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August 2012 Gregory A. Hood, MD, FACP, ACP Governor

From the Governor

Dr. Hood

2012 HB1

Make sure you understand this bill!

Background: This is a law, signed in April after a special session convened specifically for this law and enacted July 20th with supplemental, emergency regulations. Publicity for this bill centered upon its efforts as a “pill mill bill”. However, there are much broader consequences of this bill for physicians and patients.

KY ACP did partner with a group of medical/government regulation compliance attorneys in an attempt to bring a concise working guide to members as a benefit. Unfortunately, Friday, August 17th, we received word as follows:

After working on a concise guide to assist physicians in the implementation of the new guidelines, we have concluded that the emergency regulations are so ambiguous as to make it imprudent to issue guidance at this time. Based on the summary of testimony to the Oversight and Implementation committee, it is our hope that the regulations will be amended to clarify several areas (including drug testing, preventative medicine, and reporting of illegal activity to law enforcement). During the interim period, we are suggesting that physicians consult the recommendation and guidance provided by the KBML on their website, as that organization is the final arbiter of compliance. The link to the guidance can be found here . “

For specific legal advice on patient issues or bits of the bill/regulations, please consult an attorney familiar with such issues. There are also publications by the KMA, the KBML, and Cabinet for Health and Family Services. Reading, as broadly as possible, on this new law and regulations is highly recommended, especially 201_009_260e. KY ACP is actively monitoring and providing feedback to the government on these matters.

KY ACP has also solicited ACP nationally. National ACP is considering weighing in on this issue as well. On behalf of KY ACP Dr. Hood as Governor gave interviews and testimony to the implementation oversight committee in Frankfort on August 15th.

HB1 Testimony
Dr. Hood giving testimony to the implementation oversight committee

Oversight of HB1’s implementation is overseen by Sen. Robert Stivers [co-chair], Rep. John Tilley [Co-Chair], Sen. Jimmy Higdon, Sen. Ray S. Jones, Rep. Linda Belcher and Rep. Sara Beth Gregory. It is your prerogative to provide feedback on this process to them, Governor Beshear, and members of the senate and house who voted for this bill. The law does establish more stringent regulation of pain management centers. However, it goes further by specifying specific actions physicians must take when prescribing, dispensing or administering controlled substances. Regulations accompanying the law were announced, and were also made effective on Friday, July 20th.

KY ACP has provided this information in emails to members as well within the last month. As we have just received a copy of the following letter from Governor Beshear please be sure that you read this letter carefully and understand this, and the bill/regulations as fully as possible.


Subject: Reply from Governor Beshear's Office
From: Arnold Caria (Governor's Office)
Date: August 18, 2012 7:20 AM


Thank you for contacting me about the impact of House Bill 1 (HB1), Kentucky's new law designed to fight the devastating impact of prescription drug abuse on our state. Nearly 1,000 Kentuckians die every year from drug overdoses - more than are killed in car accidents. Our state cannot afford to continue on this destructive path.

Please be assured that HB1 does not prevent people who are in pain from getting the treatment they need, nor will it interfere with the legistimate practice of medicine. Likewise, the law does not require doctors to refer patients to a pain clinic for legitimate treatment.

The new law does require doctors, nurses, and others who are authorized to prescribe or dispense controlled substances to reggister with KASPER, Kentucky's electronic presciption monitoring system, and to use that system to make certain that patients are not getting prescription pain pills from several different prescibers at once.

KASPER records show that roughly 219 million doses of the narcotic hydrocodone were dispensed in Kentucky in 2011. That's nearly 51 doses for every man, woman, and child in the state. It's clear that while many Kentuckians have legitimate medical conditions that require treatment with presciption drugs, there are too many others who are not using those drugs for appropriate purposes.

The Kentucky Board of Medical Licensure (KBML) is taksed with investigating immediately all complaints about presciption writing. Because you have contacted my office about your difficulty getting a presciption for the pain medicine you previously had been receiving, I have taken the liberty of referring your concern to KBML Executive Director Michael Rodman for immediate action.

To learn more about HB1, including the procedure for filing a complaint against a physician, visit http://kbml.ky.gov or contact Mr. Michael Rodman, Kentucky Board of Medical Licensure, Suite 1B, 310 Whittington Parkway, Louisville, KY, 4022, (502) 429-7150.

Thank you again for sharing your concerns and I hope you will feel to contact me in the future on other matters of importance to you.


Steven L. Beshear


KY ACP will continue to be engaged with state leadership on this very important issue, and keep you posted with updates as appropriate.

In related news, ACP has published a white paper, “Statement of Principles on the Role of Governments in Regulating the Patient-Physician Relationship”. It can be accessed in its entirety here.

Additional coverage mentioning KY ACP on HB1 can be found at these links:


September Annual Meeting

In KY ACP’s efforts to provide you with timely and valuable CME we have an afternoon educational program that you will not want to miss! Dr. Curtis Cary will present an educational update on HIV/AIDS which meets the requirements for state licensure. Also, addressing the new HB1 regulations, Dr. Jonathan Piercy will be providing educational content on controlled substance prescribing.

