Princess Health and AMA, led by Ky. doctor, says gun violence is public-health crisis; calls for research, background checks, waiting periods for all guns. Princessiccia

Princess Health and AMA, led by Ky. doctor, says gun violence is public-health crisis; calls for research, background checks, waiting periods for all guns. Princessiccia

Congress doctors guns lobbying physicians

Gusty 06:40 Add Comment

The American Medical Association, led by a Kentucky emergency-room physician, declared gun violence a public-health crisis last week and endorsed waiting periods an background checks for purchases of all firearms, not just handguns.

"The AMA, the country's largest doctor group, also vowed to lobby Congress to overturn a decades-old ban on gun violence research by the Centers for Disease Control and Prevention," two days after the Orlando shooting that left 49 dead and 53 wounded, reports Kimberly Leonard of U.S. News and World Report. "The AMA joins the American College of Physicians in its position, which has been calling gun violence an epidemic since 1995."

Dr. Steven Stack

AMA President Steven Stack of Lexington said the research "is vital so physicians and other health providers, law enforcement and society at large may be able to prevent injury, death and other harms to society resulting from firearms. . . . With approximately 30,000 men, women and children dying each year at the barrel of a gun in elementary schools, movie theaters, workplaces, houses of worship and on live television, the United States faces a public-health crisis of gun violence."

Leonard notes, "Federal law doesn't technically outlaw the CDC from studying gun violence, but prohibits the agency from using federal dollars to advocate or promote gun control. Though President Barack Obama lifted the research ban through executive order nearly three years ago, Congress has blocked funding for these studies."

The National Rifle Association has called the public-health approach a back-door path to more gun control, Leonard writes, and "has said that doctors shouldn't be asking patients about gun ownership because they are not gun safety experts."

"Who will Congress listen to now: the healers or the merchants of death?" Lexington Herald-Leader columnist Tom Eblen asked to start his Sunday column. "The AMA's stand is unlikely to change anyone�s mind about gun control. But it underscores the absurdity of Congress� two-decade effort to block legitimate scientific research that could reduce gun deaths and injury."

Suicides accounted for about two-thirds of the 33,390 firearms deaths in the U.S. in 2014. The CDC "said 627 people were killed in Kentucky that year with firearms, a rate of 13.8 per 100,000 population, higher than the national average of 10.2," Eblen reports. He said research on gun violence could reduce those figures, just as research into auto accidents has reduced such fatalities.

Read more here: http://www.kentucky.com/news/local/news-columns-blogs/tom-eblen/article84482382.html#storylink=cpy

Read more here: http://www.kentucky.com/news/local/news-columns-blogs/tom-eblen/article84482382.html#storylink=cpy

Princess Health and Full House has Senate bill to regulate how druggists dispense 'biosimilar' medication that hasn't even been approved by FDA . Princessiccia

Princess Health and Full House has Senate bill to regulate how druggists dispense 'biosimilar' medication that hasn't even been approved by FDA . Princessiccia

food and drug administration generic drugs legislation lobbying lobbyists pharmacists

Gusty 11:39 Add Comment

Update: SB 134 passed the state House 96-0 March 23 with a floor amendment that allows communication by fax, telephone, electronic transmissions or other prevailing means by the pharmacist to the provider to suffice as notice. The bill now awaits concurrence.  

Brand-name drugs called "biologics," because they are made from living tissues, have no competition from "interchangeable biosimilar" products in the U.S. because no interchangeable products have been approved by the U.S. Food and Drug Administration. But that hasn't stopped the drug industry and Kentucky lawmakers from moving a bill to regulate how pharmacists could dispense these drugs if and when they are approved.

"This bill allows Kentucky pharmacists the ability to dispense safe and less expensive biological medications by allowing substitution of interchangeable biosimilars," Sen. Ralph Alvarado, R-Winchester, told the House Health and Welfare committee, which approved it March 17.

Current law does not allow these substitutions without advanced approval from the prescriber, Alvarado said. "This bill removes that hurdle."

