2023 Legislative Updates
ANALYSIS: 2024 MEDICARE PHYSICIAN FEE SCHEDULE PROPOSED RULE
The 2023 legislative session adjourned at the end of April. The session was heavily influenced by a number of controversial social issues including transgender rights, abortion and vaccine policy. Much of the legislature’s last week in session was spent in attempt to override vetoes by Governor Kelly as well as completing work on the state’s budget for the fiscal year which began July 1.
Among the gender related bills vetoed by the governor, which the legislature failed to override, was SB 26 which would have revoked a physician’s license for providing gender affirming care, including hormone therapy, to minors. The legislature did override the governor’s vetoes of several other bills affecting transgender individuals including legislation prohibiting student athletes who were assigned male at birth from playing on girls athletic teams as well as legislation that mandates incarcerated people to be divided by their gender assigned at birth, and which allows the state to require the separation of the sexes in settings like domestic violence shelters, rape crisis centers, public restrooms and locker rooms.
Concerning abortion policy, the legislature overrode two vetoes including HB 2313, the “born alive” bill which provides that in the event an abortion or attempted abortion results in a child born alive, the bill requires any healthcare provider present at that time the child is born alive to exercise the same degree of professional skill, care and diligence to preserve the life and health of the child as a reasonably diligent and conscientious healthcare provider would render to any other child born alive at the same gestational age and to ensure that the child is immediately transported to a hospital. Also passed over the governor’s veto was HB 2264 which, except in the case of a medical emergency, prohibits a physician from providing, inducing or attempting to provide or induce a medication abortion that uses mifepristone without informing the woman that it would be possible to reverse the intended affects of a medication abortion that uses mifepristone. The legislature failed to override the veto of HB 2325 which would have prohibited facilities where elective abortions are performed from obtaining liability insurance from the Health Care Stabilization Fund.
Finally, in one of its last actions before adjournment, the legislature passed a heavily amended HB 2285 which combined the provisions of several other bills including some which would significantly restrict the authority of the KDHE Secretary and local health officers regarding infectious and contagious diseases. The bill also would prohibit the Secretary from requiring the COVID-19 vaccine for any child enrolled in school or cared for in a childcare facility. The bill passed both chambers with very slight majorities, and a veto by the governor is expected by many.
Other less controversial bills were passed in the last week with substantial majorities, and they are unlikely to invite a governor’s veto. One is senate substitute for HB 2060, which amends Kansas Medical Student Loan programs and the Medical Residency Bridging program to allow students in the loan program to switch between approved
post-graduate residency training programs without violating their loan agreement. The bill also would add obstetrics and gynecology to the list of approved specialties that are eligible for medical student loans and associated loan forgiveness through service commitments. The bill also authorizes medical service scholarships to Kansas residents who are enrolled in or admitted to the Kansas College of Osteopathic Medicine in Wichita.
Another bill passed and sent to the governor was substitute for SB 131 which creates a licensure waiver for certain healthcare professionals accompanying sporting teams. The bill also includes provisions allowing pharmacy technicians to administer vaccinations.
The legislature also passed SB 174 which, among other things, increased the penalties for violence against healthcare providers as well as legalizing fentanyl test strips.
Regarding the state’s budget, the legislature approved a much needed 3% increase in the Medicaid physician fee schedule. Also included among the many provisions in the final budget bill was a provision preventing the Board of Pharmacy from taking action to prohibit “white bagging” of certain prescription drugs. White bagging is a practice where health insurers require that a patient’s infused or injected medication be shipped from a designated third party specialty pharmacy to the site of care for administration, usually a hospital or outpatient clinic, instead of allowing the provider to buy and bill for the drug and its administration through customary channels. The Board of Pharmacy had recently adopted regulations to more closely regulate white bagging, and this provision in the budget bill stops the Board from taking any action to prohibit that practice. It also prevents the Board from prohibiting “brown bagging” which is when the drugs are shipped directly to the patient who then takes the drug to the provider for administration. This is basically a fight between hospitals and health insurers. Insurers apparently use the practice to restrain their drug costs, and providers are concerned that it exposes them to increased liability because it circumvents the clinical sites’ established drug safety procedures and medication supply chain integrity. Interestingly, this provision was quietly inserted into the final budget bill at the behest of some insurers without a bill being introduced or any public hearings or “normal” legislative process.
Other legislation of note which failed to advance this year included the CRNA independent practice bill, medical marijuana and Medicaid expansion.
Resource: Kansas Medical Society
FEDERAL ADVOCACY
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