Legislature likely to tweak, clarify and limit last year's 'pill mill bill'

State lawmakers could narrow the focus of last year's "pill mill bill" during the legislative session that begins tomorrow, to concentrate on adults with long-term prescriptions for frequently abused painkillers, John Cheves of the Lexington Herald-Leader reported yesterday. Doctors, hospitals and patients have complained that HB 1 in its current from "restricts too many drugs in too many clinical settings, needlessly complicating medical care in an effort to shut down storefront pain clinics that recklessly hand out prescriptions," Cheves writes.

Under the law, people with long-term prescriptions for controlled substances must submit to urine drug testing to determine if they are actually taking the drug rather than selling it, and if other unprescribed drugs are in their systems. Some patients complained they were being charges hundreds of dollars for urine tests because their insurance companies denied coverage of such testing. One couple was charged more than $900 for tests to get prescriptions for insomnia and anti-anxiety medication.

The new rules, being drafted by the Kentucky Board of Medical Licensure, would reduce the mandate for drug screening to pain medicine prescriptions of 90 days or more. Other medications would not require testing unless the doctor thinks it's necessary. The new rules will say that other types of testing which would be cheaper, including hair, could be used. The board is also restricting its focus to powerful painkillers, including hydrocodone and oxycodone.

The new regulations are subject to approval by the legislature, which could write its own restrictions into law, but the consensus appears to be that the law needs tweaking, not major changes. for example, House Speaker Greg Stumbo said it should be changed to clarify that hospitals don't have to run a new background check on a patient every time they give another dose of a controlled substance during his stay. (Read more)

Pill-mill bill causing problems for patients who have long-term prescriptions: expensive drug-screening tests

In July, Kentucky started making long-time holders of certain controlled-substances prescriptions submit to urine tests to determine if they were actually taking the drugs, rather than selling them. Because insurance companies don't consider the tests medically necessary, patients often have to pay for them out of pocket. It can be expensive, reports John Cheves of the Lexington Herald-Leader, citing one couple that had to pay $533.

The tests are required under emergency regulations issued to implement House Bill 1, the "pill mill bill," and Gov. Steve Beshear has said he understands the financial burden the tests can bring on those who are not abusing prescriptions. Changes could happen in January when the emergency regulations expire and are replaced with permanent rules, Cheves reports. The Kentucky Medical Licensure Board is hearing complaints, and has extended a grace period for compliance for doctors until Nov. 1.

"But critics say they warned last spring that HB 1 — intended to crack down on the illicit sale of prescription drugs — would treat everyone like a potential felon, including doctors and patients engaged in legitimate medical care," Cheves reports. Much debate about the bill has revolved around its implication on doctors, with little attention paid to patients. Cheves reports that soon may change.

Under the law, doctors are required to get an initial urine test from patients who have long-term controlled substance prescriptions. They must also get random drug tests once a year for "low-risk" patients who are most unlikely to abuse drugs based on test results, and three times a year for "high risk" patients. The amount of people requiring drug tests is "likely to be in the tens of thousands," Cheves reports. (Read more)

No vote taken on bill for drug tests for recipients of public aid

Despite motions to do so Thursday, the House Health and Welfare Committee did not vote on a bill that would require Kentuckians who receive public assistance to submit to random drug testing. The bill did not receive a vote because there is no money to pay for the drug testing and rehabilitation that would be required, said committee chairman Tom Burch, D-Louisville.

Maysville native Ruth Chamblin spoke at the meeting, saying her 12-month-old great-niece might still be alive if such a bill had been made law, the Lexington Herald-Leader's Beth Musgrave reports. Chamblin's great-niece died after she was allegedly beaten by her niece's then-boyfriend. Fearing investigation, Chamblin's niece neglected to take her daughter to the doctor for four days after the alleged attack, and the baby consequently died. The family was on public assistance at the time, and the boyfriend was reportedly a drug abuser.

House Bill 208, sponsored by Republican Rep. Lonnie Napier of Lancaster, right, would require random drug testing for people who receive Medicaid, food stamps and other kinds of public assistance. Those who test positive on the drug screening would have 60 days to get treatment. They would continue to receive public assistance in the meantime, but if they repeatedly failed more tests their assistance would be cut off. The reasoning behind the bill is to stop people from selling food stamps to buy drugs, Napier said.

Napier said the drug testing would cost about $1.5 million a year. One Idaho study has concluded drug testing for state-aid recipients is inefficient. (Read more)

Idaho study: Drug testing for state-aid recipients inefficient

As discussion continues among Kentucky lawmakers over whether public-assistance recipients should undergo mandatory drug testing, an Idaho study has concluded such an undertaking is not cost-effective.

"The costs of legal action alone during the first year could exceed the costs of the drug testing and treatment program," says the study, as reported by The Associated Press. "To fund the costs of the program, (Idaho) would need to either appropriate additional funding for a drug-testing program, or divert funds from current programs for the screening, testing and treatment activities."

The study was conducted by Idaho's Department of Health and Welfare. It found that testing for federal welfare programs like Medicaid and food stamps is forbidden. For child-care assistance and temporary cash assistance for families, programs that cover about 10,500 Idahoans, the study showed the "costs of testing and related treatment would wipe out prospective savings achieved by removing offenders."

On Jan. 7, state Rep. Lonnie Napier, R-Lancaster, filed House Bill 208, which would requie random drug and urine testing for any Kentucky resident over 17 who gets Medicaid, food stamps or welfare benefits. Those failing the test would lose their benefits until they passed drug testing at a later date. The cost of the proposal was unknown, though Napier, right, said there are more than 600,000 Kentucky adults on welfare, and a drug test costs about $30. Those numbers result in a $18 million price tag, plus the costs of expanding drug treatment programs.

The House's Health and Welfare Committee has had the bill since Feb. 1 and does not appear likely to approve it.

Missouri, Virginia and Nebraska legislators are considering similar proposals. New Mexico lawmakers are debating whether to test for drugs as a condition to receive unemployment benefits. Minnesota and Wisconsin test convicted felons who receive some form of public assistance. Arizona "requires about 12,500 people in one federal program to complete a drug-screening questionnaire, with some then undergoing drug screens," AP reports.

The proposals have not been met without controversy. In 1999, Michigan's effort to drug test members of needy families who received temporary federal assistance lasted just five weeks before it was ruled unconstitutional, AP reports. (Read more)