The House has passed legislation that would make it easier to identify and prosecute unscrupulous doctors who overprescribe painkillers that are being widely abused in Kentucky.
The measure passed 70-28 Wednesday morning.
House Bill 1, which would put strict requirements on pain management clinics, transfer authority of the state’s prescription monitoring system (KASPER) to the attorney general’s office and make KASPER participation mandatory for those who prescribe schedule II and III narcotics, was voted out of the House Judiciary Committee Tuesday 12-0 with three representatives voting “pass.”
House Speaker Greg Stumbo, HB 1’s primary sponsor, said an average of three Kentuckians die of prescription drug overdose each day, a number that could be three to five times greater if accurate data were available.
The bill would require coroners to test for drugs in certain cases and report overdose deaths to the state Registrar of Vital Statistics and state police, and the Office of Drug Control Policy would compile an annual report of drug-related deaths.
It would also, among other items, allow the attorney general to impose a yearly fee of no more than $50 on prescribers, require pain management clinics be owned by a physician with an active state medical license, authorize prosecutors to request KASPER reports in drug investigations, allow prescribers to review their own KASPER reports and make pain management facilities accept private health insurance to shut down cash-only operations.
Franklin County Sheriff Pat Melton, who spoke in favor of the bill for the Kentucky Sheriff’s Association, said he sees how pills affect people locally every day.
“We’re losing at least three people today across our commonwealth, and locally we’ve seen several drug overdoses here,” Melton said after the committee hearing. “… Everything that everybody else is seeing, we’re seeing it here as well.
“I think we’ve been on the forefront of it, with us and city police, in fighting the pill business here.”
Melton says his office has started seeing local people doctor shop here and in other counties, including those with “pill mills.” HB 1 would make shopping for prescription painkillers and anti-anxiety medications much more difficult as doctors would be required to run a KASPER check before prescribing schedule II and III narcotics.
Stumbo, who has criticized the Kentucky Board of Medical Licensure for not referring cases to law enforcement, said doctors should be involved in policing their profession and tracking questionable prescribing habits, but he again took KBML to task for lax oversight on KASPER reports.
“In the four years that I was attorney general, I never got one, not one referral to prosecute a physician for overprescribing,” said Stumbo, who was attorney general from 2004 to 2007.
“Attorney General (Jack) Conway has said that in his now four plus years, he’s not gotten one referral from the Kentucky medical licensure board asking for prosecution of an overprescriber.
“… I would submit to you that somebody was asleep at the wheel, and it wasn’t the law enforcement community. It was the people who were in charge of policing their own profession.”
Stumbo said putting KASPER under the attorney general’s oversight would allow more proactive investigations into suspicious prescribing practices.
Dr. Preston Nunnelly, president of KBML, said the licensure board has made “a ton of progress” since Stumbo raised concerns about six months ago.
The board has entered a memorandum of understanding with the attorney general’s office to share data and discussed how to better use prescription trend reports provided by the Cabinet for Health and Family Services, he said.
Over the past six months, the board’s investigations involving prescription drugs have risen from 15 percent of its caseload to 50 percent, he said.
“The exchange of complaints from the different organizations has improved considerably, and we’re moving forward,” Nunnelly said. “We didn’t do as well as we could’ve from a proactive standpoint. We’re now taking that on, and we think that’s going to make a huge impact long-term.”
The Kentucky Medical Association spoke against parts of the bill, specifically the possible yearly fee and “broad and overarching authority” granted the attorney general over privileged information, KMA lobbyist Bill Doll said.
“We didn’t decide we wanted to pick a fight with the House speaker just for giggles,” Doll said. “We think there are some legitimate, very basic concerns in this bill.”
KMA had supported a free conference committee version of the bill, which addressed “a great number” of its concerns, Doll said. The amended bill did not come to a vote on the 60-day session’s final day.
The House introduced a bill that’s “98 percent” true to the original House Bill 4, according to Stumbo, because some key provisions weren’t included in the compromise version, said committee chairman Rep. John Tilley, a Hopkinsville Democrat.
“I want to maintain the good-faith ability to negotiate this bill,” he said, calling it the single-most important bill this session to some. “I think that’s most important, but I think we do have a couple of points we need to address.”