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http://cjonline.com/news/2015-06-02/grocers-child-advocates-await-legislatures-next-move-food-sales-tax

Grocers, child advocates await Legislature's next move on food sales tax:

Only one state, Mississippi, taxes food purchases at a higher rate

Posted: June 2, 2015 - 11:51am

Kansas already has the nation's second-highest sales tax for food, leaving grocers and child advocates wary of a potential increase as lawmakers wrangle with a $400 million budget gap.

By Justin Wingerter

justin.wingerter@cjonline.com

As the Kansas Legislature continues its prolonged search for a solution to the state's $400 million budget gap, grocers and child nutrition advocates are watching what happens to the state’s sales tax rate for unprepared food.

Most states and the District of Columbia don’t collect sales tax on food and many states that do offer a lower tax rate for food compared to other items. Kansas, however, currently taxes food at the same rate – 6.15 percent – as other consumer goods. Only Mississippi, with its 7 percent sales tax rate, places a higher state sales tax on food purchases than Kansas.

In a plan that didn’t pass the Kansas Senate on Monday, the sales tax rate on food would fall to 6 percent but not until six months after the overall sales tax rate was increased to 6.5 percent. On Saturday morning, Gov. Sam Brownback put forth a plan that would not create a separate sales tax rate for food, meaning the rate for food would increase to 6.5 percent.

Half of Kansas’ four neighboring states, Oklahoma and Missouri, tax unprepared food sales. Oklahoma’s tax rate is 4 percent while Missouri’s is 1.225 percent.

John McCormick, president and CEO of the Retail Grocers Association of Greater Kansas City, represents grocery stores in both Kansas and Missouri. McCormick says residents on Kansas’ northern and eastern borders often cross into Nebraska and Missouri for cheaper groceries.

“It’s just one more thing that could, and does, push people across the line,” McCormick said. “Gas is fairly cheap right now so they may drive across for cigarettes and liquor and while they’re there, they’re going to buy their groceries over there.”

McCormick said minor changes to the sales tax on food would create a lot of work for grocery store employees, who must electronically reset the rates each item is taxed at, while providing very few savings for consumers.

Shannon Cotsoradis, CEO of the Topeka-based nonprofit child advocacy group Kansas Action for Children, agrees.

“That’s not the kind of modification that’s really going to make a difference for struggling families,” Cotsoradis said.

Cotsoradis said the state’s comparatively high tax rate on food forces the state’s poorest families to decide between buying quality food and paying bills, such as rent and electricity. It also curbs the ability of low-income parents to buy nutritious food for their children, prompting them to purchase low-quality food in bulk instead, according to Cotsoradis.

Kansas City-based nonprofit group KC Healthy Kids points to a survey conducted last year by Fort Hays State University researchers which found 73.5 percent of the 2,203 Kansas adults surveyed supported eliminating the sales tax on food while 13.1 percent somewhat supported it.

“In addition to making healthy food more affordable for Kansans, cutting the food tax could help smaller and rural grocery businesses in the state by encouraging customers to shop in Kansas rather than in neighboring states with lower food taxes,” the group argues.

McCormick said he also supports eliminating the sales tax on food.

“I’m a proponent of zero taxes on unprepared food,” McCormick said. “That would help the lower-income wage earners.”

While Kansas Action for Children has supported eliminating the sales tax for food in the past, Cotsoradis said the group isn’t lobbying for it in the current political climate. Instead, she’s hoping lawmakers “hold the line” and ensure the rate isn’t increased.

A report released Monday by KC Healthy Kids and Wichita State University researchers found Kansas’ sales tax on food is regressive, hitting the budgets of low-income families and individuals significantly harder than middle- and upper-class consumers.

“For the case of a family of three living in a metropolitan area, we find that the incidence of taxing groceries is under 0.2 percent of household income for those with income greater than $150,000 per year, while it is over 5 percent of household income for those households with income less than $10,000 per year,” the researchers wrote.

Justin Wingerter can be reached at (785) 295-1100 or justin.wingerter@cjonline.com.
Follow Justin on Twitter @JustinWingerter.

Bill in Conference Committee to Create Medicaid Mental Health Medications Advisory Committee

Senate Sub for HB 2149 is currently in conference and expected to pass.  HB 2149 was originally a bill to provide for Medicaid coverage of donor breast milk.  The Senate added the provisions of SB 181 and a new plan for instituting management of mental health medications in Medicaid through a specialized advisory committee.  The bill amends the procedures regarding restrictions of patients’ access to any new prescription-only drug under the Kansas Medicaid Program and would establish meeting requirements for the Medicaid Drug Utilization Review Board (Board). 

Further, the bill would allow prior authorization or other restrictions on medications used to treat mental illness to be imposed on Medicaid recipients for medications subject to guidelines developed by the Board in accordance with provisions of the bill; establish instances not to be construed as restrictions; provide for the development of guidelines; establish requirements for Board review of medications used to treat mental illness available for use before and after July 1, 2015; and create a Mental Health Medication Advisory Committee (Committee), outlining Committee membership and appointments, meeting frequency, and member compensation.   

Advocates view the new provisions as a better option than SB 123 - which would have simply deleted the statutory exemption from Medicaid management for MH drugs.  SB 123 was defeated by the Senate.   Read more about this issue.

