KMS Newsletters
February 2, 2025 Newsletter
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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.
February 8, 2025 Newsletter
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February 23, 2025 Newsletter
Session Hits Halfway Mark Legislators concluded the first half of the session this week with the Senate finishing business on Wednesday and the House spending another day, wrapping up debate on Thursday night, marking the conclusion of “Turnaround”. Each chamber will consider those bills that were advanced from the opposite body and a few remaining bills that have been exempted from legislative deadlines. After the turnaround deadline, those bills that did not have a hearing or committee action and were not voted on or exempted from the deadline are now considered “dead” for the remainder of the 2025 session. While these deadlines help to thin out the number of actionable bills, they also lead to the coupling of issues through the amending of perishing proposals onto those that remain alive. In order for differing proposals to be amended together, they generally must share subject matter or a statutory connection. Both the House and Senate will return to Topeka on Tuesday, February 25th to commence the session’s second half. The following bills of interest to the Kansas Medical Society remain active and viable for advancement before the session’s conclusion. SB 29 as originally drafted would revoke the authority of the Secretary of the Kansas Department of Health and Environment to impose quarantine measures. However, the bill was heavily amended to allow the Secretary to maintain public health, with the exception of banning mass gatherings. The bill passed the Senate and now heads to the House of Representatives. KMS is opposed. SB 54 expands disclosure of third-party funding litigation. Private equity and other third parties can currently fund cases as “investments” and only the judge determines whether their funding is relevant to disclose to the jury. An increase in third-party funding has led to an increase in litigation and some alarming trends nationwide, particularly in excessive verdicts and settlements. KMS provided testimony in support of SB 54 and the requirement to disclose the participation of a third-party’s funding. The bill exempts non-profits from mandatory disclosure. The bill passed out of Senate Judiciary unanimously and passed the full Senate and now heads to the House. SB 67 as introduced would have authorized Certified Registered Nurse Anesthetists (CRNAs) the nearly unrestricted practice of medicine without any physician supervision. KMS strongly opposed SB 67 and the proponents’ characterization of the bill as an effort to merely equalize APRN and CRNA privileges. In 2022, APRNs were granted the authority to order durable medical equipment and to prescribe without a written prescribing protocol from a physician. Since that time, CRNAs have pushed for an entirely new statutory practice act that goes well beyond what was granted to other APRNs. The Senate Health Committee, in response to advocacy by KMS and physicians statewide, approved a substitute bill that strikes the original contents of SB 67, and instead amends the CRNA practice act to mirror the changes authorized for other APRNs three years ago, which is limited to allowing for prescribing drugs without a physician protocol. As amended, CRNAs must still provide anesthesia prescribing and administration pursuant to the order of a physician or dentist. KMS opposed SB 67 both in its original and amended form because we do not support allowing nonphysicians to practice medicine without supervision, regulatory oversight, and patient protections. The bill now moves to the House of Representatives. HB 2223 allowing optometrists to perform surgical procedures was introduced and has been exempted from legislative deadlines but has not been scheduled for a hearing. KMS opposes HB 2223. HB 2368 establishes licensure for Anesthesiology Assistants (AAs). This issue has been brought to the legislature for nearly a decade in an effort to allow more anesthesia providers and to establish appropriate oversight and regulation ensuring patient safety. AAs practice under the direct and immediately available supervision of an anesthesiologist. They work interdependently with CRNAs and are particularly sought in urban areas to increase capacity for anesthesiology services. KMS provided testimony in support of HB 2368 and the establishment of a strictly constructed statutory scope of practice ensuring direct supervision of an anesthesiologist. The bill has been “blessed” and could yet advance this session. Issues Failing to Advance 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 revoke the authority of the Secretary of Health and Environment to quarantine individuals and impose associated penalties. The bill was not advanced from the committee or exempted from deadlines and is now considered “dead” for the remainder of the session. KMS opposed the bill. SB 41 follows the recommendation of the Health Care Stabilization Fund Oversight Committee to add two classes of Advanced Practice Registered Nurses (APRNs) into the fund, requiring them to purchase $1M in malpractice coverage as a condition of licensure. KMS testified in support of SB 41, but it was not voted on or exempted from deadlines and is now “dead” for the remainder of the session. HB 2157 expands pharmacist's scope of practice to include point-of-care testing for and treatment of COVID-19. KMS opposed HB 2157 and it is dead for the remainder of the session. What's Next? The last half of the session will focus on reconciling priorities between the House and Senate, finalizing the Budget, and acting on any additional vetoes issued by the Governor prior to adjournment on April 12. Last week, Governor Kelly vetoed SB 63, the “Help Not Harm Act” which prohibits the use of puberty blockers and surgical treatments for minors for the purpose of gender reassignment. Both the House and Senate achieved the constitutionally required majority to override the veto. The law takes effect upon publication in the Kansas register, which is essentially immediately. There are several other issues that we could see resurrect or materialize either through amendments or in the budget process. We are monitoring all issues impacting the practice of medicine and advocating our unchanging message that Kansans deserve access to a physician-led team that does not sacrifice quality for access. If you have questions about these or other legislative matters, please contact
