The session was canceled for Monday, March 3rd; making Tuesday March 4th the Thirty-eighth legislative day.
Today's Schedule - March 4th
2:00 pm - House Convenes
4:00 pm - Senate Convenes
Here are the relevant health care related bills that are moving or have a probability that they could move this session. The House is expected to start the public mark-up of the budget this week. The 2014 session is nearly 2/3 of the way over, but there is much yet to do. Only four bills have passed both Chambers and been sent on to the Governor. The last day to introduce a House bill should have been today, Monday, March 3rd and the last day to introduce a Senate bill should have been Wednesday, March 5th. I assume the calendar will be adjusted.
Friday March 28th & Monday March 31st have been set-aside for concurrence days before the veto session begins on April 1st. That leaves only 19 working days for both Chambers to pass a budget, send it to conference committee and reach a compromise. The pressure will start to mount this week.
The following is not an exhaustive list of the health care legislation that has been introduced,rather it is a list of legislation that has been introduced this session and is moving or could potentially move this session. To see a complete health care tracker click here.
HEALTH CARE LEGISLATION
HB 5 (LM) is State Auditor Adam Edelen’s data breach disclosure law. It will require state and public agencies and their contractors to implement, maintain, and update security procedures and practices. The bill has passed out of the House with a vote of 100 – 0 on the consent calendar. Several organizations are seeking amendments to improve the bill, including one that would exempt entities already subject to HIPAA. Two improvements to the bill would include changing the word “discovery” to “determine” when requiring notification of a security breach. The second improvement would be to change the time frame from 24 hours to 72 hours. These changes would not impact the intent of the legislation while protecting the Commonwealth’s contractor’s abilities to comply. HB 5 is sponsored by Rep. Denver Butler and has been assigned to the Senate State & Local Government Committee. Senator Joe Bowen, Chairman of the Committee, said that he is studying the legislation and its impact on local governments. He said he has heard from several interested parties and has been working with Nathan Cryder in the Auditor’s office (Nathan.Cryder@ky.gov). Click here for copies: HB 5/LM HCS/LM
HB 73, introduced by Rep. Jody Richards, clarifies that managed care plans must file ALL of their terms and conditions required to participate in their network. The Department of Insurance believes that HB73 does not extend their authority beyond what they have today. The KY Hospital Association would like to delete language at the end of the bill relating to the provider credentialing: Nothing in this section shall be construed as requiring an insurer to submit standards used by the insurer for the purpose of provider credentialing. The Department of Insurance does not require this information now, even without this language and it is unclear why KHA believes it is necessary to delete the language from the bill. The bill cleared the House Banking & Insurance Committee and passed the House on a vote of 98 – 0. The bill has been assigned to the Senate Banking & Insurance Committee. Click here for a copy of the bill.
HB 98, (FN) sponsored by Rep. Damron and 15 other co-sponsors, requires that at least one school employee be available to administer or assist with the self-administration of insulin. The bill also allows a student with appropriate permissions to perform blood glucose checks. The training required by the bill must be consistent with the American Diabetes Association. HB 98 passed the House 91 – 1 and passed the Senate 37 – 1. The bill has been delivered to the Governor and is awaiting his signature. Click here for a copy of the bill.
HB 125, sponsored by Rep. Damron, allows a patient to receive a copy of their laboratory test results directly. The bill passed out of the house 97-0 and has been assigned to the Senate Health & Welfare Committee. Click here for a copy of the bill.
HB 126, is the NAIC “Own Risk Solvency Assessment” (ORSA) bill, sponsored by Rep. Damron. HB 126 passed out of the House 96 – 0 and has been assigned to the Senate Banking & Insurance Committee. Click here for a copy of the bill.
HB 138, sponsored by Rep. Yonts, requires the State Health Plan to offer a Flexible Spending Account option. The bill passed the House 99 – 0 and is now in the Senate State and Local Government. Click here for a copy of the bill.
