The 2019 legislative session was challenging, with scope-of-practice issues and a renewed push to expand Medicaid. The MSSC Legislative Committee worked closely with the Kansas Medical Society to monitor these issues and advocate on behalf of physicians and patient care. Here is a brief summary of where things stand on some of the top issues impacting physicians this year, culled from KMS updates:
Stalled. Republican-controlled bodies have promised to work toward building a Medicaid expansion plan their caucuses can support next session, although the issue likely will remain politically charged and difficult to pass.
Corporate Practice of Medicine
This bill did advance, but it was heavily amended to include provisions requested by KMS. As written, it is limited in scope, with a very narrow definition of business entities allowed to employ physicians. Additionally, the corporations are held to the same legal and ethical standards as a physician and they will be regulated by the Board of Healing Arts. Hospitals are exempted from the law.
Of the $1.4 million needed, half was allocated from the KDHE drug rebate fund and the remaining $700,000 will be pulled from all of the other health care fee agencies.
Scope of practice
A bill that would allow the independent practice of Advanced Practice Registered Nurses was introduced the final week of session but was referred to the Health committee where it will carry over until next year. Another bill was passed that will allow pharmacists to administer injections that would otherwise be self-administered by patients. As originally drafted, the bill allowed pharmacists to administer any drug by any method. KMS urged that the bill should narrow its focus so as not to be harmful and removed opposition when proponents accepted its suggested amendment.
E-prescription of opioids
HB 2389 mandates that all opioids schedules II-IV must be e-prescribed by 2021. As originally introduced, the bill would have mandated e-prescribing for all controlled substances by January 2020. KMS supported pushing back implementation to coincide with federal requirements relating to e-prescribing for Medicare Part D. Additionally, several exceptions and exemptions were adopted, including a waiver for a physician who writes fewer than 50 prescriptions a year, for technological failure or economic hardship and a number of other clinical scenarios.