The most contentious part of Senate Bill 134 has been its requirement that pharmacists must notify prescribers when they make this substitution, which advocates say is necessary because there are slight variations between the drugs.

Alvarado, also a physician, said the notification comes down to a "safety mandate," noting that if the patient had a "bad outcome" while on one of these medications, it is important for the provider to know exactly what medication the patient is taking.

Democratic Rep. David Watkins, a retired physician from Henderson, voted for the bill and supported the provider notification requirement.

"We're not talking about generics where you have exactly ideal medications, you are talking about biosimilars . . . which would be in some instances different molecules and have some different aspects," Watkins said. " I think that not notifying my office would be a gross disservice to my patients."

But the pharmacists disagree, and want substitution of interchangeable biosimilars to be handled the same way as generic medications, with the prescriber able to place a note on the prescription that says "do not substitute," said Bob Oakley, chairman of the Kentucky Pharmacists Association.

Oakley told the committee that while pharmacists support automatic substitution of an interchangable biosimilar for the name-brand biologic, they do not support notification. "Therefore, we are here to ask that we just keep it simple and keep it seamless," he said.

Rep. Addia Wuchner, R-Florence, said the bill had accommodations to make notification manageable for pharmacists, and asked Oakley what their real problem was. He replied, "It just adds more work to . . . their busy day."

But the pharmacists' lobby has cited other reasons. KPhA Executive Director Bob McFalls told James McNair of the Kentucky Center for Investigative Reporting, "Prescriber notification requirements have shown to increase costs for the health-care system overall" since they cause more brand-name drugs to be dispensed.

SB 134 passed the Senate 36-1 March 2, with Republican Sen. Jimmy Higdon, the majority whip from Lebanon, the only one voting against it. Higdon had submitted several floor amendments to modify the notification requirements, but withdrew them before the final vote.

Higdon told McNair that he didn't understand the urgency to pass this bill, noting that its passage would have no immediate effect.

�It�s the kind of bill that should be discussed,� Higdon said. �This whole thing is very complicated and futuristic, and a lot of people are talking to us about passing this. I just want to err on the side of caution. It doesn�t need to be fast-tracked. We need to do it right.�

Higdon was referring to the many lobbyists hired by pharmaceutical manufacturers that have descended on Kentucky in support of this bill.

"At least nine drug companies and groups have stated an interest in the Senate bill, according to the Kentucky Legislative Ethics Commission, McNair reports. "The number of registered lobbyists hired by pharmaceuticals employers has nearly doubled, from 46 in 2011 to 83 today. Their annual spending has more than doubled, to $824,196 in 2015."

The bill now resides in the House. Speaker Pro Tem Jody Richards, D-Bowling Green, has filed a floor amendment to remove the notification requirements.

About biologics and biosimilars

While conventional medications are made from pure chemical substances and can be easily replicated, biologics are made from living tissues and each batch varies slightly from the last, according to the FDA. That's why these products can't be called generics, which are chemcially identical.

The most common biologics are Humira and Remicade for arthritis and Enbrel for psoriasis. They are very expensive and can cost thousands of dollars each month.

"Express Scripts, the pharmacy benefits manager, estimates that while biologics accounted for only 1 percent of all prescriptions in 2014, they accounted for 32 percent of all prescription-drug spending," McNair reports.

Biosimilars are medications that are "highly similar" to already FDA-approved biological products. To date, only one of these, Zarxio, used for certain cancer patients, has been approved by the FDA, but it was not designated as interchangeable. According to the Regulatory Affairs Professional Society, six biosimilars have applied for FDA approval.

Interchangeable biosimilars are expected to produce the same clinical results in any given patient as it's "highly similar" biologic. To date, no interchangeable biosimilar medications have been approved by the FDA. When appoved, Alvarado suggested that they will cost up to 40 percent less than the biologics.

Kentucky is home to the North American distribution hubs for Amgen, Genentech and Johnson and Johnson and is the primary distribution point for many of the biologics (and soon to be biosimilars) in the U.S., according to an e-mail from RunSwitch PR.