HB 146, (FN) is the “Expedited Partner Therapy” Bill sponsored by Rep. Marzian. The bill allows a medical provider licensed to treat a patient for gonorrhea or Chlamydia to prescribe a treatment for the patient’s sexually active partner. The bill passed the House with a Committee Substitute and a floor amendment on a vote of 58 -28 with 14 members not voting. It has been assigned to the Senate Veterans, Military Affairs, & Public Protection Committee. Click here for copies: HB 146/FN; HCS/FN; HFA (1); VOTE HISTORY
HB 173 (FN/LM) is Rep. Westrom’s statewide smoking ban bill. The bill would prohibit indoor smoking in all places of employment including restaurants, bars, home day care facilities, bed & breakfasts, etc. The bill prohibits smoking within 15 feet of the entrances, windows or ventilation systems of any of these facilities. The bill has passed out of the House Health & Welfare Committee. Five floor amendments have been filed thus far, exempting e-cigarettes, cigar bars, private clubs and racetracks. The bill has its readings and is posted for passage, but its fate is still unclear. It appears that there is not enough votes to pass the bill in the House and there may be even less support on the Senate. Click here for a copy of the bill. HFA (1; HFA (2; HFA (3; HFA (4; HFA (5;
HB 190, a bill sponsored by Rep. Julie Adams, mandates coverage of genetic testing for certain people who are at risk for breast or ovarian cancer. Amendments have been offered to the sponsor that would reflect existing policies in the market today. The bill has been assigned to the House Banking & Insurance Committee, but has not been posted for consideration. Click here for a copy of the bill.
HB 221 (FN) requires court-ordered outpatient mental health services to be covered by Medicaid if the individual is Medicaid eligible. The services are subject to the same medical necessity criteria and reimbursement methodology as all other behavioral health services. The bill sets forth guidelines for the treatment plan, the collaboration required with the community mental health center (CMHC) and the duties of the court and the cabinet in cases where mental health treatment has been ordered by the courts. The Chairman of the House Health Welfare Committee Tom Burch sponsored the bill and its HCS passed out of his committee. The bill has been reassigned to the House Appropriations & Revenue Committee and has been posted for consideration. Click here for a copy of the bill. Click here for a copy of the Committee Sub.
HB 232 (LM), sponsored by Rep. Riggs, is the Consumer Security Breach bill requiring consumer notification when a data breach reveals personally identifiable information. Various groups are working on amendments including amendments that would exempt organizations that are already subject to HIPAA or Graham-Leach-Bliley. The bill has been posted in the House Labor & Industry Committee. Click here for a copy of the bill. Click here for a copy of the Committee Sub.
HB 235 is the Executive Branch Budget. The bill under consideration in the House is the Governor’s proposal as presented in his budget address on January 17th. The House Budget Review Subcommittees are holding hearings and reviewing the proposal and are expected to tweak the budget before sending it down to the Senate sometime around March 10. We expect the public budget markup process to begin this week.
The Governor’s proposed budget includes a total of $37,426,100 in restricted funds over the biennium for the operation of the Health Benefit Exchange and $23,099,600 in Federal Funds for the same period. The total proposed Medicaid Services budget for 2014-15 is $8,084,734,400 and the total for 2015-16 is $8,390,815,800.
The budget also contains language that requires the Department for Medicaid Services to submit quarterly budget analysis reports to the Interim Joint Committee on Appropriations and Revenue. The Medicaid Managed Care Organizations (MCO) are required to submit detail quarterly reports that include the following: monthly actual expenditures by service category, monthly eligibles, and average monthly cost per eligible. The budget also contains language on how an MCO will process appeals for denial or limitations of services. Click here for a copy of the bill.
HB 252, sponsored by Rep. Greg Stumbo, creates the Advisory Council on Autism Spectrum Disorders. The bill passed the House 99-0 and has been received in the Senate. Click here for a copy of the bill. Click here for a copy of the Committee Sub.
HB 286 (FN) creates a pharmacy advisory committee to the Advisory Council for Medical Assistance more commonly called MAC. The MAC has subcommittees called TAC’s (Technical Advisory Committees). This legislation merely adds the Pharmacy Committee. The subcommittees, along with the Advisory Council have no authority, but they do meet on a regular basis with the Commissioner and discuss issues of concern primarily from the provider community. The bill’s primary sponsor is Chairman Greer and it passed easily out of his committee onto the Consent Orders. The bill has passed the House and has been referred to the Senate Health & Welfare Committee. Click here for a copy of the bill.
HB 311 (FN), sponsored by Rep. David Watkins, requires girls and boys to be immunized against the human papillomavirus. The bill passed out of the House Health & Welfare Committee and is currently in the Rules Committee. Click here for a copy of the bill.
