Sunday, February 25, 2018

With legislative session more than half over, most health-related bills are still on the table; here's a roundup

For KHN's complete chart of health bills, click here.
By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. -- Most health-related bills in the legislative session appear to be driven by the state's opioid epidemic, tort reform and issues of health-care providers, but only a bill that addresses organ donation has gone to the governor, and the session is more than half over.

If signed, House Bill 84, sponsored by Republican Rep. Lynn Bechler of Marion, would require coroners and medical examiners to contact the Kentucky Organ Donor Affiliates if they know that a decedent wishes to be an organ donor. The current law only requires hospitals to contact KODA when an organ donor dies.

The bill, called "Courtney's Law," is named for Courtney Flear of Princeton, an organ donor who was killed in an automobile accident in 2015, but because of the wording of the current law her organs were not donated despite her wishes, according to Bechler's legislative update.

The opioid epidemic in Kentucky rages on, prompting lawmakers to push for bills to curb it.

Two bills are aimed at early intervention and prevention in schools. HB 55, sponsored by Rep. James Tipton, R-Taylorsville, calls for the creation of an age-appropriate curriculum on drug abuse and prevention that would be taught in every school. HB 3, sponsored by Majority Floor Leader Jonathan Shell, R-Lancaster, would require drug education as part of an "essential skills" program. Both have passed the House and are in the Senate Education Committee.

HB 246, sponsored by Rep. Danny Bentley, R-Russell, would expand access to medication-assisted therapies for treatment of substance-abuse disorders by bringing a grant-funded pilot program to the state that allows pharmacists to administer non-controlled MATs. This bill awaits a floor vote in the House.

Rep. Addia Wuchner, R-Florence, has several bills that address the opioid epidemic. HB 364 would require all pregnant women to be tested for hepatitis C, with the results added to the child's records. It also recommends that the child be tested at 24 months if the mother tests positive. Hepatitis C can be transmitted from mother to baby during childbirth. Most new cases of hepatitis C are a result of illegal intravenous drug use. This bill awaits a floor vote in the House.

Wuchner is also the sponsor of HB 148, which shifts ownership of controlled substances from a deceased hospice patient to the hospice program for disposal. Currently these drugs belong to the estate. This bill has passed the House and is in the Senate Health and Welfare Committee.

Another Wuchner bill, HB 124, calls for a comprehensive review of all state substance use disorder programs and services, and would require the state to only pay for and licence ones that follow nationally recognized evidence based protocols.

Bills for tort reform are also moving in the Republican-led legislature, with votes largely split along party lines.

HB 4, sponsored by Wuchner, would keep doctors' reviews of other doctors from being used in medical-malpractice lawsuits. It has passed the House and a Senate committee and awaits a vote in the full Senate.

Senate Bill 2, sponsored by Sen. Ralph Alvarado, R-Winchester, would limit the amount of non-economic damages that could be awarded in personal-injury and wrongful-death lawsuits. the bill is a proposed constitutional amendment, requiring a three-fifths vote in each chamber and approval by a majority of voters in a statewide referendum at the November election. It is awaiting a vote on the Senate floor, but has been passed over seven times since Feb. 14.

SB 20, also sponsored by Alvarado, would do several things, including limiting attorney fees in malpractice cases, add a requirement for a sworn statement from a doctor saying that a lawsuit has merit before it could proceed, and keep apologies or expressions of regret made by a provider from being used in a lawsuit. This bill also awaits a Senate floor vote.

Insurance and provider-issue bills are also quite prevalent, as usual.

SB 5, sponsored by Sen. Max Wise, R-Campbellsville, which would put the state back in charge of its Medicaid drug program, came about because he said pharmacy-benefit managers hired by the state's Medicaid managed-care organizations, are not paying Kentucky's independent pharmacies a fair price for their drugs -- which is putting them at risk of closing. It also calls for more transparency. This bill has passed out of committee and awaits a vote on the Senate floor.

Other states are also dealing with this issue. The Arkansas Pharmacist Association held a news conference Feb. 21 and revealed that CVS Caremark paid their CVS locations an average of $60 more per prescription than they paid their local independent pharmacies. CVS Caremark is the pharmacy benefit manager for four of Kentucky's five managed-care organization.

A bill in the Senate that is getting some pushback from consumer groups is HB 191, which would restrict the growing practice of online eye examinations. This bill, sponsored by Rep. Jim Gooch, R-Providence, is in the Senate Health and Welfare Committee.

Other bills in this category would improve telehealth access and payment to providers; update state guardianship laws; increase access to autism benefits; improve some of the administrative challenges around managed-care organizations; change how hospitals are paid for charity care; and require ambulance providers to disclose fees, among other things.

HB 64, sponsored by Rep. Stan Lee, R-Lexington, would allow eligible veterans to use hyperbaric oxygen treatment for treatment of traumatic brain injuries. This treatment is currently not covered by insurance, and the bill would not require insurance to cover it. It awaits a vote in the full Senate.

Children's health: Several of the health-related bills are aimed at improving the health of the state's children.

HB 318, sponsored by Rep. Kim Moser, R-Taylor Mill, and and SB 51, sponsored by Alvarado, would require school properties and school events to be tobacco-free. Both are sitting in their respective education committees. Alvarado has said the House needs to pass its bill first, since the Senate passed a similar bill last year but the House didn't take it up. A recent Kentucky Health Issues Poll found that 87 percent of Kentucky adults support such a law.

In the wake of a 2016 Kentucky Incentives for Prevention survey that found one in 12 of Kentucky's high-school sophomores said they had attempted suicide, HB 30, sponsored by Rep. Regina Huff, R-Williamsburg, would require educators to have two hours of in-person suicide prevention training every other school year. Current law requires a minimum of two hours of self-study every year. This bill unanimously passed the House and is in the Senate Education Committee.

Other education-related bills would require abstinence until marriage to be taught in sex-education classes, set guidelines around training for seizure disorders; and require automated external defibrillators in every school with three trained employees. Another youth-safety bill would require children under the age of 12 to wear a bicycle helmet.

Taxes and budget: In addition to the many health-related bills on the table, the Coalition for a Smoke-free Tomorrow, comprising nearly 150 organizations trying to decrease smoking in the state, is lobbying hard to raise the cigarette tax by $1, to $1.60. They say this proven tactic would not only decrease the number of teen smokers by more than 23,000, but would also cause 29,000 adults to quit smoking. Smoking is the leading cause of lung cancer in Kentucky and is also responsible for one-third of all cancers in the state.

Advocates of the tax also say it would ease the state's revenue shortage. The House is expected to release this week its version of the proposed budget for the next two fiscal years. Republican Gov. Matt Bevin proposed to eliminate funding for more than 70 programs, including five for cancer screenings and research, and local health departments are warning that adding $38.5 million to their pension liability will result in significant cuts to their programs and overall staffing if they don't get any relief.

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