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Celebrating 40 Years of Dedication: Nancy Sullivan's Enduring Legacy at Kansas Medical Society
A Personal Message from KMS Executive Director Rachelle Colombo Since 1859, KMS has been advocating for access to physician-led medical teams, the highest standards for medical care, you, and your patients. Pioneer physicians meeting at the Eldridge Hotel on a blustery February day in Lawrence recognized the value of organizing and immortalizing our mission, two years before Kansas was even a state. The practice of medicine is a high calling going back in history further than most all professions, with an emphasis on science, training, service, and measurable outcomes. In 2025, the average professional tenure equals just shy of 4 years, with most professionals switching jobs after just 3 years and 9 months. This has not been the case for the Kansas Medical Society. We have a strong tradition of principled, dedicated staff that have spanned many decades in service to advocating for the practice of medicine and the patients you care for. Today, we are honoring Nancy Sullivan, our Director of Operations who has worked at the Kansas Medical Society on behalf of Kansas physicians for 40 years. She began her career with an earnest desire to take care of people – a gift she is uniquely qualified for and has done so with excellence for four full decades. She was mentored by Jerry Slaughter, who hired her in 1985 and who will reach his own milestone of 52 years on staff with KMS next week. He embodies what it means to lead and serve with integrity and commitment and continues to foster a legacy of purpose. Both of these individuals have made it their life’s work to serve Kansas physicians, to encourage the highest quality care and to ensure policies which promote the best environment to practice and receive care. We have a proud heritage and whether you began your career 50 years ago or are just now entering practice – Jerry and Nancy have been a part of shaping healthcare in Kansas and will leave a lasting imprint on the future of medicine, here and nationwide. I hope you will take the time to learn about these forbearers of quality and service and join me in thanking them for their unwavering love and support for each of you. It is a true honor to be a member and champion of the Kansas Medical Society. Yours, Rachelle Colombo Nancy Sullivan's Legacy at KMS For four decades, Nancy Sullivan has been the heartbeat of the Kansas Medical Society (KMS), a guiding force behind its mission, and a steady presence in the ever-changing landscape of organized medicine. Hired by former KMS Executive Director Jerry Slaughter in 1985, Nancy’s journey from executive assistant to Director of Operations is a testament to her unwavering dedication, adaptability, and the deep-seated passion she holds for Kansas physicians. Nancy’s early days at KMS paint a picture of a different time—one of typewriters, carbon paper, and an in-house magazine, Kansas Medicine, painstakingly laid out by hand. From these humble beginnings, she witnessed and facilitated transformative changes, from the advent of digital communication to the expansion of KMS’s advocacy and service initiatives. Through it all, she remained a steadfast pillar of the organization, ensuring its culture of service and professionalism endured. Slaughter, who worked alongside Nancy for 40 years, describes her impact as immeasurable. “Nancy has been as important as anyone who’s sat in the corner office in sustaining the culture of service that defines KMS,” he reflects. “She’s been the glue that holds everything together—the maternal figure in this professional family.” More than just an operations leader, Nancy has been a mentor, confidante, and advocate for physicians across the state. She played a critical role in the formation of key programs such as the Kansas Healthcare Collaborative and the Kansas Medical Mutual Insurance Company (KAMMCO), demonstrating a keen ability to navigate complex policy and organizational shifts while keeping the needs of Kansas physicians at the forefront. Her dedication extends beyond logistics and leadership; it is rooted in a genuine love for the organization and its mission. “I believe in the mission of KMS,” Nancy says. “Every morning, I wake up knowing I’m working for the physicians of Kansas. That’s what keeps me going.” Over the years, Nancy has built deep relationships with KMS’s physician leaders, attending American Medical Association (AMA) meetings, organizing advocacy efforts, and ensuring seamless board operations. She has watched generations of medical professionals grow, from medical school to leadership roles, and takes great pride in supporting them throughout their careers. Dr. Aron Fast, the current KMS board president, echoes these sentiments: "Nancy is one of those unique people that you run across only occasionally - a great combination of professional attitude, a caring mindset for others, and a trustworthiness to see a job through. My experience over the past 12 years in my involvement with KMS is that Nancy never drops the ball and at the same time she is always one step ahead in preparation. I am thankful for Nancy." As KMS moves forward, Nancy’s influence will remain deeply embedded in its foundation. “If every physician in Kansas could see the value of KMS the way I do, there would never be hesitation about their membership,” she says. Her hope is that her passion and dedication will inspire continued support and involvement in the organization’s mission. Reflecting on her 40 years, Nancy sums up her time at KMS in three words: family, mission, and gratitude. It’s a fitting tribute to a woman who has not only shaped an organization but has also enriched the lives of those around her. Her legacy will continue to inspire, ensuring that KMS remains a strong advocate for Kansas physicians for generations to come. Nancy Sullivan's 40-Year Celebration – KMS invites you to share Your Memories & Congratulations! CLICK HERE to submit a note for Nancy's 40-Year Celebration!
