State prescription drug databases like KASPER cut back doctor shopping and drug abuse, new study shows

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Research from the University of North Carolina indicates drug databases like the Kentucky All Schedule Prescription Electronic Reporting system do reduce doctor shopping and change prescribing behavior.

Another article showed state drug databases "facilitate a relative decrease over time in prescription drug misuse, despite state differences in program administration," reports Maggie Clark for Stateline, the freshly revised news service of The Pew Center on the States.

A 2010 evaluation of KASPER showed 90 percent of doctors who used the system found it effective in preventing drug abuse and doctor shopping. A new Kentucky law "mandates that all physicians and pharmacists who prescribe schedule II and III drugs, such as oxycodone and hydrocodone, check the patient's prescription records before writing or filling a prescription," Clark reports. Dispensers must also register prescriptions in the state database without 24 hours of writing or filling the prescription.

Clark points out the legislation change sparked a debate about "how to balance patient privacy and law enforcements needs in fighting a serious criminal and public health problem." Attorney General Jack Conway, who wanted KASPER put into his office's hands, lost that fight as part of the legislative compromise. It will remain the responsibility of the Cabinet for Health and Family Services and, by extension, the doctor-run Kentucky Board of Medical Licensure.

Privacy issues have likewise surfaced in Vermont. "The discussion really is about what kind of access the police will have to electronic personal health information," said Allen Gilbert, executive director of the Vermont Civil Liberties Union. (Read more)

Fighting prescription drug abuse back on legislative agenda

As expected, finding a way to fight prescription drug abuse was back on the legislative agenda as lawmakers gathered for Day 1 of their special session. House Speaker Greg Stumbo introduced a bill today that will make it "mandatory for doctors to use the state's electronic reporting system for prescriptions, which would be moved from the Cabinet for Health and Family Services to the attorney general's office," report Jack Brammer and Beth Musgrave for the Lexington Herald-Leader.

Filed as House Bill 1, Stumbo said it "will correct damages caused by lobbyists for the Kentucky Medical Association in the final days of the regular session, when KMA inserted last-minute language that prevented mandatory use of this basic tool."

The bill also makes it possible for doctors who teach pain and addiction medicine at the University of Kentucky and University of Louisville to be appointed by the governor to the boards that license doctors and nurses. "The KMA's lobbyists can no longer argue that such experts do not exist or, if they do, that they should not be on the licensing boards," Stumbo said. "It is unfortunate that KMA lobbyists sought to obscure this provision."

The bill, slightly altered from House Bill 4 that did not pass before the end of the legislative session Thursday, is considered by experts to be the cornerstone of this legislative session. (Read more)

Troubling statistics discussed at prescription-drug summit

Staggering statistics were revealed this week at the Orlando-based National Rx Drug Abuse Summit, including one survey that found 2 million people age 12 and older started using prescription pain medicine for non-medical reasons in 2010. A troubling 11 percent of active-duty military personnel reported misusing pain medicine in the past month, Department of Defense research shows. And more than 15,000 people die each year because of pain killers, 1,000 of whom are Kentuckians, reports Laura Ungar of The Courier-Journal.

"Prescription-drug abuse is causing untold misery among our families," Gov. Steve Beshear said at the gathering, which was organized by Eastern Kentucky-based Operation UNITE. The problem is "wasting away the future of many people in the Commonwealth of Kentucky."

As he's done several times now, Beshear asked conference attendees to push legislators to pass House Bill 4, which should be voted on today in Frankfort. 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 genera's office from the Cabinet for Health and Family Services.

Experts said prevention is key, which involves education youth, parents, as well as doctors and pharmacists. U.S. Surgeon General Dr. Regina Benjamin doctors "need to be more cognizant of the problem," Ungar reports, recounting an incident in which a patient stole one of her prescription pads by using her 4-year-old daughter to district Benjamin.

Gil Kerlikowske, known as the country's "drug czar," said general practitioners and family medicine doctors accounted for 27 percent of all prescribers of extended-release, long-acting opioids. Internal medicine physicians were the most common specialists to prescribe, accounting for almost 17 percent of prescriptions of pain pills.

One of the problems, Kerlikowske said, is prescription drug abuse is considered more acceptable than taking other kinds of drugs. Children "see their parents taking it. It's not heroin. It's not coke." (Read more)

Rx Drug Abuse Summit in Florida, organized by Ky. group, set to start as lobbying on 'pill-mill bill' continues to ramp up

By Tara Kaprowy
Kentucky Health News

As a bipartisan group of political leaders pushes the General Assembly to pass a bill Thursday that would crack down on "pill mills" that contribute to prescription drug abuse, Eastern Kentucky's Operation UNITE has organized a national summit in Florida.

