Daily Independent (Ashland, KY)

March 4, 2013

Making it better

Legislators improve effective 2012 prescription drub law

The Independent

ASHLAND — As the 2013 session of the Kentucky General Assembly enters its final two weeks, we give legislators a “D-” for their mostly dismal performance to date.

However, not all has been lost. We given legislators an “A” for the compromise they have reached on amending a 2012 law aimed at reducing the prescription drug epidemic that has plagued this state for more than a decade.

The compromise bill — which Gov. Steve Beshear, Speaker of the House Greg Stumbo and Senate President Robert Stivers jointy and enthusiastically endorsed during an appearance before the Senate Judiciary Committee on Thursday — effectively addresses the concerns raised by conscientious medical professionals about the 2012 law without gutting the portions of the law that have proved effective in significantly reducing the illegal flow of highly addictive prescription pain medication in the state.

Before the start of the 2013 session, law enforcement officials and responsible health care professionals had expressed concern legislators would approve changes to the 2012 law that would render it largely ineffective.  

However, instead of doing that, a House-approved bill that is sailing through the Senate and is expected to easily be approved would exempt patients in hospitals, nursing homes and hospice centers from rules intended to make it more difficult for addicts to get painkillers. Those patients already are receiving their pain medications under the watchful eyes of professionals are among the least likely to abuse those drugs. In short, they are not part of the problem that has led to a prescription drug epidemic in Kentucky, and therefore they do not to be included as part of the solution.

Stumbo, D-Prestonsburg, told the House Judiciary Committee the bill he sponsored last year “is working from Pikeville to Paducah.” Deaths from drug overdoses are down, the number of painkiller prescriptions has declined and costs to the state for treating overdose patients and Medicaid bills are also on the decline.

But Stumbo admits the bill had “some unintended consequences,” which produced complaints from hospitals, doctors and patients with chronic pain and legitimate needs about costs and delays. Nearly every lawmaker heard from those complaining and at times it looked as though the law might face significant revisions.

“We’ve tried to come forth with something that didn’t retreat from what we tried to accomplish and didn’t back up from some significant gains but brought some common sense to the problem,” Stumbo said.

Stumbo said his bill — House Bill 217 —  has the support of the Kentucky Medical Association and the Kentucky Board of Medical Licensure.

Among the changes in the bill are exempting hospitals and long-term-care facilities from conducting KASPER (the state’s electronic tracking system for prescription drugs) reports for each prescription during institutional care; requiring mental or physical examinations only as deemed appropriate by the physician; a 14-day exemption for surgery patients; and exempting hospice and other end-of-life medical providers.

Stumbo said the intent of the original bill “was never to tell doctors how to practice medicine.”

One of the most-heard complaints was the requirement for expensive urine tests for which insurance companies declined to reimburse for subsequent prescriptions. Stumbo said the new regulations and bill will now require such tests only when they “are reasonably necessary.”

Dr. Preston Nunnelley, chairman of the Kentucky Medical Board of Licensure, said he’s happy with the changes.

“I think we’ve come a long way from where we started,” Nunnelley said. “Everyone was willing to look at some of the unintended consequences and made the bill a lot better and made us more comfortable with the regulations.”

Like we said, there have been few reasons to praise the 2013 General Assembly. House Bil 217 is one of those few.