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March 15 Newsletter
Final Days of the 2025 Session
As we approach the end of the 2025 session, the priorities of the legislature have come into clearer focus. First legislative leaders changed the traditional legislative calendar from ninety business days to ninety calendar days, which significantly compressed the amount of time available for consideration of bills, as well as, passing the state budget, which is one of their primary responsibilities. The legislature has also been clear that providing property tax relief is also a high priority.
This session marks the first year of a legislative biennium, meaning that issues that were not enacted or did not advance from one body to the opposite chamber in this legislative session will remain alive for consideration in the 2026 session.
This session we have seen a host of issues introduced that impact the House of Medicine, ranging from public health, workforce issues, Medicaid, and of course the ever-present scope of practice issues, including pharmacists, nurse anesthetists (CRNAs), and optometrists all seeking to expand the limits of their authorized practice privileges.
SB 67, the CRNA bill that, as introduced, would essentially dissolve the interdependent relationship between CRNAs and physicians and dentists, with the only limitations being that CRNAs engaging in independent practice could not perform surgery for implantation of medication reservoirs, nor could they perform, induce or prescribe drugs for an abortion. The bill was amended in the Senate committee to limit their independent authority to prescribe drugs and order durable medical equipment, which mirrors the changes made two years ago granting the three other categories of APRNs independent prescribing privileges. The amended bill has passed the Senate and the House health committee and awaits action by the full House of Representatives.
Similarly, HB 2223 would allow optometrists to perform certain surgical procedures, including the use of lasers, and to prescribe drugs without any limitation. The bill would also allow the board of optometry to authorize any additional procedures for treatment of the eye that weren’t specifically prohibited by the bill. Based on earlier indications from House Leaders, it was believed that because the bill was controversial and lacked a workable compromise between the optometric and medical professions, it wouldn’t advance this session. However, last week the bill was passed out of the House Health Committee at its final meeting this session. Committee members acknowledged that they heard from hundreds of physicians and optometrists before the committee's action on the bill. It is expected to be debated on the House floor next week, and if passed it will move over to the Senate where if it is not acted upon this session due to time constraints, it will remain alive for further consideration next session.
Legislators generally tend to voice disdain for refereeing these scope of practice issues, as healthcare regulation is complex, often with overlapping roles and responsibilities, competencies, competition, patient safety concerns, and lack of consensus or compromise between the professions. Although there is no substitute for the depth and breadth of medical training, some continue to believe that training in one procedure is equivalent to comprehensive training in differential diagnosis and direction of care, and that limiting scope limits access to care.
While these facts do not bear out, politics prevail, and timing and messaging are critical. Time will show that when education, training and regulation are not consistent, quality and outcomes for patients suffer. Creating two tiers of medical and surgical care does not serve Kansas patients but instead trades so-called “access” for quality and creates inconsistency in the regulation and delivery of healthcare. We continue to advocate for patients receiving the highest quality care, and for training and regulatory requirements which protect them.
Hundreds of physicians answered our call to action to attempt to stop this bill in committee, but the timing and pressure likely outweighed our ability to educate and stop this dangerous bill. Please reach out to your legislator TODAY with your concerns about this ill-conceived bill allowing nonphysicians to perform surgery without adequate training or regulation from a board that includes physicians trained in surgery and the practice of medicine.
The 2025 session is in its final days with committee work wrapping up the first part of next week. The Kansas Medical Society advocates for you and your patients every day, year-round. But your voice is especially critical NOW as legislators contemplate bills impacting your patients and consistent, high-quality care.
If you have questions or concerns about legislative matters, please
