LMS President’s Message, May 2019
Go Ahead, Stir the Pot
By Charles L. Papp, MD
Without trying to sound like the Chamber of Commerce, I must admit Lexington is a great place to live. Downtown is thriving despite the fact that we no longer have “The Big Hole.” The city is full of great restaurants, pubs, and music venues. The community is blessed with wonderful amenities, such as beautiful horse farms, Keeneland, first class college sports, and the incredible water tank in the shape of a giant Dixie Cup off North New Circle. All this in a city that is not too big and not too small leads to one of the things I like best about Lexington — your voice, your interest, your participation can make a difference. If you want to get involved, you just have to show interest. If you have a heart for a charity or an interest in an organization, be careful- you might get put on the board. I grew up in Los Angeles where if someone wanted to be involved with the Los Angeles Philharmonic or the Getty Museum, he or she needed to be rich or famous, preferably both.
In Lexington, opportunities for involvement also extend to local politics. I realize we are all busy in-patient care and we tend to ignore what goes on in City Hall and Frankfort. Unfortunately, this leaves physician representation in local and state government miniscule. This is a tragedy given the importance of our profession and its impact on the community. In contrast, I hardly want to discuss the huge presence of the legal profession in politics. They have it figured out. A strong presence in government provides opportunities to promote policies.
The Kentucky Legislature has just completed a short session in Frankfort. There were several bills proposed and many passed that dealt with healthcare. Most of the bills supported by the LMS and KMA passed. Some that we opposed also passed. I have listed some that passed and some that did not. Take a look, if you don’t like what you see – get involved.
Senate Bill 54 – This bill is sponsored by senator and physician Ralph Alvarado and addresses difficulties with prior authorizations. It requires insurers to develop processes for electronic prior authorizations (rather than all those endless phone calls). Utilization reviews will be by licensed physicians of the same specialty and subspecialty, when possible, as the ordering physician.
Urgent health care services are to have a decision no later than 24 hours and non-urgent within 72 hours. Lastly, a prior authorization for an ongoing condition is now good for the lessor of one year or until the last day of coverage by the insurance plan.
House Bill 11– Sponsored by Rep. Kim Moser, this bill prohibits use of tobacco products and e-cigarettes in schools, on school properties, in school vehicles, and during school activities.
Senate Bill 30– Sponsored by Sen. Ralph
Alvarado, this bill requires health benefit plans to cover genetic tests for
cancer risk that are in accordance with guidelines published by the National
Comprehensive Cancer Network or guidelines published by national medical
Senate Bill 84 – Sponsored by Sen. Tom Buford, this bill defines a category of health professional designated a licensed certified professional midwife as a person who is certified by the North American Registry of Midwives and issued a license by the board to provide certified professional midwifery services in the Commonwealth of Kentucky. This category does not require an RN degree; rather, the individual must satisfy certain licensing requirements. The bill has numerous provisions for oversight and regulation.
These are some bills that didn’t pass:
Senate Bill 132 – Sponsored by Sen. Paul Hornback, this bill would affect requirements for APRN prescribing privileges. The bill would have removed the one-year practice requirement before an APRN may prescribe controlled substances under a written collaborative with a physician. It also would have established conditions for an APRN to write controlled substances after four years without a collaborative agreement.
House Bill 225 – Sponsored by Rep. Kim Moser, this bill would have required advertising for legal services, such as billboard or television ads, to include warnings that it is dangerous to stop taking a medication before consulting a physician. The fear is that an elderly patient may misinterpret an ad that says it is a public service announcement and has a government logo, such as the FDA’s, as a warning to stop taking the medication.
House Bill 136 – Sponsored by Diane St. Onge, this bill would have legalized medical marijuana.
Many of you may have strong opinions regarding the bills that passed and those that failed. You may have strong feelings about health care issues that were not addressed. I realize not all physicians are able to run for office, but we can get involved through the Lexington Medical Society and the Kentucky Medical Association. Even a little support helps. These organizations are designed to help physicians share ideas, suggest proposals, engage the legislature, and support or oppose legislation. Our voices can be heard much more clearly if we do not speak alone. We seek your ideas, your experiences, and your participation. Numbers really matter. If you have been on the sidelines until now, I strongly suggest you get your feet wet by attending the Physicians’ Day at the Capitol next year. Mark the date on your calendar (it usually occurs in February) and block your schedule. This event gives you an opportunity to speak face-to-face with your legislators. In addition, if you have the ability, send a little money to the Kentucky Physicians Political Action Committee (KPPAC). Its goal is to elect lawmakers who understand the importance of a strong medical community and the health and well-being of the commonwealth. Here is a link. h