtually all other healthcare providers. For more information about the Health Care Stabilization Fund, click here.

A message from KMS Executive Director, Rachelle Colombo

In the months since the legislature adjourned the 2024 session and schools were let out for summer vacation, several political cycles have passed. June brought the Governor-ordered special session to pass tax relief for Kansas. This task was completed in just two days with a final package very closely resembling the proposals vetoed earlier in the spring. The Legislature also approved a tax incentive package designed to lure the Kansas City Chiefs and Kansas City Royals to the Kansas side of the state line in the coming years. The Governor approved the measure, and the Special Session was over, triggering the beginning of a shortened primary election season.

Read more …