We will also be welcoming the Ohio chapter ACP Governor, Dr. Greg Rouan, to our meeting. He will be continuing our multi-year initiative on efficient, cost conscious care in a review of the evaluation and management of pulmonary emboli.

New this year we welcome the Kentucky Psychiatric Association to our meeting. Immediate past president, Dr. Mark Wright will be speaking on the costs of depression.

It is especially important to note that KY ACP is providing the CME at no charge this year. There will be an excellent reception and supper in conjunction with our chapter’s annual business meeting at the fabulous Pendennis club, hosted by your ACP Governor, and the governor’s council, especially our facility host, Dr. Cap Hoskins.

The value of the CME, the educational value of the content, and the quality and experience of the evening’s meal and festivities is much more than the nominal charge for the night’s events. We encourage you highly to participate fully in the day and evening events. Please reserve your space now by completing the meeting form and remunerating your balance for the supper/annual business meeting.


Leadership Day 2012

Washington D.C.

Facebook link

Kentucky Delegation
Kentucky delegation: Dr. Mark Wallingford, Dr. Greg Hood, Dr. Curtis Cary, Dr. Lori Wagner

The Kentucky chapter was well represented at the College’s annual Leadership Day held June 6th and 7th, 2012. Our delegation met with staff members from all of the Commonwealth’s Senate and House offices, as well as representatives Geoff Davis and Brett Guthrie in person. Healthcare remains a prominent issue on the Hill. The Affordable Healthcare Act (ACA) remains a polarizing political issue and the upcoming discussions on sequestration cuts are sure to provide for additional concerns to the nation’s healthcare infrastructure. Supporting established ACP policies, the Kentucky delegation provided personalized, informed, and, at times, impassioned testimony to support and promote further legislation that would strengthen primary care and protect the state’s Medicare population.

Key “asks” presented by the delegation to congressional representatives included:

  • Permanently eliminating the flawed sustainable growth rate (SGR) reimbursement formula utilized by CMS by means of ACP supported bipartisan legislation that was introduced this session.
  • Ensuring full funding for essential health programs (National Health Services Corps, Section 747, National Health Care Workforce Commission, AHRQ, NIH, HRSA, and CDC).
  • Enacting meaningful medical liability reforms.
  • Authorizing and funding a national pilot of no-fault medical liability health courts.
  • Fully funding graduate medical education and re-aligning the program with the nation’s workforce needs.

Specific pieces of legislation supported by the ACP: Medicare Physician Payment Innovation Act (H.R. 5707)

H.R. 5707 would eliminate the SGR once and for all and transition to better payment and delivery systems that are aligned with value. Specifically the bill would repeal the SGR formula; provide more than 5 years of stable physician payments with positive increases for all physician services and higher payments for primary care, preventive and care coordination services; and establishes a process for practices to transition to new, more effective, models of care by 2018.

Please visit the ACP’s Leadership Day website for further information on these items and to find a full description of the college’s current policy stance. If you are interested in attending in future years please consider applying for the ACP Joseph E. Johnson Leadership Day Grants. Funding grants are available for the following membership categories: Young Physician, Associate, and Medical Student.


Annals of Internal Medicine Launches New Web site

Annals of Internal Medicine, the flagship journal of the American College of Physicians (ACP), is launching its Web site – www.annals.org – on a new digital platform to provide internal medicine specialists and subspecialists with a faster, more personalized Web experience across Annals, ACP Journal Club, In the Clinic, and PubMed, and a new multimedia library. An improved search function delivers faster, targeted search results that incorporate individual preferences, and sophisticated article tagging enables automatic display of related articles.


The Supreme Court and the Affordable Care Act: Milestone or Detour on the Road to Universal Coverage?

The Supreme Court's decision to uphold the Patient Protection and Affordable Care Act (Affordable Care Act, or ACA) may correctly be viewed as a milestone on the path to universal coverage, especially considering the 32 million uninsured persons who would have lost the opportunity to obtain coverage if the court had overturned the entire law. Yet, the Court's surprising decision to allow states to opt out of expanding Medicaid could result in coverage looking a bit like Swiss cheese, with big gaps for the most vulnerable, rather than the seamless expansion of coverage originally expected. Visit Annals of Internal Medcine Web site to read the full article.


Applications being accepted for 2013 ACP Health Policy Internship Program

ACP is accepting applications for the College's Health Policy Internship for Associate and Medical Student Members. This Internship represents a unique opportunity for one Associate and one Medical Student Member to develop legislative knowledge and advocacy skills by working directly with the College’s Washington, D.C., staff and participating in ACP’s annual Leadership Day. The internship will last for 4 weeks starting April 29, 2013.

The deadline for applications is October 22, 2012. For more information.