Princess Health and Princess Health andAltria, parent of Philip Morris, reports spending most on lobbying the 2014 legislature but says it didn't fight smoking ban.Princessiccia

Princess Health and Princess Health andAltria, parent of Philip Morris, reports spending most on lobbying the 2014 legislature but says it didn't fight smoking ban.Princessiccia

cigarettes e-cigarettes General Assembly legislation legislature lobbying smoking smoking ban smoking bans tobacco tobacco prevention

Gusty 13:53 Add Comment

The parent firm of the nation's largest cigarette company again reported spending more than anyone else on lobbying the Kentucky General Assembly, but says it did not fight the bill that would have imposed a statewide smoking ban in most public places.

"Altria Group, the parent company of Philip Morris USA and U.S. Smokeless Tobacco, reported spending $156,200, "far more than any other company or group, Tom Loftus reports for The Courier-Journal. "And it got the things it wanted from Kentucky lawmakers: tobacco taxes were not increased, no new tax was put on electronic cigarettes and the tobacco-industry supported bill to ban the sale of electronic cigarettes to minors passed."

Spokesman David Sutton "said not a penny of Altria's lobbying campaign went to defeat the so-called 'smoke-free' bill, though he said the company opposes such complete smoking bans within private businesses," Loftus reports. "He said he suspected Altria's lobby spending topped the list because 'We fully disclose everything'," including research time of its legal staff and its "grassroots activation" work to rally its supporters in Kentucky.

The Campaign for Tobacco Free Kids, "which reported spending $6,284 during the session, earlier this month blamed Altria for leading the successful defeat of the bill to ban smoking in indoor public places like bars and restaurants," The Courier-Journal reports.

"They've spent a lot of money on lobbying for years," the campaign's Betsy Janes told Loftus. "They've sent their message out for so long and have relationships with legislators. It's hard for us to compete with that." (Read more)

The campaign's Amy Barkley told Kentucky Health News that Altria's assertion "is very hard to believe. That said, I don�t have any hard evidence to dispute their claim. We all know the tobacco industry�s influence is very deep in Frankfort, so perhaps they didn�t need to overtly lobby against the smoke-free bill."

The Kentucky Farm Bureau Federation, which gets funding from Altria for some of its programs, lobbied against the smoking ban. It ranked eighth in lobbying expenses, with $68,821. For The Courier-Journal's lst fo top lobbying interests, click here.

Princess Health and Princess Health andActivist seeking stronger rules on reporting health-care infections says industry lobbyists misled legislative committee to kill bill.Princessiccia

Princess Health and Princess Health andActivist seeking stronger rules on reporting health-care infections says industry lobbyists misled legislative committee to kill bill.Princessiccia

health-care associated infections hospital acquired infections hospitals lobbying nursing homes

Gusty 17:51 Add Comment

"Health-care industry witnesses appeared to have presented incorrect information" to the House Health and Welfare Committee in speaking March 6 against House Bill 460, which would require all health-care facilities to report infections associated with their treatment, Dr. Kevin Kavanagh of Somerset writes in an op-ed piece in the Lexington Herald-Leader. The bill remains in committee, but its goal could be accomplished by regulation.

Dr. Kevin Kavanagh

Kavanagh is chairman of Health Watch USA, a group that tries to focus attention on the problem of health-care associated infections, also called hospital-acquired infections. He said the industry witnesses "were asked if any of the various types of facilities in Kentucky were exempt from reporting. The answer was no, that all facilities had to report through the Centers for Disease Control's national reporting system. However, critical-access hospitals and ambulatory-surgery centers are not required to report infection to the CDC. Nursing homes also do not have to report through the CDC's system."

Kavanagh writes that nursing homes report urinary-tract infections to the federal Centers for Medicare and Medicaid Services, but "there is no data on the deadly staph infection, MRSA," or a deadly gastrointestinal infection caused by the bacteria C. Difficile, "which can run rampant in some nursing homes."

Kavanagh said the industry witnesses also misled the committee when asked "asked if a patient who was going to have hip surgery could find information on infection rates on Hospital Compare," a Medicare website. He writes, "The answers appeared to indicate that such information was available," but is "woefully inadequate" because the state doesn't have an adequate reporting system.

