Liability protection approved as legislature adjourns; bill goes to governor

As we reported last week, KMS continued to urge lawmakers to address liability protections for health care providers during the COVID-19 emergency period. KMS developed and presented to the House and Senate Judiciary Committees a narrowly constructed immunity proposal that limits health care provider liability related to COVID-19 treatment, and for professional services otherwise medically necessary that were delayed or not provided due to the declared state of emergency. KMS also worked closely with the governor’s office to ensure that the administration’s questions and concerns about the proposal were addressed.

Legislative update: Provider liability bill under consideration as session wraps up

capitol dome smA message from KMS Executive Director Rachelle Colombo:
This weekend marks the passing of two full months since a state of emergency related to COVID-19 was declared in Kansas. During that time, life has changed dramatically, bringing kids home from schools, adults home to work remotely, and the suspension of most medical care that wasn’t emergent or COVID-19-related. We have heard from you regarding the challenges of adapting to delivering care during the pandemic. As schools and the economy have shuttered, the delivery of health care has soldiered on, albeit at a different rhythm and with plenty of setbacks of its own. Many of you have reached out to tell us your stories, from the challenges of procuring PPE, to maintaining payroll and waiting for patient volume to resume as you’ve tried to keep your practices afloat. Hearing from you has honed our advocacy, as we have shared your stories with federal, state, and community leaders and urged them to adopt public policies that will address the problems you have identified, as well as enabling the health care system to reopen, safely and responsibly.

COVID-19 Update: Legislative update, Provider Relief Fund, Remdesivir, virus reporting

Legislative update
The Kansas Legislature will return for one day to finish its work on May 21, the last official day of the 2020 legislative session. Legislative leaders in both the House and Senate have authorized a number of committees to hold virtual meetings during the next two weeks for consideration of high priority issues they hope to address when the entire legislature returns. KMS continues to urge legislators to consider liability protections for health care providers and the passage of Senate Bill 493, which is KMS’s proposal in response to the Hilburn ruling. Both the Senate President and the House Speaker have identified liability issues for health care providers and businesses as a priority for the virtual committee work in advance of the full legislature returning. Governor Kelly has also expressed hope that an agreement could be reached around COVID-19-related liability protections for health care providers.

COVID-19 Update: Governor to not extend stay-at-home order, BCBSKS no-interest loans, free N95 mask decontamination

Governor to issue plan for reopening state, will extend emergency declaration
At her Wednesday press conference, Gov. Laura Kelly said she will announce plans for re-opening the state during a televised speech at 6:30 p.m. Thursday. She also indicated that she would not be extending the statewide stay-at-home order, which expires at midnight May 3. The governor also said that she would extend the state’s emergency disaster declaration by two weeks through May 14, preserving state eligibility for federal disaster relief. After that time, she said, the State Finance Council could extend it for an additional 30 days. In order for the emergency declaration to remain in place beyond June 13, she said the Legislature would need to extend it through a Concurrent Resolution.

COVID-19 Update: Statewide order to expire, legislature to reconvene, new PPP loans available

Governor to issue reopening plan this week
At her Monday briefing, Gov. Laura Kelly said her administration would issue plans to reopen the state by Thursday, April 30, before the statewide stay-at-home order expires at midnight May 3. In absence of the statewide order, restrictive policies may be imposed as warranted by public health officials in individual counties. Gov. Kelly said KDHE Secretary Lee Norman, MD, will have authority to override local health officials. The governor also said that she discussed with White House officials on Monday the need to significantly improve the state’s testing capacity to help minimize the spread of the virus as public activity increases.

COVID-19 Update: KMS response to Executive Order, new PPP details, elective procedure podcast

 A message from KMS Executive Director Rachelle Colombo:
We have heard from many of you regarding the Governor’s executive order on medical services. Concerns about her authorization of unlicensed, unsupervised providers without malpractice coverage and questions about what protections are afforded to physicians are warranted and not yet easily answerable. Although KMS has made requests for liability protections both for COVID-19-related care and care which has been delayed or deferred due to COVID-19, Executive Order 20-26 does not reflect our requests or suggested provisions.