HB 335 is commonly referred to as the false claims bill. Speaker of the House Greg Stumbo is the sponsor and Chairman of the House Judiciary Committee John Tilley is the primary co-sponsor. A state false claims bill would establish enhanced civil liability and penalties for committing fraud against the state. HB 335 would allow the Attorney General or a private citizen to sue on behalf of the Commonwealth, with some of the proceeds going to the person (whistleblower) bringing the suit. There are civil protections for the whistleblower, treble damages and steep penalties for each fraudulent claim, making health care claims very attractive for these types of suits. Nearly identical bills have been introduced in previous years: HB 4 in 2011 and HB 401 in 2012. These bills have passed the House by an overwhelming majority and died in the Senate. There is a coalition working together to oppose the bill. Click here for a copy of the bill.
HB 344, sponsored by Rep. Greer, makes some technical changes to the name of the Kentucky Applied Behavior Analysis Licensing Board. In addition, the bill establishes a licensing procedure and requirements for registered behavior technicians. The bill was originally sent to the House Licensing and Occupations Committee but was reassigned to Chairman Greer’s Banking & Insurance Committee. Former Rep. Scott Brinkman appeared before the Committee this past week to testify on behalf of the legislation. Rep. Brinkman co-sponsored the original legislation with Rep. Greer. The Committee Substitute made some improvements to the bill and the bill passed easily to the Consent Calendar. Click here for a copy of the bill. Click here for a copy of the Committee Sub.
HB350, (FN/LM/CI), sponsored by Rep. Marzian, is the medical marijuana bill. The bill passed out of the House Health & Welfare Committee this past week and could be ready for a floor vote this week. There seems to be more support than many thought and could possibly pass if allowed to come to a vote on the floor. The Republicans have voiced opposition in both the House and Senate. Click here for a copy of the bill.
HB 361, (FN) allows a Medicaid recipient to assign his rights to a state fair hearing to a provider. The bill also requires all MCO’s to follow the Pharmacy Audit procedures required in the commercial market. The bill, sponsored by the Speaker of the House, Rep. Greg Stumbo, is being pushed by the Kentucky Hospital Association. The association held their day at the Capital on Thursday of this past week and the bill picked up four co-sponsors including two Republicans, and Rep. Overly, another member of Leadership. HB 361 was introduced on February 10th and assigned to the House Health & Welfare Committee on February 11th, but has not been posted for consideration yet. It now has a companion in the Senate, SB 166, introduced by Senator Leeper. The Speaker is convening a meeting of industry leaders to discuss the issue this week. Click here for a copy of the bill.
HB 362, introduced by Rep. Stone, is an act relating to out of network benefits offered by a health benefit plan. The bill requires an insurer offering a health benefit plan with out-of-network benefits to not limit the network to health care providers performing services or treatment within the Commonwealth of Kentucky. HB 362 also requires a health benefit plan with out-of-network benefits to not limit covered services to services or treatment provided within the Commonwealth of Kentucky. The bill was heard in the House Banking & Insurance Committee this week. Rep. Stone introduced a committee sub this week that simply said if you have an insurance product with in state limitations then you must offer a product that does not have in state limitations. Click here for a copy of the bill. Click here for a copy of the Committee Sub.
HB 369, introduced by Rep. Yonts, lowers the statute of limitations on a written contract from 15 years to 10 years. Kentucky is the only state with a 15-year statute of limitations. No other state has a limitation longer than 10 years. The bill was heard this week in Judiciary and passed to the Consent Calendar, but Rep. Yonts, the bills sponsor has filed an amendment and pulled the bill off of the Consent Calendar. The floor amendment would make the bill apply to all contracts that are signed after the effective date of the legislation. Click here for a copy of the bill. HFA (1)
HB 395 (HM), a medication synchronization bill, was introduced by Rep. Wuchner on February 13th. The bill requires a health plan to pay a dispensing fee on each prescription when the patient elects synchronization of multiple prescriptions for the treatment of chronic illnesses’ and synchronization is in the best interest of the patient. In order to permit synchronization, an individual or group health benefit plan shall pay a prorated daily cost-sharing rate for any medication dispensed by a network pharmacy. HB395 also requires the Department for Medicaid Services to allow medication synchronization. The bill has been referred and posted in the House Banking & Insurance Committee. Click here for a copy of the bill.