"For acute-care hospitals, only, bloodstream MRSA infections (a relatively rare event), colon surgeries, abdominal hysterectomies, urinary tract infections and central-line infection data can be found. Little use for patients needing hip surgery. In the past, CMS has posted on the Hospital Compare website information regarding hospital-acquired conditions, and was slated in the future to have information on neck and spine surgery. However, this information is now gone from Hospital Compare. I can only assume it, too, has fallen to the legions of health-industry lobbyists." (Read more)

For Kavanagh's March 6 testimony to the committee, click here. For his March 13 rebuttal to industry witnesses, go here.

Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy

Read more here: http://www.kentucky.com/2014/03/13/3136695/mandate-reporting-of-ky-health.html#storylink=cpy

Princess Health and Bill to shield nursing homes from lawsuits clears Senate along party lines; not looking healthy in House despite TV, radio ads.Princessiccia

Princess Health and Bill to shield nursing homes from lawsuits clears Senate along party lines; not looking healthy in House despite TV, radio ads.Princessiccia

advertising health journalism health policy legislation legislature lobbying long-term care newspapers nursing homes politics state government; General Assembly tort reform

Gusty 13:52 Add Comment

Last week the state Senate approved on party lines a bill that would make lawsuits against nursing homes go through a review panel first. Republicans supported the bill and Democrats voted against it in a 23-12 vote that marked the clearest partisan split in the Senate in this year's legislative session.

Senate Bill 9 would create medical review panels of three physicians and an attorney moderator to hear complaints against long-term care facilities and vote on whether the suit had enough merit to go to court.  The bill's sponsor, Senate Health and Welfare Chairwoman Julie Denton, R-Louisville, declind to answer an opposign senator's questions about the bill. She said in introducing it that the panel would be advisory but its opinion would be admissible in court and would curb such lawsuits, reports Jack Brammer of the Lexington Herald-Leader.

Bills like this have failed in years past and could have diverse implications for Kentucky communities and nursing homes. At least one Kentucky newspaper looked around and found that lawsuits are one reason Extendicare Health Services Inc. shed management responsibilities last year for all 21 of its facilities in Kentucky, reports Nick Tabor of the Kentucky New Era in Hopkinsville.

Without Extendicare management in Western Kentucky, the volume of nursing-home lawsuits in the region appears to be shrinking, Tabor reports. In recent years, nearly all the Christian County cases that have been closed were dismissed through settlements, not by judges declaring them unfounded. This suggests the bill would minimally affect the county, writes Tabor. Other Kentucky communities may be affected differently; judges differ from circuit to circuit.

Although the bill passed the Senate, it appears to be on its deathbed in the House. Rep. Tom Burch, D-Louisville, who chairs the House Health and Welfare Committee, joked about its prospects to Tabor: �I can�t make any predictions about the bill this time, but I�ve called in three priests to have the last rites ready.� If nursing homes received this new layer of protection, he said, hospitals and day-care centers would want it too.

A similar bill died in Burch's committee last year; this version is being supported by television and radio commercials urging viewers and listeners to call their legislators in support. When Extendicare announced last spring it was transferring management of all its Kentucky facilities to a Texas company, it cited Kentucky�s �worsening litigation environment� and said tort reform seemed unlikely here.

Bernie Vonderheide, director of Kentuckians for Nursing Home Reform, said most so-called �frivolous� lawsuits would cease if the state imposed minimum staffing requirements on nursing homes, his group's main legislative goal. (Read more)

Princess Health and McConnell helped Amgen delay price limits on dialysis drug.Princessiccia

Princess Health and McConnell helped Amgen delay price limits on dialysis drug.Princessiccia

Congress lobbying lobbyists pharmaceuticals politics

Gusty 10:40 Add Comment

Senate Republican Leader Mitch McConnell of Kentucky, whose public statements usually emphasize the need to cut federal spending on entitlement programs, as they did in Lexington Friday, apparently passed up an opportunity to rein in Medicare spending when he signed off on a big favor for a significant campaign contributor in the fiscal-cliff deal.

