The Kentucky House of Representatives on Wednesday approved a measure aimed at combatting the abuse of prescription drugs.
The legislation, one of two issues being considered in the special legislative session, is largely similar to what the chamber passed earlier this year during the regular session, which ended April 12. It has the strong backing of law enforcement, prosecutors, city and county officials and the Kentucky Chamber of Commerce, all of whom testified in support of the bill on Tuesday before it was approved by the House Judiciary Committee. Governor Beshear, Attorney General Jack Conway and the Judiciary Committee’s chairman, Rep. John Tilley, have also been key supporters.
“All of us feel it is imperative to return to our original proposal as much as possible, after efforts to reach a compromise with the Senate in the regular session’s final hours were hindered by the Kentucky Medical Association’s lobbyists,” said House Speaker Greg Stumbo, who sponsored the bill. “The result then was legislation too weak for the scale of the problem we are facing. It would have left us with a system less effective than what we already have.”
“If enacted, House Bill 1 will be another major step forward in the state’s push to limit drug abuse on all fronts,” said Chairman Tilley, D-Hopkinsville, who presented the bill on the House floor. “We just passed two new laws targeting synthetic drugs and meth; we need to add this as well. Lives literally are at stake.”
The hallmark of House Bill 1 is moving KASPER, the state’s prescription drug monitoring system, from the Cabinet for Health and Family Services to the Attorney General’s office.
In addition, all physicians who prescribe controlled substances would be required to register – only about a third does now – and they could pay a maximum $50 annual fee to help cover costs if other revenue sources are insufficient. They would then consult KASPER reports to ensure that patients are taking their medicine safely and appropriately. Doctors would use KASPER to confirm that patients are suitable candidates to receive potentially addictive drugs. The bill also calls for periodic KASPER checks on patients requiring long-term use of Schedule II and III drugs, which include such medicine as OxyContin. This requirement would exclude such situations as hospice and emergency care.
Speaker Stumbo noted that a 2010 survey found that nearly 90 percent of physicians who use KASPER say its reports caused them to change what they had originally planned to prescribe. The Kentucky Board of Medical Licensure, meanwhile, already recommends doctors take this step with every patient.
In an attempt to close down illegitimate pain clinics, Speaker Stumbo’s bill would require those in this field to be owned by a physician licensed in Kentucky, and the physician would have to be on the premises treating patients at least half of the time. The pain clinics would also be required to accept health insurance as a form of payment instead of just accepting cash. Together, these changes would keep the fly-by-night owners from setting up shop quickly in a community and replacing doctors who may get in trouble with the law.
All prescribers of controlled substances, meanwhile, could not dispense more than a 48-hour supply of this medicine from their offices. This provision has been especially effective in such states as Florida, which had seen in-office dispensing skyrocket.
House Bill 1 also includes several provisions designed to increase medical oversight of prescription drugs and greater cooperation among licensing boards and law enforcement.
It calls on physician and nursing licensing boards to set standards on proper prescribing and dispensing practices, and to bar prescribing by anyone convicted of drug felonies, either here or in another state. These boards would also set regulations on how to handle complaints – which would no longer have to be publicly sworn and notarized – and decide how to suspend licenses when public or patient health is in immediate danger. In addition, the boards would include pain and addiction specialists, and the boards would have to establish continuing-education requirements on addiction and pain management.
For law enforcement, House Bill 1 would allow county and commonwealth’s attorneys to have access to KASPER if they are conducting an official investigation. The Attorney General, the licensing boards and the Kentucky State Police also would work more closely to target prescription drug abuse.
Other aspects of the bill call on Medicaid officials to monitor the prescribing practices of doctors treating those enrolled in the healthcare program, and coroners would be called upon to report drug overdoses and deaths to the State Registrar of Vital Statistics and Kentucky State Police. This will be designed to protect individual privacy while giving the public a much clearer picture of the number of those dying. Speaker Stumbo said he suspected it is three to five times higher than the nearly 1,000 deaths now being reported annually.
“This bill will go a long way to putting a stop to a problem that has taken so many of our citizens and left a void in so many families,” Speaker Stumbo said. “We cannot afford to ignore it any longer.”
The bill now heads to the state Senate for its consideration.