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