COVID-19 Update: Governor emergency order on medical services, telehealth, MIPS credit for clinical trials

Governor issues medical services emergency order
Today, Gov. Laura Kelly announced Executive Order 20-26, a sweeping emergency order that eliminates all statutory provisions relating to supervision and delegation requirements for virtually all health care providers who are rendering COVID-19-related care. Among other things, the order removes all collaborative practice, supervisory, or protocol-based agreements between physicians and other health care providers (APRNs, PAs, LPNs, pharmacists, health care profession students, etc.), for any care provided during the COVID-19 emergency declaration period. The order states that health care providers can provide “medical services…without supervision from a licensed physician or nurse, without criminal, civil, or administrative penalty related to a lack of supervision or…a supervision agreement.”

COVID-19 Update: Liability protection, Medicaid rates, further federal support urged, payor policy changes, updated guidance

KMS urges Gov. Kelly to implement financial and liability actions
Today, KMS again requested specific measures from Governor Laura Kelly regarding liability protection and financial support for Kansas physicians. To offset the financial strain facing most practices, KMS urged the state to implement long overdue increases in the Medicaid physician fee schedule. Physicians’ fees under Kansas Medicaid have for the most part been frozen since 2006, and in several cases have actually decreased. KMS believes Medicaid payment rates should be increased to have parity with Medicare payment rates. KMS also urged the Governor to extend liability protections to health care workers during the COVID-19 state of emergency.

COVID-19 Update: Liability protection sought from state, payments issued to providers, new licensure policy, and other updates

KMS urges Gov. Kelly to issue executive order on liability amid COVID-19 pandemic
Today, KMS formally requested Governor Laura Kelly to join other state executives, such as New York Governor Andrew Cuomo, who issued an executive order providing immunity from civil liability to health care professionals for any injury or death alleged to have been sustained directly as a result of an act or omission by such professionals in providing medical services during the COVID-19 pandemic, unless such injury or death was caused by a professional’s gross negligence. KMS believes that physicians and other health care providers should not incur liability for care decisions or outcomes made during the public health emergency period when a physician’s judgment, for example, to provide medically appropriate diagnostic or therapeutic procedures is delayed or denied in order to preserve equipment, drugs, or other resources for COVID-19-related needs.

COVID-19 Update: Financial resources, liability coverage, telehealth, PPE, and more

SBA $10,000 Advance Forgivable Loan (distinct from PPP)
Potentially forgivable loans are currently available under the Payroll Protection Program (PPP, see previous KMS update), but it is important that physician practices know that they are also now eligible for an Economic Injury Disaster Loan advance of up to $10,000. This loan advance will not have to be repaid. The loan advance will provide economic relief to businesses that are currently experiencing a temporary loss of revenue. Get more information and the application.

COVID-19 Update: CARES Act podcast, new federal and state resources

Financial Relief Available: CARES Act Podcast

While circumstances stemming from the COVID-19 virus are putting immense financial strain on physician practices, a major new source of federal aid is beginning this week. The “Coronavirus Aid, Relief, and Economic Security” (CARES) Act is the single largest relief package ever passed by Congress and there are a number of provisions that can help physician practices. In a previous update, we provided an overview of the CARES Act. Today, we are supplementing that information via a podcast discussion with Dan Murray, Kansas State Director of the National Federation of Independent Business. This 10-minute discussion provides a succinct outline of what physician practices need to be aware of in considering whether to apply for relief under the CARES Act. This is a time-sensitive federal program, so we hope you will take a few minutes to familiarize yourself with its provisions.

COVID-19 Update: New state and federal guidance

A message from KMS Executive Director Rachelle Colombo:

Thank you for continuing to share your experiences with us, as well as your questions and concerns so that we may work to address issues you are facing. We have taken your stories and concerns directly to the governor and legislative leaders, particularly regarding the immense financial impact on physician practices during this pandemic. Also in response to those concerns, we will be hosting a podcast this week to outline newly available opportunities for practices to obtain financial relief—please watch for forthcoming details via email. We know you are continuing to show up for your patients—with or without COVID-19 infection—and we are working hard to support you in the ways you need most.

