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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.


The committee will be inviting comments from the Insurance Department about costs associated with a 1332 waiver for the reinsurance provision included in the bill. The committee will also ask for information from the Kansas Attorney General about increased costs associated with investigating fraud and abuse given an expanded Medicaid population.

Additionally, consideration of the expansion bill has been complicated by the House of Representatives vote this week to not advance the proposed constitutional amendment on abortion. That vote, which fell four votes short of passage in the House, prompted discussion in the Senate health committee whether state funds might be used on abortion. Proponents of the constitutional amendment argued that, if the abortion amendment is not passed, the state’s portion of expansion funding could be used on abortions.

For now, it appears that further consideration by the committee of the expansion bill is likely to be delayed until issues related to the constitutional amendment on abortion are resolved. While the path ahead for expansion is unclear, KMS will continue to work with legislators and advocate for the bill.

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Next week in the House Health and Human Services Committee, the committee chair has scheduled an informational “roundtable discussion” (as opposed to a hearing) on a proposal by APRNs to allow advanced practice nurses to practice independently with an unlimited scope of practice. Participating on behalf of KMS will be KMS President LaDona Schmidt, MD, and Chair of the KMS Legislative Committee, Kevin Hoppock, MD.
 
Nurses have advocated similar proposals for several years, typically arguing that such bills are simply a codification of current nursing practice and a ready way to increase patient access to care in rural and underserved areas of the state. Proponents of the legislation also contend that APRNs are interchangeable with primary care physicians, have comparable or better patient outcomes, and will help drive down health care costs.
 
Because of the very significant differences in the education and clinical training of physicians and APRNs, KMS opposes legislation that would essentially remove any distinctions between advanced practice nursing and the practice of medicine. KMS supports the concept of physician-led care teams as the best model to safely and efficiently meet the health care needs of our state, including primary care in rural and other underserved areas.

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As always, we will keep you updated on these issues and others that could affect the practice of medicine in our state. If you have questions about this update or other legislative matters, please contact KMS Executive Director Rachelle Colombo: This email address is being protected from spambots. You need JavaScript enabled to view it..


Previous legislative updates available at: www.kmsonline.org/legislature