The legislature reconvened on Tuesday, Feb. 5, 2013 for the second part of the 2013 Kentucky General Assembly. Lawmakers went to work quickly and by Friday several bills had cleared at least one chamber. There were several new bills introduced relating to pharmacy but no action was taken on any pharmacy-related measure this week.
PBM Transparency Bill Introduced
Senate Health and Welfare Chairman Julie Denton (R-Louisville) filed SB 107 on Wednesday. The bill establishes a set of basic disclosures that PBMs must make in their dealings with contracted pharmacies:
- It requires that the PBM disclose in its contract with the pharmacy the pricing indices it uses to calculate the reimbursement paid to the pharmacy for drug products.
- Additionally it specifies that if the PBM uses maximum allowable cost (MAC) to determine reimbursement, it must notify the pharmacy what products are subject to MAC and what the MAC is for each of those drugs.
- It requires that the PBM update MAC pricing at least weekly and notify the pharmacy of these updates.
SB 107 also requires PBMs to establish a process whereby a pharmacy may appeal a MAC price and sets the parameters for the appeal and price adjustments if warranted. This is KPhA's top priority for the session. KPhA's Government Affairs Committee worked throughout the fall to research and draft the legislation. KPhA is working with APSC, APCI, EPIC and KIPA to push this legislation.
Tamper-Resistant Opioid Bill Set For Hearing
No Vote Expected
The House Judiciary Committee has scheduled an informational hearing for February 13 on HB 74, a billrestricting the substitution of "tamper-resistant" opioid drugs. No vote is expected to be taken. HB 74 prohibits a pharmacist from substituting an opioid that does not have tamper-resistant qualities for one that does unless the pharmacist obtains written permission from the prescriber. KPhA opposes this bill.
Legislature to Revisit Prescription Drug Abuse Issue
Lawmakers once again will address the issue of prescription drug abuse in Kentucky. House Speaker Greg Stumbo (D-Prestonsburg) introduced HB 217 this week to make changes to the comprehensive prescription drug abuse law passed last year in a special session (HB 1). Stumbo's bill incorporates suggestions put forth by physicians, pharmacists and law enforcement officials and addresses many of the issues brought up in hearings on the issue conducted during the interim.
Two major changes of interest to pharmacists are included in the proposal. HB 217 eliminates the requirement that hospitals and long term care facilities report drugs administered directly to patients to the state's electronic controlled substances database (KASPER). Another provision eliminates the need for pharmacists to report the loss or theft of controlled substances to the state police. This requirement created unnecessary duplicate reporting requirements since pharmacists must already file reports with the DEA, Board of Pharmacy and local law enforcement officials. Both of these changes were requested by pharmacy representatives during the interim hearings.
HB 217 appears to have broad bipartisan support and is expected to be heard by the House Judiciary Committee next week.
House Speaker Files Prompt Payment Bill
House Speaker Greg Stumbo (D-Prestonsburg) introduced legislation on Thursday granting the Department of Insurance more authority over payments to providers by Medicaid Managed Care Organizations (MCOs). HB 5 is a response to ongoing problems health care providers are experiencing getting paid for services provided to Medicaid recipients enrolled in managed care. Currently, providers are having to deal with both the state Medicaid agency and the Department of Insurance to resolve payment delay issues. Oftentimes providers are frustrated with inability to get final resolution. At a hearing of the Budget Subcommittee on Human Resources this week, both representatives from the Department of Insurances and Medicaid discussed the prompt payment issue. The DOI testified that while they had the ability to fine the MCOs for violations of the current prompt payment laws, they did not have the ability to force the MCOs to make payment.
Bill Clarifies Psuedoephedrine Reporting
A bill to clarify that a written signature can be used to meet the reporting requirements under Kentucky's pseudoephedrine law was introduced this week by Representative Brent Yonts (D-Greenville). The bill was filed at the request of the Office of Drug Control Policy (ODCP) to clean up confusion created by the passage of a new pseudoephedrine law last session. That bill seemed to require that pharmacies had to obtain an electronic signature from purchasers of PSE. HB 146 has been assigned to the House Judiciary Committee.
"Conscience Clause" Legislation Filed
After a lull of several years, the issue of a "conscience clause" has again surfaced. Representative Joe Fischer (R-Ft. Thomas) filed a bill this week (HB 143) allowing a health care provider, health care institution or payor to refuse to provide or pay for a medical service that violates his or her conscience. The issue was a hot topic shortly after the FDA approved the "morning after" pill several years ago but has since died down. HB 143 was likely prompted by new federal rules on contraceptives. The bill has been assigned to the House Health and Welfare Committee.
Medicaid Publishes Regulations on Medicaid Managed Care Implementation in Region 3
The Department for Medicaid Services has issued a series of new regulations establishing the guidelines for the new Medicaid managed care system in Region 3. The regulations outline the policies and procedures for recipients, providers and managed care organizations for the plans operating in Jefferson and surrounding counties. The regulations were filed as both emergency and ordinary regulations. The regulations essentially implement the contractual requirements between Medicaid and the four MCOs that began providing services in the region on January 1, 2013.
The public comment period on the regulations closes on February 26, 2013.
The regulations can be viewed at:
- SB 51, a bill eliminating the requirement that APRNs have a collaborative care agreement with a physician in order to prescribe nonscheduled drugs has been filed by Senator Paul Hornback (R-Shelbyville).
- SB 94 was filed this week by Senator Carroll Gibson (R-Leitchfield). The measure adds additional requirements to collaborative care agreements between APRNs and physicians.
- HB 181 was introduced on Tuesday by Representative Carl Rollins (D-Midway). The bill places new limits on the amount of pharmacy school scholarships available under a program to encourage students from coal-producing counties to attend pharmacy school.