The National Rx Drug Abuse Summit aims to "foster understanding and cooperation among those involved in the battle against the epidemic," reports Laura Ungar for The Courier-Journal.

The event starts tomorrow in Orlando and is expected to draw 700 people. "I think it's important because Kentucky's not an island ... This truly needs to be a national effort, standing up against the problem," Karen Kelly, president and CEO of Operation UNITE, which serves Eastern Kentucky's Fifth Congressional District, told Ungar.

Tuesday's agenda will include an address by Gov. Steve Beshear and Dr. Regina M. Benjamin, the U.S. surgeon general. About 1,000 Kentuckians died last year from prescription drug abuse, more than the number of people who died in car accidents.

But while Beshear, Attorney General Jack Conway and key legislators in both parties push to pass a bill that would crack down on the problem, the Kentucky Medical Association is pushing back.

An editorial Sunday in the Lexington Herald-Leader says the KMA "should support the effort to pass this bill and fight this killer." It said, "Drug abuse is not a problem society dumps at the door of physicians. It's one deeply entwined with how we deliver medical care and police the providers."

Today, 15 business lobbying groups issued a press release calling on the legislature to pass the bill, noting that it would "limit direct dispensing of narcotics at a physician’s office to no more than a 48-hour supply. This will help control the supply of narcotics and allow for better monitoring of prescription drug abuse." Dave Adkisson, president and CEO of the Kentucky Chamber of Commerce, said in the release, “Businesses large and small, rural and urban are all experiencing cost increases due to prescription drug abuse. Drug abuse is not only a social problem, it is a bottom-line business issue for Kentucky employers.”

Besides the Chamber, other groups joining in the release were the Kentucky Association of Manufacturers, Associated General Contractors, the Home Builders Association of Kentucky, Kentuckians for Better Transportation, the Kentucky Coal Association, Coal Operators and Associates, the Kentucky chapter of the National Federation of Independent Businesses and local chambers in Louisville, Lexington, Northern Kentucky, Southeast Kentucky, Christian County and Hardin County.

Meanwhile, the legal battle against prescription-pill abuse continues. Last week, a Christian County jury found three men guilty of mailing large amounts of oxycodone from Florida to Kentucky. Peter Nibert, 27, of Pasco County, Fla., is believed to have mailed more than 3,000 pills in 2010. Cary Alder, 24, and Scotty Highsmith, 26, both of Hopkinsville were sentenced 10 and 15 years respectively for their part in the scheme.

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.

This is Child Abuse Awareness Month; tips for prevention

April is child abuse awareness month, and the state Cabinet for Health and Family Services is reminding Kentuckians that it's the law to report suspected child abuse or neglect.

"Protecting our children should be everyone's number one priority, and during the month of April, we are raising awareness about the warning signs of child abuse and how to report it," Gov. Steve Beshear said. "The cabinet works year round to educate our families and investigate every aspect of abuse. Together, we can make Kentucky a safer place for all our children."

To report child abuse, Kentuckians should call 800-KYSAFE1. Calls are anonymous. If the report meets the criteria for abuse, an investigation is conducted within 24 hours in most cases or, if the child is suspected to be in immediate danger, they are conducted within the hour.

Callers should try to know the child's name, approximate age, address, parents' names and location of the child when the call is made. They should also have names and phone numbers of other people who have information about the suspected abuse.

The ultimate goal is to reunite families when circumstances improve. "We want children to return home to a stronger, safer family," said Jim Grace, assistant director of the Department for Community Based Services' Division of Protection and Permanency.

The cabinet's handling of child abuse investigations and its reluctance to release records pertaining to child abuse deaths and near deaths has been a hot-button issue in the past year. The Courier-Journal and Lexington Herald-Leader both sued the cabinet for refusing to turn over records and a judge twice ruled the cabinet was wrong not to do so. Since, it has released hundreds of pages of records, but has chosen to redact, or omit, some of the information therein. In January, Beshear acknowledged the cabinet had been accused of "operating under a veil of secrecy in a supposed attempt to protect inept workers and a poorly designed system."  Legislators have since heard hours of arguments about the issue, and a bill that would create an external panel to review child abuse cases involving fatalities and near-fatalities, while imposing more secrecy, is one of the few measures that could pass the General Assembly when it re-convenes for one day next Thursday to end its legislative session.