COVID-19 update: CARES Act becomes law — what physicians need to know

The CARES Act was signed it into law by the President, following Congress’ swift action on the massive coronavirus relief bill. The following information via the National Federation of Independent Business (NFIB) provides a few key highlights related to the new loan program which will be available to physician practices.

It is expected that most small businesses will be interested in this opportunity—if your physician practice is looking to take advantage of the small business loan, you should get in contact with your financial institution as soon as possible.

COVID-19 update: Financial resources, PPE, and telehealth

A message from KMS Executive Director Rachelle Colombo:

We heard from many of you about financial strain, lack of PPE, testing concerns, and questions around telehealth. Thank you for taking the time to share your experiences with us. It helps us focus our advocacy on those things that are most important to you. We hope this update provides quick access to some of the answers and resources you need. We are talking to policymakers at every level, every day. Sharing your stories is powerful and timely. In addition to the resources from government at the state and federal level, your local communities are looking for ways to support you. As an example, the Kansas Farm Bureau—which has local chapters throughout rural Kansas—has reached out and encouraged physicians to call upon their members for help with childcare and homemade protective equipment, and has pledged to partner with us in conversations with our congressional delegation to ensure these needs are met.

Personal Protection Equipment (PPE) updates amid COVID-19

KMS has received numerous inquiries regarding Personal Protection Equipment (PPE) during shortages amid the COVID-19 response. We are working with federal, state, and local officials to address your questions and provide accurate responses given rapidly changing circumstances. We will post the latest PPE information here and in our periodic COVID-19 updates as we receive it, as well as respond to your individual questions by email.

COVID-19 update: March 24, 2020

A message from KMS Executive Director Rachelle Colombo:

KMS is here to support you as you work to care for your patients, to protect your own health, and to ensure your practice is best equipped to navigate the many changing circumstances ahead due to COVID-19. To that end, we want to hear from you about the challenges you are experiencing and how we can better advocate for the resources you need at this time. We are in constant communication with federal, state, and local leaders to collect, distill, and disseminate COVID-19 information for our members as well as to report your needs back to policymakers.

Telehealth and other payor updates

On March 17, the Trump Administration announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of health care services without having to travel to a health care facility. This temporary broadened telehealth access to Medicare patients (under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act), is effective March 6, 2020.

Legislature adjourns for spring break amid uncertainty

This week, the Senate canceled all committee meetings scheduled for after Tuesday. Therefore, the Public Health and Welfare Committee did not hold the hearing that had been scheduled for SB 493, the bill in response to the Hilburn ruling. In light of the fast-moving developments this week regarding COVID-19, the Legislature was focused on passing a budget (its sole state constitutional duty each session), which it accomplished on Thursday.

Suggested Resources for Maintaining Your Mental Health During COVID-19

As we continue to face challenges posed by the COVID-19 pandemic, KMS seeks to support our membership with a variety of resources. The Federation of State Professionals’ Health Programs (PHP) and the KMS PHP has compiled the following list of free resources available that will hopefully assist you in maintaining your own health. If you need additional resources or emotional support, the KMS PHP staff can be reached 24 hours a day at (785) 235-2383.

Hilburn response bill, coronavirus updates

This week in the Public Health and Welfare Committee, a bill to respond to the Hilburn ruling was re-introduced (SB 493). The first bill introduced to that end was not approved in time to meet legislative deadlines.

Like the first proposal, we believe this bill represents the best response to the state Supreme Court's recent decision that struck down Kansas’ cap on non-economic damages in a motor vehicle personal injury case. Because there is uncertainty about whether the ruling also applies to medical malpractice actions, KMS is advocating for needed updates to the Health Care Stabilization Fund coverage requirements while we await further clarification from the Court.

