KMA 10th District Update, January 2025
By James Borders, M.D., KMA 10th District Trustee
Perhaps the most important role of organized medicine is to educate the public about the needs and challenges of the practice of medicine. When educated properly, the public’s legislative representatives will advocate for any reforms necessary to protect the vital public asset that we physicians represent.
According to Dr. Christine Sinsky, AMA’s vice president of physician satisfaction, the stress that physicians face that contributes to burnout is not what the public tends to believe. Taking care of sick people is hard work, but training prepares most physicians quite well for this reality, and people attracted to the practice of medicine expect this. Burnout is largely due to physicians doing the wrong work- work that support staff could do if available in sufficient numbers, such as to scribe or to manage computer data entry. Other work that could be considered “wrong” is administrative- such as the effort spent seeking prior authorization.
For the 2025 legislative session, the number one priority of the Kentucky Medical Association will be prior authorization reform. We believe that the chance to make progress in this area will be enhanced by taking an incremental approach. The idea is that insurers should be forced to establish an exemption program that allows physicians/practices who achieve a high rate of prior authorization approval to be exempt from the process for a defined timeframe. Insurers would be required to submit regular reports to the legislature of the number of physicians and practices that are participating in the exemption. Such legislation would only apply to plans regulated by the state, which would exclude Medicaid. The financial and medical impact of the reforms would receive ongoing examination in the hopes of supporting further administrative relief for physicians over time.
Another opportunity to enhance physician wellness and well-being will be to pass legislation that reforms the KAPER-1 form, the hospital/insurer credentialing application for physicians, by eliminating stigmatizing language that asks physicians about “prior” mental, emotional, and/or physical health instead of focusing only on current untreated conditions.
The other anticipated legislative push will be by non-physician providers attempting to enlarge their scope of practice. Physical therapists want to be allowed to order imaging, and physician assistants will be seeking legislation to allow them to order schedule II medications and change their practice act language from “supervised” by physicians to “collaborate” with physicians. KMA will also promote improved physician reimbursement and expansion of residency training openings.
The evolving political climate predicts legislation attempting to remove restrictions or expand exemptions to vaccinations, to remove the mandate on fluoride in tap water, and lower the barrier to establish freestanding birth centers.
Please make every effort to participate in Physicians’ Day at the Capitol which will be held on February 19th. More details about the KMA’s legislative efforts will be discussed by Cody Hunt, KMA’s Director of Health Policy, during the January meeting of the Lexington Medical Society.