The deal delayed for two years price controls on a class of drugs including Sensipar, used by kidney-dialysis patients and manufactured by Amgen, "the world's largest biotechnology firm," Eric Lipton and Kevin Sack of The New York Times reported Jan. 19.

"The news was so welcome that the company�s chief executive quickly relayed it to investment analysts," the Times reported. "But it is projected to cost Medicare up to $500 million over that period. Dennis J. Cotter, who studies the cost and efficacy of dialysis drugs, told the newspaper, �Everybody is carving out their own turf and getting it protected, and we pass the bill on to the taxpayer.�

McConnell spokesman Robert Steurer said the senator did not push for the provision. The Times story did not focus on McConnell, saying "Supporters of the delay, primarily leaders of the Senate Finance Committee who have long benefited from Amgen�s political largess, said it was necessary to allow regulators to prepare properly for the pricing change." And it noted the firm "also has worked hard to build close ties with the Obama administration." It did note that former McConnell chief of staff Hunter Bates is among "a small army of 74 lobbyists for Amgen, which was "the only company to argue aggressively for the delay, according to several Congressional aides of both parties."

According to the Center for Responsive Politics, which analyzes lobbying and campaign contributions, Amgen's political action committee gave McConnell $7,000 during the 2011-12 election cycle, an amount exceeded by only seven other senators, none of them in the Senate leadership. McConnell was the main negotiator on the fiscal-cliff deal with Vice President Biden.

UPDATE, Jan. 25: Writing on BillMoyers.com and then on Salon, Bill Moyers and Michael Winship report that since 2007, "Amgen employees and its political action committee have contributed $73,000 to Senator McConnell�s campaigns," almost $68,000 to Sen. Max Baucus, D-Mont., chairman of the Finance Committee, and $59,000 to Sen. Orrin Hatch, R-Utah. They also note that Republican Rep. Richard Hanna R-N.Y., and Democratic Reps. Peter Welch of Vermont and Jim Cooper of Tennessee have introduced a bill "to repeal the half billion-dollar giveaway to Amgen. The story includes Moyers' video interview with Welch.

Princess Health and Nursing home chain says it will lease its Kentucky facilities because legislature didn't pass bill to filter lawsuits.Princessiccia

Princess Health and Nursing home chain says it will lease its Kentucky facilities because legislature didn't pass bill to filter lawsuits.Princessiccia

courts General Assembly legislature litigation lobbying long-term care nursing homes state government tort reform

Gusty 15:23 Add Comment

A major nursing-home chain says it will lease all of its Kentucky properties to a Texas company because a bill to insulate nursing homes from lawsuits did not pass the General Assembly this year,

Extendicare Health Services owns Pembroke Nursing and Rehabilitation Center, Shady Lawn Nursing Home in Cadiz and 19 other facilities in Kentucky, reports Nick Tabor of the Kentucky New Era in Hopkinsville. The company has been riddled with problems. A 2009 study ranked three of its Kentucky facilities among the country's worst nursing homes.

"The combination of a worsening litigation environment and the lack of any likelihood of tort reform in the state of Kentucky has made this the prudent decision for our company and its unitholders," said Tim Lukenda, president and CEO of Extendicare.

In this year's legislative session, nursing homes lobbied for a law that would have created medical review panels to evaluate potential lawsuits against nursing homes, personal-care homes and some facilities for the intellectually and developmentally disabled. The goal of the panel was to help eliminate frivolous lawsuits against the long-term care industry.

The Pembroke facility has been sued 20 times in Christian Circuit Court since 2002, and seven of the suits are still pending, Tabor reports. The others were dismissed, most with confidential settlements. (Read more)

Princess Health and Pill-mill bill does not pass as legislative session ends in failure; special session starts Monday.Princessiccia

Princess Health and Pill-mill bill does not pass as legislative session ends in failure; special session starts Monday.Princessiccia

attorney general doctor shopping doctors General Assembly legislation legislature lobbying pain clinics pill mills state government

Gusty 12:18 Add Comment

Though it's considered by experts as the most important bill needed this year, the Senate failed to pass a measure that would crack down on so-called pill mills before the end of the legislative session last night. Gov. Steve Beshear, above, called a special session that will begin Monday to give legislators more time to consider the bill, as well as approve funding for a $4.5 billion road-building plan � which was the main cause for the legislative gridlock.