HB 421, sponsored by Rep. David Watkins, provides for treatment of acquired brain injuries. The bill is being pushed by Kentucky’s facilities that treat acquired brain injuries. HB 421 requires a commercial or MCO health benefit plan to provide coverage for a minimum of sixty (60) visits per calendar year for acquired brain disorders at hospital facilities, interdisciplinary outpatient medical rehabilitation program, residential rehabilitation programs, skilled nursing facilities, assisted living facilities, outpatient rehabilitation facilities, and acute or post-acute residential transitional rehabilitation facilities. Coverage cannot be denied or terminated solely because the treating facility is not in a certain location. Finally, the bill exempts a health benefit plan that provides coverage for treatment of acquired brain injuries from the high-risk pool assessment. The bill, which has 3 Democrats and 3 Republican sponsors, has been sent to the House Banking & Insurance Committee.
HB 482, sponsored by Rep. Greer, adds several health care providers to 304.17A, thereby adding those providers to the list of professionals that can be reimbursed by health plans. The list of “health care providers” include psychologists and psychological practitioners, occupational therapists, behavior analysts, physical therapists, speech-language pathologists or audiologists, social workers, marriage and family therapists, and professional counselors licensed pursuant to state law. The bill has not been assigned to a committee. Click here for a copy of the bill.
HB 505, sponsored by Rep. Burch, is an act relating to reorganization, but it actually establishes the Office of the Kentucky Health Benefit Exchange to administer the Patient Protection and Affordable Care Act. HB 505 would confirm Executive Order 2013-418 and transfer the Kentucky Access Program to the Office of the Kentucky Health Benefit Exchange from the Department of Insurance. The bill has not yet been assigned to a committee. Click here for a copy of the bill.
SB7, sponsored by Senator Bowen, was the first bill to pass both Houses and be signed by the Governor. The bill establishes a Collaborative Prescribing Agreement Joint Advisory Committee made up of APRNs and physicians. SB7 is an agreement between the medical and nursing communities regarding the prescription authority for Advanced Practice Registered Nurses (“APRNs”) prescribing non-scheduled legend drugs.
SB 29 would require licensure as opposed to certification of a person practicing acupuncture. The bill, sponsored by Senator Buford, passed the Senate 37-0 and has cleared the House Licensing & Occupations Committee. It was scheduled for a vote on the House Consent Calendar on Feb. 18th, but was been removed from the Consent Calendar and placed in the regular orders. Click here for a copy of the bill.
SB 52, sponsored by Senator Denton, would require the Cabinet for Health and Family Services to apply for a Medicaid waiver for a pilot program permitting health professionals to charge a $10 missed appointment fee. The pilot program would be in the Kentucky counties of Jefferson, Letcher and Pike. The bill passed favorably out of the Senate Health & Welfare Committee. Sen. Denton filed a floor amendment that would assess the penalty after 3 missed appointments. The bill passed the Senate with a committee substitute on a vote of 28-8 and has been assigned to the House Health & Welfare Committee. Click here for a copy of the bill. Click here for a copy of the Committee Sub. SFA (1, SFA (2.
SB 73, sponsored by Senator Buford, defines 'preauthorization’ and establishes a requirement for pharmacy benefit managers to expedite the process of preauthorization of a non-formulary drug product. The bill was introduced on January 15th and sent Senate Banking & Insurance, but has not been on the agenda as of yet. Click here for a copy of the bill.
SB 76, sponsored by Senator Denton, clarifies that a reciprocal license may be granted to an out-of-state provider located in one of Kentucky's seven contiguous bordering states and establishes requirements for licensure in the contiguous state, including any requirement for a physical location in the state as a condition of issuing or renewing a license, be substantially similar to the licensure requirements in this state. The bill also adds two members of the durable medical equipment profession to the advisory council of the Kentucky Board of Pharmacy. The bill has passed out of the Senate and is posted in the House of the Health & Welfare Committee. Click here for a copy of the bill. Click here for a copy of the Committee Sub. SCA (1.