In its effort to increase awareness about child abuse, the cabinet offered strategies for parents to prevent abuse, including:

• never discipling a child when a parent's anger is out of control

• never leaving a child unattended, especially in a car

• learning the signs of physical abuse, nothing bruises, cuts, burns or other injuries a child can't explain

• teaching children the difference between "good touches," "bad touches" and "confusing touches"

• listening to a child when he or she doesn't want to go with something

• noting a change in a child's behavior or attitude

• teaching children what if he or she gets lost

• teaching children the correct name for private body parts

• being alert for talk that indicates premature sexual understanding

• paying attention when someone shows an unusual interest in a child

• making sure a child's school or daycare will only release him or her to a designated person
(Read more)

Bill amendment could make dental, vision care more expensive

A last-minute amendment to a bill intended to limit when insurance companies could terminate policies may end up costing Kentuckians more out-of-pocket dental and vision expenses, Courier-Journal political writer Joseph Gerth writes in his weekly column.

The implications of House Bill 497 changed when Sen. Tom Buford, R-Nicholasville, "filed a one-paragraph amendment that was brought to him at the last minute by a lobbyist for the Kentucky Dental Association," Gerth writes. "That amendment said that if you have vision or vision insurance, your insurance provider can't require your health care provider to give you discounted rates on services that aren't paid for by the insurance plan."

That could mean that low-cost plans that only cover a few procedures but offer "added benefit by making sure you're not paying inflated prices for other services" may no longer be available, Gerth reports. Opponents say insurance companies will stop offering such plans because people won't buy them without the discounts. And people who can't afford more expensive plans will sacrifice dental and vision insurance.

On Tuesday, the Senate adopted the amendment and passed the bill. The bill cleared the House the next day. Gov. Steve Beshear has not indicated if he will sign or veto it.

Advocates say the bill will save in dental and vision care costs. Opponents say people will have difficulty having access to case. As for who's right, Gerth writes: "Bill advocates have presented no evidence to suggest that, and there have been no full-fledged hearings for the dentists behind the bill to make their case or to answer the questions that need to be asked." (Read more)

Legislation to fight pill mills will need to strike balance between law enforcement and medicine, panelists on TV show make clear

By Tara Kaprowy
Kentucky Health News

The legislation meant to crack down on so-called "pill mills" will turn on striking a balance between thwarting prescription drug abuse and making sure doctors and patients don't feel their hands are tied, it became clear on statewide television Monday night.

On KET's "Kentucky Tonight," Attorney General Jack Conway argued strongly for the legislation, as did state Rep. John Tilley, D-Hopkinsville, chair of the House Judiciary Committee. Dr. Shawn Jones, president of the Kentucky Medical Association, said physicians are interested in fixing the problem but don't want legislation to be overly burdensome. State Sen. Tom Jensen, R-London, chair of the Senate Judiciary Committee, would not commit to either side, but did voice some concerns.

Conway said 90 Kentuckians a month die from prescription-pill overdoses, and Kentucky is the fourth most medicated state in the country. And he said the problem is expected to grow, with 80 percent of middle-schoolers saying they know someone who has used prescription pills for off-label purposes.

But Jones warned legislators should not over-reach. "When we write legislation and we try to mandate medical care, it's very difficult," he said. "We think primarily our role as physicians is to protect the right of the patient to relieve suffering. . . . We think we need to address this problem. How to do that is the big issue."

Right now, all prescriptions dispensed in Kentucky are tracked through the Kentucky All Schedule Prescription Electronic Reporting, a system known as KASPER. The Cabinet for Health and Family Services is charged with tracking disturbing trends that show up in the system and conveying those anomalies to the doctor-dominated board that licenses doctors. That is not happening, Conway said. "In my first four years in office, I've never gotten a referral from the Kentucky Board of Medical Licensure," he said, adding under the current system law enforcement has no way to "get at the data" unless they already have a case file opened.

House Bill 4 would put Conway's office in charge of tracking KASPER data and allow it to track data without opening a case. It would also require pain clinics to be owned by doctors or advanced registered nurse practitioners and require doctors to use KASPER when seeing new patients and periodically thereafter. Now, only about one in four physicians have KASPER accounts, Conway said. An alternative measure, Senate Bill 98, would not shift power to Conway's office, but would require that doctors be the owners of pain clinics.

Jones said requiring doctors to use KASPER is too heavy-handed, in part because the system does not instantly respond to doctors' requests. Conway acknowledged the system is old and "needs to be updated," but said Gov. Steve Beshear set aside $4.5 million in his proposed budget to do so.