Beshear wasn't happy, and blamed Senate President David Williams: "His rank partisanship, his obstructionist attitude, have caused numerous special sessions and cost the taxpayers millions of dollars of unnecessary expenses." The special session will cost more than $60,000 per day. "He's Senate president. I can't do a thing about that," Beshear said. "But what I can do is make sure that the people of this state know very loudly and clearly what damage he is causing to Kentucky."

Beshear even criticized Williams in his agenda for the special session, which included "legislation to enhance and expand tools and resources critical to Kentucky's continuing efforts to address the scourge of prescription drug abuse that plagues our citizens."

Negotiators on the prescription-drug measure, House Bill 4, came up with a compromise that pleased the Kentucky Medical Association, which opposes moving the state prescription-drug monitoring system to the attorney general's office from the Cabinet for Health and Family Services and the doctor-controlled Kentucky Board of Medical Licensure. The compromise would still make that move, and still limit ownership of pain clinics to physicians, but dropped a requirement that all physicians pay $50 to use the system.

Beshear railed against the impasse. "Sen. Williams willfully ignored the visible misery of our communities and allowed this essential bill to die," he said in a press release. "Why? Because of his road projects." Some lawmakers said another factor was House Democrats' refusal to override any of Beshear's budget vetoes, in spite of what Williams said was House Speaker Greg Stumbo's pledge to override. Stumbo denied making such a pledge.

On the road issue, "Williams wanted Beshear to sign the transportation projects list into law before the Senate voted on the bill authorizing the road construction money. Without the funding bill, those projects couldn't get started," reports Ryan Alessi of "Pure Politics" on cn|2, a cable-company news service. "Williams didn't want to give Beshear the ability to veto the project list and be able to unilaterally decide how to spend the $4 billion in federal and state road and bridge construction money."

According to Beshear, $288 million was allotted in the funding plan for Williams' district, $130 million of which would have been funded in the near future. But Williams "made some last-minute fine-print changes that moved an additional $155 million of those projects in his district ahead of those in other communities around the state." (Read more)

Princess Health and Doctors' lobby still working for changes in 'pill mill' legislation.Princessiccia

Princess Health and Doctors' lobby still working for changes in 'pill mill' legislation.Princessiccia

doctor shopping doctors drugs General Assembly legislation legislature lobbying physicians prescription drug abuse prescription drugs privacy

Gusty 09:15 Add Comment

By Al Cross
Kentucky Health News

The Kentucky Medical Association, historically one of the most powerful lobbying interests at the General Assembly, has mounted a last-ditch attempt to change or perhaps kill the bill that would crack down on "pill mills" that contribute to prescription drug abuse.

The bill would require pain clinics to be owned by doctors, require doctors to participate in the state's prescription-tracking system, and move the system to the attorney general's office from the Kentucky Board of Medical Licensure, which is made up almost entirely of doctors and has done little to curb the growing problem.

The tracking system remains the central concern for the KMA, which issued a "call to action" for physicians to contact legislators and argue that it "could infringe on privacy and lead to excessive oversight of legitimate medical practices," reports Mike Wynn of The Courier-Journal. "Other critics have said the bill could make doctors reluctant to provide pain medication for legitimate patients."

KMA President Shawn Jones told Wynn, �We would like to see something come out of this session. We would just like to make sure that it is something that addresses both the needs of law enforcement and at the same time is not overreaching in its imposition on our ability to practice medicine in a professional way.�

The KMA�s call notes that the system "tracks medications such as Xanax, Valium and Klonopin and was placed under the cabinet�s responsibility partly for patient privacy and protection," Wynn notes. Jones told him, �The access to that data really should be limited to government agencies that are charged with public health, and not law enforcement.�

Moving the tracking system to the attorney general's office is "pretty much a cornerstone of this legislation," Senate Majority Floor Leader Robert Stivers, R-Manchester, left, told Ryan Alessi Friday night on cn|2's "Pure Politics" program. He said the medical licensure board "hasn't done a whole lot" about prescription drug abuse, and indicated that part of the bill would stand.

