By the first of February, all of the pomp and circumstance associated with the start of the legislature has passed; by this time, legislative issues and strategies have begun to take shape. The House Health and Human Services committee held its first hearing of the session on HB 2082, allowing pharmacists to administer drugs. This same issue was heard last year in the Senate Public Health and Welfare Committee; despite requests from KMS to bring physicians and pharmacists together to discuss the proposal and how it should be limited, no such meeting among clinicians occurred. Pharmacists testified that many patients struggle with self-administered injections and would improve adherence with their prescribed treatment plan if pharmacists could administer the drugs. They also referenced long-acting injectables for psychiatric patients as something pharmacists ought to be able to administer. Though their anecdotes were specific, the bill is written broadly, with no limitation on what drugs can be administered and includes language that requires physicians to “opt-out” if they do not want their patient to have their prescription administered by a pharmacist. KMS opposes HB 2082.
Next week, the House Health Committee will hold hearings on HB 2066, allowing for APRN independent practice and HB 2146, allowing for the corporate practice of medicine. Both bills create alternate standards for the practice of medicine than those to which a physician is currently held. HB 2066 eliminates the collaborative practice agreement required for APRNs to prescribe and perform other delegated medical acts. The bill also eliminates the legal distinction between a medical diagnosis and nursing diagnosis. If enacted, HB 2066 would allow APRNs to practice indistinguishably from physicians while remaining licensed and regulated by the Board of Nursing. KMS opposes HB 2066.
HB 2146, allowing for the corporate practice of medicine was introduced by Blue Cross and Blue Shield of Kansas City and is supported by Cerner Corporation and the Kansas Chamber. The bill would allow a corporation to directly employ a physician to provide care to both their employees and the public. Under current law, private corporations are not licensed health care providers, they are not regulated by the Board of Healing Arts nor the Kansas Department of Health and Environment and they do not carry medical malpractice coverage. Additionally, the independence of physician judgment is conflicted in an employment relationship. KMS opposes HB 2146 but has convened a task force on the corporate practice of medicine. The task force has established principles and will continue to consider the complexities of consistently regulating the corporate practice of medicine to ensure that patients are protected.