SB 82, will establish an oversight board for the Cabinet of Health & Family Services to hire the Secretary of the Cabinet. The legislation will not apply to the current Secretary. The bill is sponsored by Senator Denton and was reported favorably out of the Senate State & Local Government Committee and passed out of the Senate on a vote of 23 – 15. The bill has been assigned to the House Health & Welfare Committee. Click here for a copy of the bill. Vote History.
SB 103, sponsored by Senator Denton, is similar to HB 98, relating to diabetes. This bill has passed the Senate and has been posted to the House Health & Welfare Committee. Click here for a copy of the bill. SFA (1; SFA (2.
SB 118 (HM), sponsored by Senator Denton, requires a health benefit plan providing coverage for prescription eye drops to refill a prescription, if requested, between 23 and 30 days from the original date of the prescription, assuming the refills are medically necessary. Coverage for additional bottles is limited to one bottle every three months. This bill passed out of the Senate Banking & Insurance Committee with a committee substitute and passed out of the Senate on a vote of 37 – 0 on February 27th and has not been assigned to a House Committee. The committee substitute was a compromise between the Optometrists and the insurance industry. The compromise conforms to market standards. Click here for a copy of the bill. Click here for a copy of the Committee Sub.
SB 119 establishes Medical Review Panels for all malpractice and malpractice related claims against a health care provider, other than those claims agreed for submission to binding arbitration. The independent panel will include three health care experts. The three health care experts could include nurses, physicians, hospital personnel, long term care home personnel or others whom Kentuckians depend upon for their care. They will review the evidence of a potential case before it goes to court. To ensure fairness, each side represented in the case would select a panelist with the third panelist being agreed to by the other two experts. This ensures a fair and unbiased decision from the panel. The expert panel will decide whether the standard of care was violated, but they would not make a finding of fact or conclusion of law. The results of the panel would be admissible in court, but does not deny any Kentuckian access to the legal system. The bill was heard in Senate Health & Welfare and passed out favorably 7 – 3 with one abstention. The bill passed out of the Senate on a vote of 22 – 14 and has been assigned to the House Health & Welfare Committee. Click here for a copy of the bill. Click here for a copy of the Committee Sub. Vote History
SB 124 (LM/CI) exempts "marijuana" drugs from the definition used in FDA-approved studies or compassionate use programs and the substance cannabidiol when recommended by a physician practicing at a state research hospital. The bill, sponsored by Senator Denton, has passed out of the Senate Health & Welfare Committee and is awaiting passage. Click here for a copy of the bill.
SB 130 requires an agency head to pay any costs awarded by a court out of his or her personal fund if the court determines that they have willfully withheld records. The agency head will also be required to vacate his or her position with the agency for five years and to forfeit his or her pension benefits. The bill is sponsored by Senator Denton and was assigned to the Senate Judiciary Committee on February 12th. Click here for a copy of the bill.
SB134, sponsored by Senator Westerfield, requires the Kentucky Board of Medical Licensure to develop a program to certify physicians to offer testimony on the basis of the physician’s professional knowledge and skills. The Board would implement regulations governing the program and establish the basis on which an expert witness certificate would be issued. Similar legislation has been offered in years past (2012) in the House by Rep. Burch and Rep. David Watkins. The bill has received opposition from some insurance companies. The health benefit plans have not expressed an opinion as of yet. The bill has been assigned to the Senate Judiciary Committee. Click here for a copy of the bill.
SB148, sponsored by Senator Buford, is a bill that creates parity for cancer medications. This bill would prohibit health benefit plans from requiring a higher co-payment, co-insurance, or deductible for patient administered anticancer medications oral medications than is required for the same medications injected or intravenously administered by a health care provider. The bill has been assigned to the Senate Banking & Insurance Committee. Click here for a copy of the bill.
SB 159, sponsored by Senator Buford, permits primary care centers to provide Medicaid managed care reimbursed school-based and Head Start-based dental care programs. The bill was introduced last week and was assigned to Senate Health & Welfare. Click here for a copy of the bill.
SB166, sponsored by Senator Leeper, is the same as HB 361. It is legislation that allows providers access to a state fair hearing. Senator Leeper is registered as an Independent and serves as Chair of the Appropriations & Revenue Committee, two additional co-sponsors have signed on to the bill, one Democrat and one Republican. The bill was assigned to the Appropriation & Revenue Committee. Click here for a copy of the bill.
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