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Kentucky Regulatory, Legislative and Reimbursement Report – October-November-December 2015

Kentucky Regulatory Update

  • TB Testing For Health Care Workers Regulation Filed
    • The TB testing for health care workers regulation (902 KAR 20:205) was filed with the Legislative Research Committee (LRC) on December 15 and will be published in the upcoming Administrative Register. It is anticipated both the regulations regarding TB testing for health care workers and TB testing for residents in long term care settings will be heard before the Administrative Regulation Review Subcommittee (ARRS) in January 2016 followed by hearings in both the House and Senate Health & Welfare committees in February 2016. click here for more information
  • Provide VIS Before Administering Vaccines
    • The Kentucky Department for Public Health has notified Kentucky Pharmacists Association that some patients have received influenza immunizations at a Kentucky pharmacy where a Vaccine Information Statement (VIS) was not provided by the pharmacist prior to vaccine administration.   KDPH appreciates the assistance of pharmacists in administering influenza vaccinations to Kentuckians during each influenza season as well as other vaccinations throughout the year, but asked KPhA to alert pharmacists about this gap in the expected steps in providing immunization services.
    • VISs are required by Federal law whenever certain vaccines are administered, http://www.immunize.org/catg.d/p2027.pdf and http://www.cdc.gov/vaccines/hcp/vis/about/facts-vis.html.

Kentucky 2016 Legislative Update

  • Medical Malpractice Reform Legislation Filed
    • The Senate Republican Caucus announced its 2016 legislative priorities and once again legislation creating medical review panels was included as a top Senate priority. Senator Ralph Alvarado (R-Winchester) who is also a physician, filed SB 6 that would establish medical review panels to review medical malpractice claims prior to civil litigation. Newly elected Governor Matt Bevin has also said medical malpractice reform is a priority for his administration.
  • Legislation Filed Would Legalize Recreational Marijuana
    • Senator Perry Clark has filed SB 13 which allows for sale, cultivation and private use of marijuana by those over the age of 21. Governor Matt Bevin announced his support for legislation legalizing medical marijuana only in Kentucky.
  • Proper Disposal of Sharps
    • Representative Mike Denham (D-Maysville) filed HB 160 requiring the Department for Public Health to develop guidelines for the safe disposal of hypodermic needles at certain locations, including pharmacies. The legislation does not require pharmacies to have proper containers for hypodermic needles, but instead the Department for Public Health would encourage pharmacies to have them.

Kentucky Pharmacists Association 2016 Legislative Priorities

  • PBM and MAC Transparency
    • The proposal from Kentucky Pharmacists Association is to strengthen existing notification and appeal requirements for MAC pricing in the original MAC transparency bill. Click here for more information
  • Biosimilars Legislation to Be Considered in the Upcoming Session
    • The pharmaceutical industry is expected to propose legislation that would restrict the automatic substitution of interchangeable biosimilar products.
  • Restriction of Medication Dispensing under Specific Circumstances
    • A clarification in statute that Pharmacy Benefit Managers and insurance companies can only restrict medication dispensing under specific circumstances is being sought. click here for more information
  • Specialty Drugs
    • PBMs and insurance companies are moving more and more drugs into the specialty drug class, requiring that they be dispensed by ‘specialty pharmacies’. Oftentimes the requirements for the designation of “specialty pharmacy” cannot be met by most independent pharmacies. click here for more information

Kentucky Board of Pharmacy 2016 Legislative Priorities

  • The Kentucky Board of Pharmacy have proposed the following statutory changes: click here for more information
    • Board of directors member term limits
    • Pharmacy technician criminal background checks
    • Licensing for third part logistics providers
    • Legislation for in-state and out-of-state outsourcing facilities

Long-Term Care Facility 2016 Legislative Priorities

  • The following pre-filed bills are of important interest to the long-term care community: click here for more information about these bills and others affecting long-term care.
    • HB94 Mental Health Treatment
    • HB95 Telehealth Services
    • HB109 Offenses Against Vulnerable Victims
    • HB163 Nurse Licensure Compact
    • HB197 Medicaid Eligibility
    • SB6 Medical Review Panels
    • SB31 Medical Malpractice Actions
    • Mandate Electronic Visit Verification System for Medicaid Personal Care Services
    • Appeal Determination by a Managed Care Organization

KentuckyOne Health Partners

  • Bundling Changes That Could Affect Select Nursing Facility Admissions
    • KentuckyOne Health Partners implemented a program they call a “Clinically Integrated Network” (CIN) that is “committed to coordinating evidence-based, cost-effective services”.  KentuckyOne sent out Requests for Information (RFIs) to nursing facilities in early June 2015 and implemented the CIN program effective July 1, 2015.  Second, CMS approved a waiver for Catholic Health Initiatives to waive the 3-day hospital stay requirement (click here for more information) for SNF payment for two (2) different criteria referenced in the CMS waiver document above.

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