However, Stivers said he and other supporters of the bill might drop the bill's 30-day limit on the length of painkiller prescriptions because of concerns that it would raise costs to patients. Those concerns helped delay the bill on the 59th day of the legislature's 60-day session. House Speaker Greg Stumbo "has said the issue could be resolved with a simple fix in the bill�s language," Wynn notes.

Stivers and Stumbo were among a group of bipartisan political leaders, led by Gov. Steve Beshear, who issued a statement Friday calling on the General Assembly to pass the bill Thursday, when it is scheduled to reconvene. The legislature is in recess, pending possible vetoes of other legislation by Beshear.

KMA "also takes issue with a $50 fee that the attorney general would be able to charge doctors to fund the program," Wynn reports. "Jones said the amount will only continue to climb in coming years to address a societal problem that doctors did not create. Proponents contend that the fee is nominal and is capped by statute except for inflation adjustments." (Read more)

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Legislature passes bill on personal-care homes but stalls on one to regulate pill mills as doctors lobby hard.Princessiccia

Princess Health and Legislature passes bill on personal-care homes but stalls on one to regulate pill mills as doctors lobby hard.Princessiccia

attorney general doctor shopping doctors drug abuse drugs General Assembly legislation legislature lobbying physicians prescription drug abuse

Gusty 13:02 Add Comment

By Al Cross
Kentucky Health News

The effort to quash "pill mills" that feed one of Kentucky's worst problems, prescription drug abuse, stalled on the next-to-last day of the General Assembly's session and faces cloudy prospects on April 12, when the legislature returns to conclude its business. But the legislature gave final passage to a bill aimed at limiting the admission of mental patients to personal-care homes.

The snag in the pill-mill bill stems from the Kentucky Medical Association's opposition to moving the state's electronic prescription-tracking system to the attorney general's office from the Kentucky Board of Medical Licensure, which is controlled by doctors and has been found to go easy on them, compared to other states. The bill includes several other measures, including a requirement that pain clinics must be owned by doctors.

After Sen. Carroll Gibson, R-Leitchfield, failed in a parliamentary maneuver to make the bill more difficult to pass, and Senate President Pro Tem Katie Stine, R-Southgate, ruled that his motion had lost on a voice vote, Majority Floor Leader Robert Stivers, R-Manchester, "said it might be better to consider the bill April 12, but Sen. Ray Jones, D-Pikeville, said delaying a vote on it would give its opponents more time to try to kill it," report John Cheves and Jack Brammer of the Lexington Herald-Leader. "Stivers called for party caucuses to meet to discuss the issue. After the caucus meetings, the Senate adjourned and Stivers said lawmakers would work on the bill for possible consideration April 12."

The session's final day is scheduled to give the legislature a chance to override any vetoes by Gov. Steve Beshear, so a bill passed then could be killed by a veto. That might seem unlikely, since Beshear has been among those pushing for stronger action against pill mills. However, if he were unhappy with a bill the legislature sent him, he could veto it and call a special legislative session to pass one more to his liking. That possibility, and his power to set the agenda of a special session, could make him a player in the negotiations between now and April 12.

The bill�s sponsor, House Speaker Greg Stumbo, D-Prestonsburg, downplayed the problem. He blamed it on "confusion over a provision that limits the amount of drugs that may be supplied to a patient at any one time," Mike Wynn of The Courier-Journal reports. "Some lawmakers feared that limits on prescriptions would cause more patient co-pays, but a simple fix to the bill�s language could allay those concerns, Stumbo said."

Also on Friday, the legislature sent Beshear a bill that would "require potential residents at personal-care homes to be screened for brain injuries by medical professionals," the Herald-Leader reports. "Personal care homes provide long-term care for people who do not need full-time nursing care but need some assistance."

