Bills to become law on vaping, pharmacy reform, vaccinations, drugs, at-home blood testing, coverage of cancer screening, more
By Melissa Patrick
Kentucky Health News
In its 2024 session the Kentucky General Assembly has passed dozens of health-related bills that address a range of topics. With one day left in the session, here are some of them:
Vaping: House Bill 11 limits legal sale of vaping products to those approved by the U.S. Food and Drug Administration. It also creates a database of retailers that sell the products and sets fines for retailers, manufacturers and wholesalers who violate the law.
HB 142 requires school districts to adopt specific policies that penalize students for possession of “alternative nicotine products, tobacco products or vapor products” and report nicotine-related incidents to the state Department of Education. Changes in the Senate, accepted by the House, allow schools and their governing bodies to apply for grants related to nicotine usage and remove the mandate that schools suspend students with a third possession violation.
Pharmacy reform: Senate Bill 188 changes laws governing commercial pharmacy benefit managers, with requirements aimed at saving the state’s independent pharmacies from closing. It provides for dispensing fees, bans PBMs from forcing patients to get their drugs through mail order, and keeps them from steering patients to pharmacies that they own.
The bill, sponsored by Sen. Max Wise, R-Campbellsville, also prohibits a PBM from reimbursing a pharmacy that it owns at a higher rate than a community pharmacy, or from keeping a community pharmacy from filling a 90-day prescription for a maintenance drug. And PBM will not be able to penalize a community pharmacy from sharing information with a patient on the cheapest option to pay for their medications.
Reducing barriers to screening
Cancer detection: HB 52 will require health-insurance plans to cover all preventive cancer screenings and tests that are consistent with nationally recognized clinical practice guidelines without requiring patients to pay any cost-sharing requirements, including a deductible charge for the services.
The sponsor, Rep. Deanna Frazier Gordon, a Republican from Richmond, told Kentucky Health News in February that the cost for screenings is often a barrier for people who often don’t get screened because they don’t have symptoms.
HB 115 will eliminate co-payments and cost-sharing requirements for high-risk individuals who need follow-up diagnostic imaging to rule out breast cancer. Currently, screening mammograms are covered by insurance, but follow-up exams are often not.
“Thousands of Kentuckians require diagnostic and supplemental breast imaging every year, yet many forgo them due to out-of-pocket costs. Not any more,” Molly Guthrie, vice president of policy and advocacy at the breast-cancer foundation Susan G. Komen, said in a news release. “This life-saving legislation means they will now receive the breast imaging they require, leading to an earlier breast cancer diagnosis and often better health outcomes.”
Vaccines and drugs
Pseudoephedrine: HB 386 will raise the annual purchase limits on pseudoephedrine to help people with chronic allergies legally obtain enough of the medication to meet their needs. The bill changes the current 24-gram annual limit to an 86.4 grams, and remove the limit on the number of packages per transaction, said sponsor Robert Duvall, R-Bowling Green.
Kratom: HB 293 will regulate kratom, a natural herbal supplement that is not currently regulated. It is often used for anxiety, pain, PTSD and opioid withdrawal. The bill defines kratom, prohibits sales to people under 21, puts it behind the counter and provides guidelines for manufacturing and labeling. It also says federal law supersedes state law on the matter.
Blood thinners: HB 31 allows Medicaid patients in Kentucky who are on blood thinners to use at-home machines to test their blood. Patients on some blood thinners, like warfarin, now require a weekly trip to the doctor’s office for blood work that looks at how fast their blood clots.
Amanda Crabtree, a registered nurse at University of Kentucky Chandler Hospital, told WKYT-TV that she hopes that other states will follow Kentucky’s example in this legislation. Crabtree said she expects that Medicaid patients could receive their at-home machines as soon as this summer.
Health-care business issues
Provider liability: HB 159 will protect health-care providers from criminal liability when a medical error harms a patient unless the harm results from gross negligence or wanton, willful, malicious or intentional misconduct.
This effort was led by the Kentucky Nurses Association, which said the bill “will prevent health-care professionals from being charged criminally for making a medical error; that makes it good for nurses and nursing, and puts Kentucky at the forefront of developing laws to protect health-care workers.”
Workplace violence: HB 194 extends to contract workers, such as travel nurses, the law that makes violence against health-care workers a third-degree assault. It also extends this protection, now limited to hospitals, to contract employees at health clinics, doctor offices, dental offices and long-term care facilities.
Sepsis: HB 477 establishes diagnostic criteria for sepsis allow hospitals to preserve current rules used for reimbursement of sepsis care, which allow payment when it is detected early, instead of only allowing reimbursement after organ failure occurs.
“We know that if sepsis is caught early, the likelihood of survival is great,” Jim Musser, vice president for policy with the Kentucky Hospital Association, told Kentucky Health News in March. “But for every hour that we wait, the chance of mortality increases by 7 percent.” In sepsis, “The body responds improperly to an infection,” says the Mayo Clinic. “Sepsis may progress to septic shock . . . When the damage is severe, it can lead to death.”
Other health bills that passed
Youth medical records: HB 174 allows parents have access to their child’s medical records until they turn 18. Right now, children 13 and older must sign a waiver for parents to have access to them. HB 174 also updates the state’s Medical Orders for Scope of Treatment form, which defines a person’s end-of-life wishes.
Veteran suicide prevention: HB 30 calls on the state Department of Veterans Affairs to create a suicide prevention program for service members, veterans and their families.
Stuttering: SB 111 eliminates some insurance coverage limits on speech therapy for stuttering. It was promoted by former UK basketball star Michael Kidd-Gilchrist, who has overcome stuttering.
Medicaid: SB 71 is designed to keep people from coming to Kentucky to establish residence so that they can sign up for drug treatment to be paid for by Medicaid. One challenge resulting from this practice, according to Rep. Shane Baker, R-Somerset, is that when they leave the program, they are often homeless.
SB 280 will allow Level II trauma centers that partner with a university to get the university-hospital rate for services delivered as part of that residency program.