legislation ensures a non-political, professional vetting process for individuals seeking appointment to the state’ s medical licensure board. The bill was introduced by Senator Alvarado at the beginning of this session and was initially heard by the Senate Licensing, Occupation and Administrative Regulations Committee. The bill made its way through the legislature, passing the Senate on February 3. The bill passed the House Health and Welfare Committee and then the full House unanimously on March 28 after the addition of two floor amendments. Following the Senate’ s concurrence with the two amendments, the Governor signed the bill into law on April 8.
SENATE BILL 20: INDEPENDENT AP- PEALS PROCESS FOR MEDICAID MCO CLAIMS
Senate Bill 20 was another bill sponsored by Senator Alvarado. If you cannot tell by now, Senator Alvarado, who is a practicing physician in Winchester, KY, in his second year as a state senator has been a tour de force in Frankfort. Senate Bill 20 is a measure that addresses concerns of patients, physicians and hospitals about the difficulty associated with appealing coverage denial and nonpayment of claims by Medicaid Managed Care Organizations( MCOs). The bill creates new sections in the Kentucky Revised Statutes, which will permit a provider who has exhausted an internal appeal process to be entitled to an external, independent, third-party review as well as an administrative appeals hearing under Kentucky Revised Statutes Chapter 13B. The bill also requires an MCO to send a final determination letter, establish proceedings for an administrative appeals hearing, provide a mechanism for attorneys’ fees and establish a fee for the party that does not prevail to cover costs. The bill was introduced in the Senate Health and Welfare Committee before being sent to the senate floor, passing unanimously on February 10. After being passed by the House Health and Welfare Committee, the bill passed the House unanimously and was signed into law by the Governor. to ensure that the medical records reflect which specific product has been dispensed to the patient. This provision of the bill created the most controversy as there were a total of seven amendments on the Senate floor and three amendments on the House floor, most of them relating to the communication process between the pharmacist and the prescribing practitioner. In the end, the bill passed the Senate and House almost unanimously. The Governor signed the bill into law on April 9.
OTHER BILLS OF INTEREST
• Senate Bill 154( Senator Buford) changes a requirement that supervising physicians review and sign off on 10 percent of overall medical notes written by PAs under their supervision. With this change, physicians, practices and institutions would outline and determine the parameters for medical notes for which they will countersign. They would have to include that information in the application for supervising physician assistants with the Kentucky Board of Medical Licensure.
• House Bill 95( Representative Burch) requires the Department for Medicaid Services to establish a pilot project responsible for creating Medicaid coverage and reimbursement criteria for telemonitoring services.
• House Bill 115( Representative Burch) includes eligible underinsured people in the colon cancer screening program.
• House Bill 489( Representative DeWeese) adds the physician pronouncing death to the list of those providers who may complete a death certificate.
• Senate Bill 33( Senator Wise) requires that students receive CPR training one time while enrolled in grades 7-12.
And finally, the Coup de Grace!
SENATE BILL 134: BIOSIMILARS
Senate Bill 134 was once again sponsored by Senator Alvarado along with Senator Thomas. This bill addresses the ever-growing list of biologic medical products known as a biosimilar. Biosimilars are officially approved versions of original biologic products based on a formula that is highly similar to and has no chemically meaningful differences in terms of safety and efficacy from an already-approved biological product. Examples of biosimilars include Zarxio which is a biosimilar of Neupogen and Inflectra which is a biosimilar of Remicade.
Senate Bill 134 updates the Kentucky Pharmacy Practice Act to allow Kentucky pharmacists the ability to dispense less-expensive biologic medications to patients by allowing substitution of an interchangeable biosimilar. The bill also ensures there will be transparent communication between pharmacists and prescribers
SENATE BILL 18: FAIR CONTRACTING
I have left the discussion of Senate Bill 18, submitted by Sen. Alvarado, for the end because it was one of the last bills passed, literally in the last hour of April 15, the last day of the session. Before I describe the drama of how the bill was passed, I would like for you to understand the significance of this bill and the work that multiple GLMS and KMA members and staff put into the passage of this bill. The bill originated from another resolution submitted to the KMA House of Delegates by GLMS. It was introduced by Senator Alvarado in the 2015 Legislative Session and gathered significant momentum before being stalled by the addition of a committee amendment. In the interim, several GLMS members, including Dr. Bruce Scott, Dr. John Roberts and Dr. Bob Couch met with representatives from the insurance companies to discuss several concerns the insurers had. There was a consensus that concerns were addressed and Senator( continued on page 8) JULY 2016 7