Coronavirus Resources for Kansas

As developments surrounding COVID-19 rapidly evolve, it is more critical than ever to rely on trusted resources for the latest, accurate information. We recognize Kansas physicians are on the front lines of this pandemic and we intend to be available to support you however we can.

Working in conjunction with state and federal agencies and others, KMS will be distilling and disseminating information for Kansas physicians here.

Short legislative week, coronavirus updates

After a short break, the Legislature resumed work on Wednesday this week. However, there was little action on bills under consideration, with the exception of a handful of committees. As has been the case for several weeks now, the impasse over Medicaid expansion and the constitutional amendment on abortion has left little room for movement on other issues.

Expansion bill, coronavirus updates

This week, the Senate Public Health and Welfare Committee held its last meeting before “turnaround day,” the deadline by which health bills must be approved if they are to pass over to the other chamber. The committee adjourned without further considering the Medicaid expansion bill (SB 252), again signaling that an expansion bill appears unlikely to be approved until issues related to the constitutional amendment on abortion are resolved.

Expansion bill development, APRN discussion

This week, the Senate Public Health and Welfare Committee made several changes to the Medicaid expansion bill, adjourning without further action. The amendments made to the bill include a work and education provision, a conscientious objection provision, and prerequisites that must be met before expansion could be implemented in our state.

More importantly though, the committee’s action makes clear that the expansion bill would likely continue to be delayed until issues related to the constitutional amendment on abortion are resolved. Proponents of the constitutional amendment argue that, if it is not passed, the state’s portion of expansion funding could be used on abortions.

Expansion bill delay, APRN roundtable

This week, the Senate Public Health and Welfare Committee was expected to discuss—and potentially amend—the Medicaid expansion bill, SB 252. Instead, the committee will be seeking additional information pertaining to the expansion bill before moving forward with consideration of amendments.

Expansion, Hilburn, and Coronavirus updates

This week, the Senate Public Health and Welfare Committee met for the first of three scheduled days to discuss the Medicaid expansion bill, SB 252. As a starting point, Committee Chair Sen. Gene Suellentrop (R-Wichita) invited Kansas Attorney General Derek Schmidt to brief members on the status of ongoing legal challenges to the Affordable Care Act (ACA), which provides for Medicaid expansion.

Expansion talks continue, Hilburn response bill

This week the Senate Public Health and Welfare Committee continued the hearing on SB 252, Medicaid expansion, with opponents testifying on both Wednesday and Thursday. With the hearing concluded, the process of discussing the bill and debating potential amendments among committee members begins. If the bill is favorably passed out of committee, the full Senate will debate it and proposed amendments before potentially passing it to the House, where the process would repeat and continue.

KMS Legislative Update — Week 2

This week, KMS was among about 20 organizations to give oral testimony at the Senate Public Health and Welfare Committee in support of Medicaid expansion. Among the others testifying were KDHE secretary Lee Norman, MD, Tom Bell, President and CEO of the Kansas Hospital Association, and Lynn Fisher, MD, on behalf of the Kansas Academy of Family Physicians.

Legislative update — Week 1

The 2020 legislative session began this week, highlighted by Gov. Laura Kelly’s State of the State address. In her 37-minute speech, the governor clearly indicated that her top priority this session is Medicaid expansion. She also signaled that she would continue to oppose tax reform proposals prioritized by Republicans. That sets up at least two points of contention between the governor and the Republican-controlled legislature.

Preview of the 2020 legislative session

capitol domeOn January 13, members of the Kansas Legislature will return to the Statehouse. KMS has spent the last several months preparing for the 2020 session and—as has been true for the last 40 years—we will be at the Capitol every day advocating for you and your patients. This promises to be a busy, complex session and several important health care discussions will be at the forefront.

Key to understanding which issues emerge and advance is the impact of the looming elections this summer and fall. In 2020, the entire legislature must stand for election—40 senators and 125 representatives. Nationally, Kansans will also cast ballots for the U.S. President, Vice President, one U.S. Senator and four U.S. Representatives.

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