Issue briefs: 2010 session

(*Refer to our Bill Tracker for up-to-date information about a bill's movement through the legislative process.)

ARNP scope of practice expansion

An informational hearing on the ARNP scope of practice bill (HB 2447) was held on February 25. The bill, as written, would allow nurse practitioners to make medical diagnoses, practice completely autonomously, prescribe drugs and order any medical interventions without any physician collaboration or protocols. KMS submitted written testimony opposing the scope of practice expansion.

Naturopaths scope of practice expansion

HB 2575 would license naturopaths. The bill also removes the prohibition on prescribing or administering prescription drugs or controlled substances, topical or otherwise, and allows naturopaths to prescribe and administer bio-identical hormones. Naturopathic medicines would include prescriptions for testosterone and also would allow naturopaths to conduct the school health assessments required for children. Currently only physicians and KDHE qualified nurses are allowed to perform school health assessments.

Pharmacists seek expanded vaccination authority

Pharmacists would be allowed to expand their ability to administer vaccinations under a bill (HB 2448) introduced before the House Committee on Health and Human Services. A pharmacist or a pharmacy student or intern under the direct pharmacist supervision may currently administer vaccine to a person 18 years of age or older pursuant to a vaccination protocol with a physician licensed in Kansas. This new proposal would expand the ability and allow pharmacists to administer influenza vaccine to those 6 years and older and any vaccine to those 12 years and older. Both would continue to require a vaccination protocol.

Medicaid provider reimbursement cuts

In light of the State’s dire budget situation, Governor Mark Parkinson in late November directed all state agencies to reduce their budgets for the remainder of fiscal year 2010. As a result, fees for all Medicaid services provided were reduced by 10 percent; the ordered cuts are indefinite in duration and impact all service providers–including physicians and hospitals–equally.

In discussions with the Governor, KMS has expressed concern that declining reimbursement could adversely affect access to care for our state’s most vulnerable citizens. Medicaid rates have historically remained below both Medicare and private health insurance companies; further reductions in those already low reimbursements may, at best, result in physicians limiting the number of Medicaid patients they accept. At worst, physicians may opt to discontinue accepting new Medicaid patients altogether.

KMS will continue to communicate with the Governor, legislative leadership and the Kansas Health Policy Authority on this issue. Legislative testimony provided on this issue includes:

• House Committee on Aging & Long Term Care (January 19, 2010)

Health Care Stabilization Fund; State refuses obligation to reimburse costs

Under state law, the State of Kansas pays the full cost of liability claims for KU residents, and partially covers costs associated with claims against KU medical school faculty. The Health Care Stabilization Fund manages the claims process for the State, pays all costs associated with liability claims and then is reimbursed by the State for such expenditures.

During the fiscal year 2009, as a result of the severe state budget shortfall, then-Governor Sebelius directed the Kansas Secretary of Administration to suspend those reimbursements to the Health Care Stabilization Fund. That action resulted in the state not paying $2.9 million of expenses which is due the HCSF. The next year, again as a result of deteriorating state finances, Governor Mark Parkinson ordered a similar action, called “allotment,” for fiscal year 2010 and 2011; if the allotment orders are carried out, it will cost the HCSF–which is funded mostly by the physicians and hospitals of Kansas–somewhere between $8-9 million. 

The Kansas Medical Society continues to strongly oppose use of the allotment action for such purposes. We have introduced legislation which would exempt the Health Care Stabilization Fund from the allotment statute; our testimony is support of SB 414 is available here.