Health bills dealing with insulin cost, substance-use disorder and long-term-care staffing pass legislative chambers Tuesday

By Melissa Patrick
Kentucky Health News

Health-related bills are on the move in the General Assembly, with several of them passing out of their respective chambers Tuesday. 

House bills sent to the Senate include one that would help some Kentuckians with diabetes pay for their life-saving medication, another aimed at decreasing the stigma around getting syringes and needles in drug stores, and one related to temporary nurse aides.  

The Senate bill now in the House would remove prior-authorization requirements from drugs that help people who have a substance-use disorder deal with their addictions. 

Rep. Danny Bentley (LRC photo)

House Bill 95, sponsored by Rep. Danny Bentley, R-Russell, would cap the cost-sharing requirements for prescription insulin at $30 per 30-day supply for state-regulated health plans. The bill does not include Medicaid, Medicare or self-insured government plans.

Bentley, who is a Type I diabetic, said it is important for this bill to pass because many Kentuckians have to make a regular choice between paying their rent or buying their insulin. 

He explained that the cost of insulin has tripled between 2002 and 2013, even though the cost to manufacture the drug is between $3.69 to $6 per vial. 

“If I was paying cash for my insulin, if I didn’t have the insurance I have, my insulin would cost me $12,000 a year,” Bentley said while holding up a vial of insulin. 

He added that without the insulin, people can suffer serious health consequences, such as losing their sight, amputation or even death. 

Rep. Patti Minter, D-Bowling Green, whose son has Type I diabetes, said, “No one should lose their sight because they don’t have access to something that costs $6 a bottle to manufacture. ” Minter is a primary sponsor of the bill.

According to the 2020 Kentucky Diabetes Fact Sheet, 13.7% of Kentuckians have been diagnosed with diabetes, and an estimated 158,200 adults have the disease, but are undiagnosed. Not all use injectable insulin. 

HB 95 passed the House 95-0 to a round of applause. A similar bill passed the House during the last legislative session, but died in the Senate as legislative business was truncated by the pandemic.  

HB 219, also sponsored by Bentley, would remove pharmacy recordkeeping requirements for sale of hypodermic syringes or needles and allow their sale of without a prescription, with a limit of 30 of each and proof that the purchaser is 16 or older.

"House Bill 219 removes obsolete recordkeeping requirements for the sale of hypodermic syringes by pharmacies. The goal is to increase the availability of syringes in order to reduce the spread of diseases such as HIV, which turns into AIDS and hepatitis C," said Bentley. 

He added that as it stands, people who buy syringes and needles in pharmacies have to sign a black book that asks what that person plans to use them for, and removing this requirement "destroys that stigma." 

After changes in committee and on the floor, the bill would require pharmacies offering retail sale of syringes and needles to provide educational materials on safe and proper disposal of the products; referral information for syringe exchange programs and treatment of substance-use-disorder; and to offer a naloxone prescription that could be used to reverse an opioid overdose. It passed 97-0. 

HB 276, sponsored by Rep. Kim Moser, R-Taylor Mill, would allow nurse's aides who were trained as temporary Covid-19 personal-care attendants under an emergency executive order from Gov. Andy Beshear to apply their supervised training toward their state certification and registration. Moser said the bill will affect about 300 attendants who have been working in long-term care during the pandemic. The bill passed 96-0. 

Sen. Ralph Alvarado (LRC photo, Jan. 9)

Senate Bill 51, sponsored by Sen. Ralph Alvarado, R-Winchester, would ban the requirement of prior authorization for any prescription drug that is used in the treatment of alcoholism or opioid-use disorder that contains methadone, buprenorphine or Naltrexone, or that is approved by the U.S. Food and Drug Administration for the mitigation of opioid withdrawal symptoms. 

Prior authorization is a process insurers use to get their approval before a patient can get a drug. Alvarado, a physician, said such authorizations are common for these medication-assisted therapies and can take days or weeks. 

"Providers are routinely stymied by PA requirements at the critical moment when patients are ready to begin treatment and address their alcohol or opioid use disorder," he said, adding that the requirement puts the patient at risk of "relapse, overdose or even death." 

The bill also calls for an annual report to be sent to the Department of Insurance that shows the number and type of providers that have prescribed medication for addiction treatment, broken down by those who prescribed it in conjunction with behavioral therapy and those who did not prescribe it in conjunction with behavioral therapy. 

"Frankly, in conclusion, this is going to help save lives here in the state of Kentucky," Alvarado said. The bill passed 34-0.