2023 Legislative Summary
2023 Legislative Session Advocacy SummaryThe 2023 Regular Session of the Kentucky General Assembly came to an end on March 30, 2023. Although this year was a "short" 30-day session, it was packed with pharmacy advocacy efforts. Much of our energy was directed at defending the profession on a number of bills that could have negatively affected the Kentucky pharmacy community. Because of your support, we were able to prevent the passage of legislation that would have removed Board of Pharmacy-authorized protocols and another bill that would have overhauled the Board of Pharmacy. We fought to remove stiff penalties for pharmacists who could have unknowingly violated the law by dispensing medications to patients receiving gender transition therapies.
The KPhA Government Affairs Committee (GAC), led by Chair Craig Martin, met on a weekly basis to review bills of interest and advise the KPhA Board on the Association's position. Each year the GAC recommends our legislative priorities and is tasked to successfully advance our advocacy agenda. This year, those priorities included passing comprehensive PBM reform legislation, maintaining pharmacist ability to provide vaccinations for patients down to age 3, and payment parity in Medicaid. If you followed our advocacy efforts throughout the session, thank you! Special thanks to everyone who answered our calls to action - personal communication with your legislators is the most effective advocacy mechanism we have when fighting for the profession.
The summaries below are provided by the Kentucky Retail Federation as part of our ongoing advocacy engagement with KRF:
Governor Vetoes Board Advisory Council Bill, but lawmakers override it
Beshear argued that the legislation was unconstitutional because it would allow private organizations to appoint members to a public board and that was the role of the Governor. The Senate and House quickly overrode the legislation and sent it to the Secretary of State and it will take effect 90 days after the close of the legislative session. The bill in its original form would have prohibited the Kentucky Board of Pharmacy from requiring the licensure of out-of-state pharmacists. A regulation promulgated by the board would have required the licensing of out-of-state pharmacists. The bill was amended to remove those provisions and instead expand the Board of Pharmacy advisory council that will include independent pharmacists, a veterinary pharmacist, a hospital pharmacist, a long-term care pharmacist, a specialty pharmacist, and others. The advisory council will advise the board on scope of practice issues, and an expansion of their role. The board of pharmacy still makes the final decisions on any scope of practice issues within their authority.Governor signs pharmacy legislation
Gov. Beshear signed several bills that will impact pharmacies and pharmacists. Below is a description of some of the measures impacting pharmacies.
Test Equipment for Illicit Drugs: As a result of the passage of HB 353, testing equipment used by lay persons to determine the presence of fentanyl or other high-potent synthetic opioid derivatives, will no longer be considered drug paraphernalia. This is the next step in harm reduction, as deaths from fentanyl-laced products are on the rise.
Medical Marijuana: Senate Bill 47 is legislation that would, for the first time in Kentucky, legalize medical marijuana for use by patients with certain medical conditions. The legislation, as originally filed, would have required patients to have an initial visit with a pharmacist and an annual visit for a continued recommendation of medical marijuana. The bill passed the Senate with changes removing the role of a pharmacist, but members of the House raised concerns about the removal of a pharmacist. It did pass the House and was signed by the Governor. The Cabinet for Health & Family Services will be responsible for regulating medical marijuana, and the agency has until Jan. 1, 2025, to develop regulations. The bill is the culmination of a five-year grassroots effort by medical marijuana supporters.
A patient will receive a recommendation from a physician or an APRN, and they will receive a medical marijuana card that will allow a caregiver to receive the product on their behalf. The product will be provided by a dispensary.
Pharmacist groups raised concerns that the legislation uses the word dispense and there is no definition of dispense in the legislation. Additionally, a pharmacist would be prohibited from reviewing KASPER to know if the patient is using medical marijuana that could interact with other medical prescriptions dispensed by a pharmacy. The House would not consider any amendments due to the late passing of the bill by the Senate and the Senate’s refusal to accept any other version of the legislation. The bill was quickly signed by the governor.
Biomarker Testing Coverage: House Bill 180, sponsored by House Health Services Committee Chair Kim Moser (R-Independence), requires health insurers to provide testing for biomarkers for certain cancers and other healthcare conditions where such testing could provide key information in treating certain illnesses. It would also cover pharmacogenetics. The health insurers opposed provisions of the legislation and requested changes, but proponents of the legislation argued against those changes. The bill was passed and has been signed by the governor.
APRN prescriptive authority: The APRNs were finally successful in getting changes to the collaborative agreement between physicians and APRNs, after an agreement was reached to remove the CAPA-CS after four years. For APRNs not prescribing controlled substances prior to the establishment of this act, but wanting to prescribe, they must enter an agreement with a physician that is regularly reviewed. The APRN must work for a healthcare entity or a physician directly. Senate Bill 94 also creates a Controlled Substance Collaborative Practice Agreement Council that will review requirements, and the composition of the board will include two APRNs and two physicians.
Medicaid Area Deprivation Index Scores and Medicaid Reimbursement: A resolution passed by the legislature would require the Department for Medicaid Services to study and establish Medicaid reimbursement rates based on a Medicaid Area Deprivation Index to determine if higher reimbursements would improve access to healthcare in areas that lack the necessary Medicaid providers. The department would have to study the results of other states that have taken steps to account for social risks and health-related social needs in Medicaid reimbursements. They would also be required to assess the Area Deprivation Index to determine whether or not it is a valid measure of social-related health risks. The department is required to submit a report to the legislature by Nov. 1, 2023 (SJR 54).
Expedited Partner Therapy: The General Assembly approved legislation on the final day that expands expedited partner therapy for the treatment of sexually transmitted diseases to include more diseases. Expedited partner therapy allows a healthcare provider treating a patient for sexually transmitted diseases to also treat partners of the patient without an in-person office visit. The bill would also allow for the retail sale of HIV self-administered testing kits. House Bill 349 was sponsored by pharmacist Rep Bentley (R-Russell) and has been signed by the governor.
Delta-8 THC Products: A bill that regulates Delta-8 and other intoxicating hemp products is now law. HB 544, sponsored by Rep. Rebecca Raymer (R-Morgantown), requires the Cabinet for Health and Family Services to develop regulations on Delta-8 by August 2023. The bill requires the regulations to prohibit anyone under the age of 21 from purchasing Delta-8 and requires those products to be kept behind the counter. Labeling of Delta-8 products and other intoxicating hemp products would also be required. The issue of contaminated hemp products has been a concern of the legislature in the past, when they required labeling of CBD products.