Patient privacy is another consideration, since House Bill 4 would also allow county and commonwealth's attorneys, along with law enforcement, access to KASPER data, Jones said. Jensen pointed out another concern: "You don't want to have a chilling effect on physicians to prescribing medications on a patient. I hate to think we're doing something where doctors are going to say, 'I don't want to give someone pain meds because I might be monitored and I might get in trouble.'"

Bob Talley of Bowling Green, who called in to the show and said he has chronic pain, agreed with Jensen, saying he "certainly does not want the political process to make it harder for my doctor and harder for me to get legitimate treatment."

Though Jensen pointed out potential problems, he said he is "still in the mode where I'm learning" because he hasn't been involved in the process of sculpting what has been proposed. "I think this is a broad bill, it's a big bill that we need to look at cautiously," he said.

Tilley agreed "the devil is in the details," but said something needs to be passed before the impending end of the legislative session. "This is a scourge. People are dying," he said. "It's imperative we act this session."

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.

Meds-for-meth bill stalls in state House committee

A measure aimed at curbing methamphetamine production failed to come to vote in the House Judiciary Committee Tuesday. Rep. John Tilley, a Hopkinsville Democrat who chairs the committee, said he hopes Senate Bill 3 will be voted on later this week.

The bill, which was passed by the Senate March 2, "would allow consumers to buy 7.2 grams per month of medications containing pseudoephedrine and up to 24 grams annually, an amount adequate for most cold or allergy sufferers, according to testimony," reports Deborah Yetter for The Courier-Journal. "A doctor's prescription would be required for an additional 7.5 grams per month or an additional 90 grams per year." The bill would exempt liquid or gel-cap formulations of the drug.

Right now, Kentuckians can buy 9 grams of the medicines per month and 120 grams per year.

Some committee members said they are concerned people could be breaking the law if they get or own too much of the drug. Rep. Joe Fischer, R-Fort Thomas, said his wife takes Claritin D, which contains pseudoephedrine, for allergies on a regular basis and asked if the bill would make it too hard for people like her to get the drugs without going to the doctor first. (Read more)

Smoking ban bill clears House committee for first time; but sponsor says she won't take it farther this session

A measure for a statewide smoking ban passed the House Health and Welfare Committee today, the first time such a bill has cleared committee in legislative history, Deborah Yetter reports for The Courier-Journal.

But House Bill 289 is not expected to be called for a vote this year, said its sponsor Rep. Susan Westrom, right, D-Lexington. "I'm not someone who wants to shove something down someone's throat," she said, adding she plans to reintroduce the measure next year.

Westrom predicts support will continue to grow as "people come to realize local smoking bans have worked well in cities, including Louisville, Lexington and Owensboro. Already, 23 states ban smoking statewide in indoor public spaces," Yetter reports.

Support for the bill was given a significant boost when the Kentucky Chamber of Commerce stepped behind it. President David Adkisson said the majority of business owners the chamber talked to support a ban. "We now feel like it needs to be statewide and not a patchwork," he said.

HB 289 passed with a 10-2 vote. Rep. Addia Wuchner, R-Burlington, a candidate for Congress in the Fourth District, was one of two Republicans to vote against the measure, calling it "well meaning" but too intrusive on people's rights. "It is not the role of the government to go this far," she said. (Read more)

Campbellsville pharmacists have mixed views about meds-for-meth bill; a good example of localizing a statewide issue

Pharmacists have mixed opinions about a bill that would require a prescription to purchase pseudoephedrine after a monthly or yearly limit has been reached, reports Calen McKinney for the Central Kentucky News Journal in Campbellsville. (Photo by McKinney)

The drug is the key ingredient used to make methamphetamine. Last week the Senate approved a bill that would limit non-prescription individuals' purchases to 7.2 grams per month and 24 grams per year.

Tresa Phillips at Nation's Medicines in Campbellsville told McKinney she feels the system in place now — an instant computer tracking system called MethCheck — is working. "I'm not sure that a new law is going to make a big difference," she said, adding that a person who is buying the drug already has to show state-issued identification.

However, Jay Eastridge at Eastridge-Phelps Pharmacy applauded the move. "It sort of restricts pseudoephedrine getting into the wrong hands," he said. "I wholeheartedly support the bill." Eastridge said pharmacists have become "gatekeepers" in the face of the meth epidemic and "it's just painful to watch" people coming in "from one drug store to the next seeing what they can get."

Ed Baise of the Medicine Centre agreed that pharmacists have "become the police" when it comes to limiting pseudoephedrine. But he said the drug should be put in a class of its own and pharmacists should be responsible for controlling purchases. Baise pointed out allergy sufferers could be inconvenienced by the bill. "This may help some," he said, "but it's not gonna solve the problem." (Read more)

Smoking ban can't get a vote due to Republican boycott over chairman's block of measure for drug tests for welfare recipients

There could have been a vote Thursday on a bill for a statewide smoking ban, but a Republican boycott of the Democratic-controlled House Health and Welfare Committee over another bill prevented that.

