Medicaid, corporate medicine top list of 2019 issues

In Advocacy, Feature by admin

The 2019 legislative session is gearing up to be an interesting one, as lawmakers from Wichita are the new chairs of both health committees, and a new, Democratic administration brings fresh eyes to old issues.

The new session began Jan. 14 and features local leaders Sen. Gene Suellentrop, R-Wichita, chairing the Senate Public Health and Welfare Committee, and Rep. Brenda Landwehr, R-Wichita, chairing the House Health and Human Services Committee. Also of note, health committee vice chairman Rep. John Eplee, R-Atchison, is a longtime family medicine physician.

The MSSC Legislative Committee also convenes for its first meeting of the year on Jan. 25. The committee, which works closely with the Kansas Medical Society, monitors health-related legislative activities and advocates on behalf of patients, physicians, and the practice of medicine in Kansas.

Legislative analysts predict Medicaid expansion, scope-of-practice legislation and ñ new this year ñ the corporate practice of medicine will surface as the major health-care issues during this year’s session.

Newly elected Gov. Laura Kelly, who campaigned on the promise of making Medicaid expansion a top priority, brings hope for supporters who want to expand the state-run federal program, which provides health care to low-income and disabled people. Under former Gov. Sam Brownback, Kansas has refused to expand the program and take advantage of federal dollars that would pay for 90 percent of the cost of expansion.

“Now there may be some possibility to move forward with Medicaid expansion, which we have supported for a long time,” said Kevin Hoppock, MD, chairman of the MSSC Legislative Committee.

Rachelle Colombo, KMS director of government affairs, agrees that Kansas may see some movement this year on the politically divisive issue. “I think we can expect to see continued efforts on behalf of Medicaid expansion prove more successful than in years past,” she said.

KMS does not support Kelly’s expected push to legalize medical marijuana, Colombo said. Kelly told the Kansas City Star in November that she senses momentum among Kansas legislators to legalize medical marijuana with strict regulations.

Scope-of-practice issues come up every session, and 2019 will be no different. APRNs will push for independent practice; pharmacists are looking for more freedom to practice collaboratively – such as administering injections and providing broader drug therapy management without a physician component; and podiatrists are looking to be allowed to call themselves “podiatric physicians.”

Some KMS leaders already met with the APRNs – whose group is presenting legislation again this year proposing independent practice without medical board oversight – and found very little common ground upon which they could agree. “There is only one way to become a physician, and that is through medical school,” Hoppock said.

Also on the radar is the issue of the corporate practice of medicine. Colombo said, by case law, it is prohibited in Kansas, but two large health insurance providers ñ Blue Cross Blue Shield of Kansas and Cerner – and the Kansas Chamber of Commerce are looking to pass bills that would allow companies to directly employ physicians.

Physician groups do not typically support this practice because they believe “it undermines the independent and soundness of physician judgment if an employer can direct medical practice,” Colombo said.

She said the issue had not come up in any meaningful way over the past few years, but a renewed push for legislation promises to bring it back into the spotlight this year.

“It undermines the primacy of the physician-patient relationship,” Colombo said. “Physicians work for patients. If theyíre directly employed by a corporation, that could be a very serious conflict of interest. We have questions about protection and liability.”