Senate Bill 115 "stems from the death last year of Larry Lee, a brain-injured resident who disappeared from a personal care home and was found dead four weeks later on the banks of the Licking River, not far from the Falmouth Nursing Home in Pendleton County," the Herald-Leader notes. "There are about 2,500 to 3,000 people in 82 free-standing personal care homes across Kentucky," and many are mentally disabled or mentally ill. Kentucky Protection and Advocacy, a watchdog state agency, released a report last week saying that said placement of the mentally ill in personal-care homes violates federal disability laws. (Read more)

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Princess Health and Makers of Sudafed, similar cold medicines again lead in legislative lobbying expenses, and that doesn't count their radio ad campaign.Princessiccia

Princess Health and Makers of Sudafed, similar cold medicines again lead in legislative lobbying expenses, and that doesn't count their radio ad campaign.Princessiccia

advertising drugs General Assembly legislation legislature lobbying meth methamphetamine state government

Gusty 12:50 Add Comment

The Consumer Healthcare Products Association, which is fighting legislation that would limit the amount of pseudoephedrine that could be bought without a prescription, remained the leading spender among lobbying interests at the General Assembly in February, the state Legislative Ethics Commission said in its monthly newsletter.

CHPA, which represents manufacturers and distributors of over-the-counter medicines, spent $192,985 on lobbying in February, and a total of $388,000 for the first two months of the session. Those amounts do not include an extensive radio advertising campaign, which from all indications has cost more than the spending that had to be reported.

Other health-care interests were among the top spenders in February. Ranking second through 11th were the Kentucky Hospital Association ($38,422, for a two-month total of $74,543); the Kentucky Chamber of Commerce ($30,056, two-month total $63,404); Altria (Philip Morris) Client Services ($28,129, two-month $50,434); the Kentucky Farm Bureau Federation ($24,805, total $38,655); AT&T ($24,199, total $47,432); the Kentucky Medical Association ($21,958, total $42,731); the Kentucky Education Association ($21,629, total $45,249); the Kentucky Retail Federation ($21,191, total $45,452), which also opposes the meds-for-meth bill; Kentuckians for the Commonwealth ($18,317, total $34,188) and the Kentucky Optometric Association ($18,227, total unavailable).

Princess Health and House panel OKs "meds for meth" bill; chair predicts passage.Princessiccia

Princess Health and House panel OKs "meds for meth" bill; chair predicts passage.Princessiccia

drugs General Assembly legislation legislature lobbying meth methamphetamine

Gusty 17:29 Add Comment

The bill to limit purchases of the cold medicine used to make methamphetamine cleared another legislative hurdle Monday, and the chairman of the committee that approved it predicted that it will become law despite a heavy lobbying effort by over-the-counter drug makers.

By a 10-4 vote, the House Judiciary Committee approved a version of Senate Bill 3 that differs slightly from the version passed by the Senate. Rep. John Tilley, a Hopkinsville Democrat and the committee�s chairman, predicted the revised SB 3 will pass on the House floor. "Tilley said Senate leaders have signed off on the changes the House committee made," Jack Brammer reports for the Lexington Herald-Leader. The House version clarifies "language regarding prescriptions" and would ban "criminals convicted of meth-related offenses from purchasing pseudoephedrine for a five-year period," Mike Wynn of The Courier-Journal reports.

The core of the bill would allow consumers without meth records to buy 7.2 grams of medicines with pseudoephedrine each month, approximately a two-week dose, and up to 24 grams per year, without a prescription. Another 7.5 grams a month or 90 grams a year could be available with a prescription. "Experts have testified that those amounts are adequate for most cold and allergy sufferers, and more than 90 percent of all purchasers use dosages that fall below the proposed thresholds," Wynn reports. "State law already limits purchases to 9 grams per month, with a yearly cap of 108 grams, and purchasers are required to present a photo ID and sign a log at the point of sale."

The bill would not apply to gelcaps, which are more difficult to use for meth, or liquids, which are used for children. (Read more)