"Republicans were upset over the committee chairman's decision not to have a vote on House Bill 26, sponsored by Rep. Lonnie Napier, R-Lancaster, which would require the Cabinet for Health and Family Services to implement a substance-abuse screening program for recipients of public assistance," reports Greg Hall for The Courier-Journal.

Chairman Tom Burch, D-Louisville, said he didn't allow a vote because he didn't want to "embarrass" Napier. "Whether he admits it or not, you don't embarrass somebody by killing their bill in front of them," he said. "You just hear it."

Just eight of 16 committee members were present; at least nine are needed to move a bill. Six of the absentees were Republicans; two were Democrats. "Without a committee majority present, no vote was take on HB 289, the smoking ban sponsored by Rep. Susan Westrom, D-Lexington. Burch said he likely will call a special committee meeting early next week to hear the bill," Hall reports. (Read more)

Senate panel and House OK bills to tackle prescription-bill abuse

Two bills aimed at attacking the state's prescription drug abuse problem made headway yesterday, with a major difference between the House and Senate measures, reflecting possible turf battles between state agencies and doctors' desire to maintain as much control over regulation as they can.

Senate Bill 2 would keep the state drug monitoring system — known as the Kentucky All Schedule Prescription Electronic Reporting, or KASPER — the responsibility of the Cabinet for Health and Family Services. House Bill 4 would give it to the attorney general's office.

The Senate Judiciary Committee approved Senate Bill 2 on an 8-to-1 vote. House Bill 4 passed the full House 81 to 7. The bills' low numbers reflect their importance to legislative leaders in both chambers.

Lawmakers feel the issue will ultimately be taken up near the end of the session in a conference committee, whose members represent the House and Senate and come together to come to an agreement between the two chambers, reports Jack Brammer for the Lexington Herald-Leader.

SB 2 originally required that doctors use KASPER when dispensing narcotics and get a KASPER report before issuing a prescription. At the request of the Kentucky Medical Association, bill sponsor Sen. Jimmy Higdon, R-Lebanon, changed that stipulation, requiring the Kentucky Medical Licensure Board, made up mainly of doctors, to issue regulations on how doctors should use KASPER. Higdon said he made the change in order to get the bill out of committee, a move that angered Sen. Ray Jones, D-Pikeville, who accused the KMA of trying to "gut the bill." (Read more)

HB 4 would still require the use of KASPER, used by only less than a third of doctors, and "would bolster regulation on pain clinics and call on coroners to perform mandatory drug tests in cases of deaths with an unknown cause," reports Tom Loftus for The Courier-Journal. "It also would give commonwealth's and county attorneys access to the data in KASPER and would require that pain clinics be owned by a licensed physician or an advanced practice registered nurse." SB 2 would allow only doctors to own pain clinics, but Sen. Brandon Smith, R-Hazard, said clinics with non-physician owners should be grandfathered in if they have not have previous problems with the law.

As for whether the KASPER should stay in the cabinet or go to the attorney general, Sen. Tom Jensen, R-London, said he doesn't has one strong feeling over the other. "We have to make sure the enforcement is there, whoever is doing it. properly," he told Ryan Alessi on CN|2's "Pure Politics." 

Anti-meth bill passes Senate; limits monthly pseudoephedrine purchases to 7.2 grams a month and 24 grams a year

In an effort to curb methamphetamine production, the Senate passed a bill Friday that will limit the amount of pseudoephedrine that can be bought monthly and annually.

Senate Bill 3, approved 25-11, will allow consumers to buy 7.2 grams of medicine containing pseudoephedrine per month and up to 24 grams per year. The bill now goes to the House for consideration. House Speaker Greg Stumbo, D-Prestonsburg, said House members generally support what the bill is trying to accomplish but want to study its details, report Jack Brammer and Beth Musgrave of the Lexington Herald-Leader.

Right now Kentuckians are allowed to buy 9 grams per month and 120 grams per year. Sen. Robert Stivers, R-Manchester, sponsored the bill, which originally only allowed the purchase of 3.6 grams per month and 15 grams per year. That changed after Sen. Jerry Rhoads, D-Madisonville, filed an amendment that increased the limit to the 7.2 and 24 grams. (Associated Press photo by the late Ed Reinke of Sen. Stivers)

The bill also prohibits anyone who has been convicted of a drug-related offense from buying the drug for five years. Pseudoephedrine, which is in several cold and allergy medicines, is the key ingredient to make meth. The bill does not pertain to pseudoephedrine that comes in gel or liquid format; meth is more difficult to make using these formulations.

