GLMS News is a monthly
publication of the Greater
Louisville Medical Society
101 W. Chestnut Street
Louisville, KY 40202
(502) 589-2001
Fax (502) 581-9022
www.glms.org
GLMS News reserves the
right to make the final
decision on content and
advertisements.
GLMS NEWS STAFF
Bert T. Guinn, MBA, CAE
Executive Vice President/CEO
[email protected]
Kate Williams
Communications Designer
[email protected]
Aaron Burch
Communications Specialist
[email protected]
McKenna Byerley
2016 HEALTH CARE LEGISLATION BILLS PASSED
SENATE BILL 17: MAINTENANCE
OF CERTIFICATION/LICENSURE
Senate Bill 17 (Sen. Alvarado) prohibits the state
from requiring initial board certification or recertification in order for physicians to obtain or
retain their medical license. Board certification
in a specialty is, and always has been, voluntary
in Kentucky. KMA proactively fought to keep it
that way.
SENATE BILL 18: FAIR CONTRACTING
Senate Bill 18 (Sen. Alvarado) changes current law
and requires insurers to follow a new and fairer set
of procedures before changing an existing agreement with a provider. Specifically, SB 18 requires:
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MEMBERSHIP
STATUS
As of March 2016, active
GLMS membership
numbered 1,969, which is
79 percent of physicians
practicing in Jefferson
County.
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ninety (90) days’ notice for a material change;
notices for material changes dealing with
membership networks or new/modified insurance products to be sent by certified mail;
notices for all other material changes to be
sent in an orange-colored envelope;
notices that describe the material changes;
an opportunity for providers to use “real-time
communication” to discuss the proposed
changes with the insurer;
a clean, consolidated informational copy
of the agreement after three (3) material
changes in a twelve (12) month period; and
an opportunity for providers to object to pro posed material changes by utilizing specifically defined procedures.
SENATE BILL 19: STATE LICENSURE BOARD APPOINTMENTS
Senate Bill 19 (Sen. Alvarado) stipulates that appointees for the Kentucky Board of Medical Licensure (KBML) shall come from names submitted by
the Kentucky Medical Association. This legislation
ensures a non-political, professional vetting process for individuals seeking appointment to the
state’s medical licensure board. A number of other
state professional organizations already enjoy
this privilege, and KMA seeks the same right to
safeguard the selection process used to appoint
members to KBML.
SENATE BILL 20: INDEPENDENT
APPEALS PROCESS FOR MEDICAID MCO CLAIMS
Senate Bill 20 (Sen. Alvarado) is a measure that addresses concerns of patients, physicians and hospitals about the difficulty associated with appealing coverage denials and nonpayment of claims
by Medicaid Managed Care Organizations. Senate
Bill 20 allows providers who have exhausted the
internal appeals process of a Medicaid managed
care organization to request an impartial administrative hearing through the Cabinet for Health
and Family Services.
SENATE BILL 134: BIOSIMILARS
Senate Bill 134 (Sen. Alvarado) updates the Kentucky Pharmacy Practice Act to allow Kentucky
pharmacists the ability to dispense less expensive biologic medications to patients by allowing
substitution of an interchangeable biosimilar.
Because biologic products differ from generics in
complexity and are not identical chemical products, SB 134 also ensures there will be transparent communication between pharmacists and
prescribers to ensure medical records reflect
which specific product has been dispensed to
the patient. Physicians in Kentucky will retain
the authority to use “Do Not Substitute” or DNS.
SENATE BILL 154: PHYSICIAN
ASSISTANT CO-SIGNATURE REQUIREMENTS
Senate Bill 154 (Sen. Buford) changes a requirement that supervising physicians review and sign
off on 10 percent of overall medical notes written
by PAs under their supervision. With this change,
physicians, practices and institutions would outline and determine the parameters for medical
notes for which they will countersign. They would
have to include that information in the application for supervising physician assistants with the
Kentucky Board of Medical Licensure.
OTHER BILLS OF INTEREST
House Bill 95 (Rep. Burch) requires the Department for Medicaid Services (DMS) to establish a
pilot project responsible for creating Medicaid
coverage and reimbursement criteria for telemonitoring services. Telemonitoring services consist
of scheduled remote monitoring of data of a patient’s health while the patient is at home or other
location designated by DMS. Clinical information
gathered by the telemonitoring services will be
shared with the treating health care provider.
House Bill 115 (Rep. Burch) includes eligible underinsured people into the colon cancer screening
program.
House Bill 489 (Rep. DeWeese) adds the physician
pronouncing death to the list of those providers
who may complete a death certificate.
Senate Bill 33 (Sen. Wise) requires that students
receive CPR training one time while enrolled in
grades 7
GLMS MISSION - Promote the science, art and profession of medicine; Protect the integrity of the patient-physician
relationship; Advocate for the health and well-being of the community; Unite physicians regardless
of practice
2
GLMS
NEWSsetting
APRILto
2016
achieve these ends.