Three weeks into the 2017 legislative session, bills are moving at a rapid pace and committees are considering a host of issues affecting Kansas physicians.
House Bill 2046 enacts licensure of anesthesiologist assistants (AAs) under the Board of Healing Arts. AAs are trained in the physician assistant model and work under the direct supervision of an anesthesiologist. HB 2046 was heard in House Health and Human Services committee on January 30 and is supported by KMS, the Kansas Society of Anesthesiologists and the American Academy of Anesthesiologist Assistants. Certified Registered Nurse Anesthestists (CRNAs) have expressed opposition to the bill due to concerns that AAs will compete for urban jobs and could affect CRNA workforce placement. However, in the more than 14 other states that currently license and employ AAs, they work seamlessly alongside physicians and CRNAsâ€“in much the same way physician assistants, nurses and physicians partner to provide care in other fields of medicine.
Senate Bill 69 and House Bill 2169 are identical bills, introduced on behalf of several health care provider groups (including KMS) whose members participate in KanCare, the state's Medicaid managed care program. As highlighted by the federal government's recent denial of the KanCare extension waiver, there have been difficulties in moving the Medicaid population into KanCare's managed care model. (The Center for Medicare & Medicaid Services' letter of denialâ€“linked aboveâ€“highlights a number of incidents of federal non-compliance as well as process and communication breakdowns within the KanCare program.)
KMS has worked closely with the administration to communicate issues that impede physician participation in KanCare and continues to partner with the state to encourage access to high quality care for vulnerable Kansans. These two bills require Medicaid managed care organizations contracting with the state to have uniform standards and processes for credentialing, appeals processes, prior authorizations and more. KMS will testify in support of SB 69 when it is heard before the Senate Public Health and Welfare Committee on January 31.
House Bill 2030 was introduced by representatives of chain pharmacies and would allow pharmacists to administer vaccinations to children ages six and older. Proponents argued that access to vaccinations inhibit higher vaccination rates for school-age children and that pharmacists are adequately trained to administer required immunizations. KMS testified in opposition based on the principle that care is best when it is less fragmented, pediatric vaccination rates in Kansas are high and should be administered by a physician equipped to handle adverse reactions and utilizing the visit to assess the patient's overall health. An amendment was offered to limit the bill to children ages 12 and older, ensuring that all pediatric immunizations continue to be administered by a physician, but allowing pharmacists to administer recommended vaccinations such as meningitis and HPV to adolescents. The bill passed as amended from the committee and awaits action by the full House.
House Bill 2027 was introduced at KMS' request and allows physicians providing medical retainer agreement services (also called concierge medicine and direct primary care) to bill patients directly for anatomic pathology services as long as the provider of such services and the cost is disclosed to the patient. The bill was among the first to pass out of committee and be heard on the House floor.
House Bill 2045 re-instates institutional licenses for individuals employed by state institutions providing mental health services pursuant to a written protocol with a licensed physician. The bill passed out of the House Health and Human Services committee and next it goes to the full House of Representatives.
House Bill 2064, expanding Medicaid coverage in Kansas has been scheduled for hearings in the House Health and Human Services Committee the week of February 6. KMS will testify in support of efforts to insure more Kansans in a fiscally responsible manner which does not shift costs among providers.
Bills continue to be introduced and assigned to the health committees on a daily basis. As new proposals emerge, the KMS Legislative Committee evaluates the issues and formulates KMS policy positions consistent with KMS principles. Our online bill tracker lists those issues on which KMS takes a formal position and testifies before the legislature.