"I still don't think it's the best situation," Stivers said of the revised bill. "It's what we could get passed. Let's see what this does."

Opponents, namely the Consumer Healthcare Products Association, were "disappointed with the outcome of the vote," said Scott Melville CHPA president and chief executive. "CHPA is committed to working with legislators to win the battle against methamphetamine, but gaining the upper hand against meth producers and dealers does not require unnecessary restrictions imposed on many Kentucky families — particularly seasonal allergy sufferers — by burdening them with increased health-care costs, lost wages, and unnecessary trips to the doctor."

The CHPA represents makers of over-the-counter drugs and is continuing a vigorous and expensive campaign of lobbying and radio commercials to defeat the bill. (Read more)

Compromise meds-for-meth bill clears committee; third drug-related bill to pass this week

Update, March 2: Just hours after the committee approved the bill, Senate Majority Leader Robert Stivers, R-Manchester, "declared its future uncertain," reports Jack Brammer for the Lexington Herald-Leader. Stivers said there is "a very successful lobbying campaign" against Senate Bill 3 and said he did not "want to subject lawmakers to continued pressure by the makers of pseudoephedrine," Brammer reports. Though he wouldn't call the bill dead for this year, Stivers said he would decide soon on whether he would continue to pursue the bill's future. (Read more)

The compromise bill that will require a prescription to buy pseudoephedrine after a monthly or annual limit is reached passed 7-4 in the Senate Judiciary Committee this afternoon.

Senate Bill 3 will allow people to buy up to 3.6 grams of the drug a month and a maximum of 15 grams per year. After those limits have been reached, patients will have to see a doctor to obtain a prescription for more. The intent of the bill is to curb methamphetamine production — pseudoephedrine is the key ingredient to make the drug.

Now, people are limited to buying 9 grams per month and 120 grams per year.

Today, the committee approved an amendment to the bill, which will allow patients to buy 7.5 grams per month if a doctor says that amount if required, which amounts to 90 grams a year under these special circumstances.

The bill also prevents anyone who has been convicted of any drug-related crime — whether the crime was related to meth or not — from buying pseudoephedrine without a prescription for five years.

Sen. Robert Stivers, R-Manchester, made an impassioned argument for the bill, which he introduced earlier this week. He said the compromise works because "any box you look on will tell you that you should take this for no more than 14 consecutive days without seeing a doctor." The 3.6-gram monthly allotment will allow for 14 days' use.

As for the criticism that the reduction won't be enough to cover whole families who may be suffering from allergies or cold, Stivers argued "anyone who is subjecting a child to this continuous use on a repetitive basis is not really taking care of the child or the symptoms that cause their problems."

Carlos Gutiérrez of the Consumer Healthcare Products Association, which represents makers of over-the-counter medicine, said it is "adamantly against" the compromise bill, saying "we feel very strongly about the rights of consumers to buy a legal product." He pointed out if a chronic allergy sufferer takes 1 pill a day, that adds up to 7.2 grams per month.

Sen. Tom Jensen, R-London, questioned Guetiérrez and had him confirm that 84 percent of people who buy pseudoephedrine use less than 15 grams of the medicine per month, according to 2010 figures. He further established that the remaining 16 percent of people are buying 60 percent of all the pseudoephedrine sold in Kentucky.

House Judiciary Committee approves two bills to curb synthetic, Rx drug abuse

Cracking down on drugs is one of the most pressing topics of the 2012 General Assembly, and lawmakers showed they were serious about it this afternoon. (Associated Press photo by Ed Reinke of House Judiciary Committee Chairman Rep. John Tilley, D-Hopkinsville)

In an effort to get a handle on prescription drug abuse — and so-called pill mills that supply the addictive medications — the House Judiciary Committee approved a bill that will place controls on pain management clinics, reports Jack Brammer of the Lexington Herald-Leader. House Bill 4 also puts the power to police the problem into the hands of the attorney general; cracks down on prescribers who have had trouble with the law for drug-related crime; requires that the clinics be owned by people who have a medical background; and will get a detailed look at how many deaths are occurring by having coroners report any death caused from the use of drugs or drug overdoses.

"We don't really know how bad (the problem) is," said House Speaker Greg Stumbo, the Prestonsburg Democrat who filed the bill. "I think it will astound us when we get the results in because I think it might double what we think the numbers are."

The committee also approved House Bill 482, which prohibits trafficking and possession of synthetic drugs that are sold as bath salts or incense in convenience stores and other places. The measure, sponsored by committee chairman John Tilley, D-Hopkinsville, was passed unanimously.

Both bills will now go to the full House for consideration. (Read more)

Meds-for-meth compromise bill introduced

Lawmakers said they would compromise on the idea of making pseudoephedrine available only by prescription, and they have. Senate Bill 3 would only require a prescription for medicines containing the drug after a patient has bought 3.6 grams of it per month and a maximum of 15 grams per year. Gelcaps and liquid forms of the drug would still be excluded. (Associated Press photo by John Flavell of recovering addict Melanda Adams and Senate Majority Floor Leader Robert Stivers, who introduced the bill)

Now, people are limited to buying 9 grams per month and 120 grams per year of cold and allergy medicines containing pseudoephedrine, which is the key ingredient to make meth. The bill would also prevent anyone who has been convicted of a meth-related crime from buying the drug without a prescription for five years.

Last week, Sen. Robert Stivers, R-Manchester, withdrew a bill that would have required a prescription for any purchases of the drug. Stivers introduced this new bill yesterday and told The Courier-Journal it gives people who use the medicines "adequate opportunity without incurring medical expenses or the cost of a prescription to access these on a monthly basis and an annual basis."

Opponents to the bill still feel it is too restrictive, with the Consumer Healthcare Products Association continuing "to oppose burdensome restrictions to over-the-counter cold and allergy medicines that thousands of law-abiding Kentuckians rely upon for relief," Elizabeth Funderburk, senior director of communications for the group that represents makers of over-the-counter medicine and dietary supplements, told the Louisville newspaper.

Opponent Pat Davis, mother of six and wife of 4th District U.S. Rep. Geoff Davis, railed against the new proposal. "I'm not sure why they're calling it a compromise bill because I'm not sure who they compromised with," she said. She pointed out if four members of her family were to get sick with a cold, and took Sudafed to treat it for seven days, that would amount to 13.44 grams of the medicine — nearly the annual limit. "Really what this bill is is the same bill," she said. "They're throwing out a few crumbs, which they're calling 15 grams."

Jackie Steele, commonwealth's attorney for Laurel and Knox counties, told the paper that the lower limits could lead to a reduction in meth labs, but not for long. "I hope this cures it," he said of the meth-lab problem. "I don't think it will."

In London, whose Walgreens has the highest sales of pseudoephedrine in the state, Police Chief Stewart Walker agreed with Steele. "The bad guy is always going to figure a way around this," he said. "(With the compromise) you probably leave the door partly open and there's so much more room for added work."

The Senate Judiciary Committee could consider the new bill Thursday, and the entire Senate could vote on it this week, Stivers told the Lexington Herald-Leader. (Read more) For The Courier-Journal's story, by Jessie Halladay and Tom Loftus, click here.

Meds-for-meth bill sent back to committee; compromise in the works, original sponsor says

The bill that would make pseudoephedrine — the key ingredient to make methamphetamine — available only by prescription was taken off the Senate floor Thursday afternoon. The bill's original sponsor, Sen. Tom Jensen, R-London, said "he expects a compromise is near," reports Jessie Halladay for The Courier-Journal.

"We've probably reached some consensus on where we want to go," said Jensen, right, but declined to go into details about the compromise. Of a possible concession, he would only say, "It's not necessarily what I want and it's not necessarily what the industry wants," but would be a step in the right direction.

Senate Bill 50, which was narrowly approved by the Judiciary Committee last week, has been opposed by the pharmaceutical industry, which says it imposes an unnecessary burden on users who need the medicine for the relief of colds and allergies. Many law enforcement agencies, including the Kentucky Narcotics Officers Association, support the bill, saying it would made a big dent in the number of meth labs found in the state. The bill excludes pseudoephedrine that is sold gel-cap format. (Read more)

Lawmakers hear more complaints about managed care

Patients with mental illness are being denied medication, forced to try cheaper drugs that have already been proven not to work for the patient, or not getting them in time because of delays in approval. These were some of the complaints of the state's new Medicaid managed-care system, reports Deborah Yetter of The Courier-Journal.

"If this is how it's going to be, it is scary," Dr. Scott Haas, chief medical officer of the Bluegrass Mental Health/Mental Retardation Board, told the state Senate Health and Welfare Committee Wednesday. "It is dangerous, and it ultimately is going to cost us a lot of lives."

The testimony is the latest that highlights the weaknesses of managed care, which the state changed to on Nov. 1 to for 560,000 Medicaid recipients living outside the Louisville area. Executives of the three companies hired to provide the care — CoventryCares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky — last week pledged to do better.

The majority of yesterday's testimony focused on the system's problems in dealing with mental illness, but Deb McGrath, executive director of the Epilepsy Foundation of Kentuckiana, said she's been inundated with "complaints about delays or rejections in medications patients need to control seizures," Yetter reports. "Something has to be done," McGrath said. "It's just a vicious cycle." (Read more)

Group fighting meds-for-meth bill says it spent nearly $200,000 in January on lobbying, and that apparently omits radio buys

The group fighting a bill that would make the key ingredient for making methamphetamine available only by prescription spent more than $194,000 last month alone to lobby lawmakers, far more than any other lobbying interest at the General Assembly.

The Consumer Healthcare Products Association "reported spending more on Frankfort lobbying for the month than the next eight largest groups combined," reports Tom Loftus of The Courier-Journal. "That's almost an obscene amount of money to be spending on one month on one issue," said Senate Majority Leader Robert Stivers, R-Manchester. Stivers is sponsoring the bill, which would require a prescription for cold and allergy medicine that contains pseudoephedrine.

The group with the second highest spending was the Kentucky Hospital Association, at $36,120.

CHPA "is a group of manufacturers and distributors of over-the-counter medicines whose members include Bayer Healthcare, GlaxoSmithKline and Johnson & Johnson," Loftus reports. In a statement Monday, the group said it is again "efforts by some legislators to deny law-abiding citizens nonprescription access to certain cold and allergy medicines they depend on."

The $194,957.76 spent on lobbying apparently does not include what the CHPA spent on broadcast advertising, which it does not have to report. As of Feb. 3, the group had spent more than $82,000 running ads on Louisville, Lexington and Somerset radio stations owned by Clear Channel Communications Inc., the nation's largest radio operator, according to public-inspection files at those stations, the only ones that have been checked by Kentucky Health News and its journalistic partner, Jonah Engle. In 2011, CHPA paid the Kentucky Association of Radio and Television more than $93,000 to run ads, according to public-inspection files from Cumulus Broadcasting, another major owner of stations in Kentucky.

As for lobbying expenses, more than $12,000 was spent on salaries for three lobbyists, plus nearly $4,000 for food, lodging, beverage and transportation expenses. More than $150,000 was spent "for professional and technical research and assistance," plus nearly $27,000 for "educational and promotional items."

"I'm not surprised they reported so much for lobbying because it's obvious they're doing a pretty good job of getting their message out ... which I believe is a misleading scare campaign," said Sen. Ray Jones, D-Pikeville, who is co-sponsoring the meds-for-meth bill. (Read more)

Legislators hear about serious problems in managed-care system

The switch to the new Medicaid managed-care system is proving to be a nightmare, health officials told lawmakers Wednesday, with long delays in payment to providers and treatment for patients.

"It appears to me the only place the savings can come from is the delay and denying of care," said Dr. Shawn Jones, president of the Kentucky Medical Association and physician in Paducah. "Patient care is being delayed and, in some cases, simply prevented." (Video from cn|2)

Jones was one of several officials who testified at a meeting of the Senate Health and Welfare Committee. The new system requires pre-authorization for procedures that were once routinely covered, so patients spend hours in waiting rooms or are told to go home and return after their procedures have been given the go-ahead. In one instance, a woman in labor came to the hospital to deliver "and the managed-care company insisted that her care be pre-authorized," reports Deborah Yetter of The Courier-Journal.

"Fourteen days later, mom and baby are home and we still have no pre-authorization," said Joe Grossman, chief financial officer of Appalachian Regional HealthCare.

Problems started Nov. 1 when the state turned its Medicaid program outside the Louisville region to three managed care companies. (Louisville-area recipients have long been managed by Passport Health Plan.) The move is intended to save the state money and fill a hole in the Medicaid budget. But officials said the three companies — CoventryCares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky — seem to be purposefully delaying claims payments, though the state has already paid them $135 million since Nov. 1.

"I feel like I've become a bank to these out-of-state insurance companies," said Grossman, whose eight-hospital chain is owed $8 million. "I've lent them money."

The managed care companies did not testify Wednesday, but issued statements saying they intend to address the issues at hand. Neville Wise, the state's acting Medicaid commissioner, " said he believes the issues are just temporary bumps that can be ironed out," Ryan Alessi of cn|2's "Pure Politics" reports. The requirement that childbirth be pre-authorized, for example, has since been rectified, Yetter notes. State Sen. Julie Denton, R-Louisville, asked Wise, "How many more ludicrous scenarios can there be?" (Read more)