House Appropriations Apr 23-24, Senate Ways and Means Apr 28

The Consensus Revenue Estimating Group met April 20 and the report contained more bad news – forecasting $98.2 million reduced revenues for FY 16 and $100.8 million reduced revenues for FY 17.  The current fiscal year estimates reduced revenues of $87.5 million – and increased adjustments of $244.5 million, mostly from the passage of the rescission bill in February.  It is not clear where the $157 million difference will leave the overall budget for FY 15 – ending June 30.  But the mega-budget bill will require further adjustments unless significant tax policy bills are moved forward.

Even with the Governor’s Allotments last Fall, the rescission bill H Sub for SB 4) addressed a $300 million budget shortfall for fiscal year 2015 (ending in June) to prevent the state from defaulting on its financial obligations. The legislation included several transfers, cuts and delays in funding, including $158 million from the State Highway Trust Fund, $7.9 million in delayed payment to the Kansas Employment Retirement System and $7.1 million from the Job Creation Program Fund. The House of Representatives passed the bill by a vote of 88-34. The Senate passed the bill by a vote of 24-13 sending it to the Governor to sign into law on February 16.

Currently, Senate Sub for HB 2135 remains in conference committee – this is the 2015 Legislative Session’s Mega-Budget Bill.  Only the Senate has passed a mega-budget bill this session, which puts the House of Representatives in the uncomfortable position of having to either concur with the version as it emerges from conference, or send it back for more work.  There is no opportunity for floor amendments unless they move forward their own House bill.  The House and Senate Conference Committee ended its negotiations with a tentative agreement, but did not move it to the floor for concurrence – choosing instead to hold it over to the Veto Session.   It is likely that the late session budget adjustments that typically are passed in an Omnibus bill will simply be rolled into Senate Sub for HB 2135.  As it stands, the bill spent about $16 million more than the Governor’s proposed budget – ending up around $141 million below revenue estimates.

The Appropriations Committee will meet this week and Senate Ways and Means will meet next week to cover the discussion of omnibus items.  State Budget Director Shawn Sullivan indicated today that the Governor will be meeting with his staff this week to make recommendations for revenue enhancements.  His policies for increasing tobacco and liquor taxes, as well as some income tax adjustments, have seen no action to date.  Both bills had public hearings during the regular session.

House Appropriations Committee -  Thursday April 23 beginning at 10:00 am and Friday April 24 beginning at 9 am in Room 112-N

Senate Ways and Means Committee  - Tuesday April 28 beginning at 3 pm in Room 548-S

April 1, 2015      by Association of Health Insurance Plans

Contact:
Ben Jenkins

Washington, D.C. – States in which Medicaid plans manage prescription drug benefits are realizing large-scale savings, according to a new analysis by The Menges Group.

The study, “Comparison of Medicaid Pharmacy Costs and Usage in Carve-In Versus Carve-Out States,” examined 35 states and DC that used the Managed Care Organization (MCO) model in their Medicaid program and either included (carved-in) or excluded (carved-out) pharmacy benefits from coverage.  The report found that carve-in states outperform carve-out states by a wide margin, saving Medicaid $2.06 billion in state and federal expenditures in 2014 alone. 

With regard to significant cost savings in carve-in states, and in light of their better coordination of services, the authors conclude: “Our findings suggest that states that maintain prescription drugs as part of the MCO benefit are able to achieve cost savings while at the same time provide highly integrated care.  The pharmacy carve-in model appears to resoundingly fulfill both objectives.”

Key findings of the report include:

• Across 28 states using the carve-in model, the net cost per prescription was 14.6% lower than the average net cost per prescription in states not carving in pharmacy.
• This 14.6% differential created a $2.06 billion net savings in state and federal expenditures in FFY2014 for states deploying the carve-in model.
• The seven carve-out states had a 20% increase in net costs per prescription from FFY2011-FFY2014 -- in stark contrast to the 1% increase in net costs per prescription experienced by the 6 states that recently switched from a carve-out to a carve-in model.
• The seven carve-out states “missed” a total of $307 million in savings in FFY2014 which would have occurred had they used a carve-in model.

“Medicaid plans’ ability to provide coordinated care through pharmacy benefits is crucial for beneficiaries and critical to protecting taxpayers and state budgets,” said America’s Health Insurance Plans President and CEO Karen Ignagni. “Allowing health plans to coordinate health and pharmacy benefits is essential for improving and maintaining the health of Medicaid  beneficiaries and protecting limited state resources.” 

To view the full analysis, click here. 

For more information on how carving pharmacy into Medicaid managed care organization (MCO) benefits is critical for beneficiary outcomes, click here. 

###

Senate Sub for HB 2149: Amended by Senate Public Health and Welfare March 17 to include new language designed to replace SB 123.

Senate debated and amended the bill March 23. Bill passed Senate 40-0 March 24.

Advocates knew that there would have to be another proposal brought forward in order to preserve the $6.5 million fiscal note, which is included in both the Senate and House budget bills. 

Section 3: includes the provisions of SB 181, which had already passed the Senate:

Access to New Prescription-only Drugs under the Kansas Medicaid Program  The Secretary of Health and Environment (Secretary) would be allowed to implement prior authorization of any new prescription-only drugs until such drugs are reviewed by the Board at its next scheduled meeting. During the period before the new drugs are reviewed by the Board, the drugs would be approved for use as indicated in package insert guidelines approved by the federal Food and Drug Administration and clinically reputable compendia, as approved by the Secretary in rules and regulations. 

Under existing law, the Secretary is prohibited from restricting patient access to prescription-only drugs through a program of prior authorization or a restrictive formulary, except by rules and regulations. The current requirement that these proposed rules and regulations be submitted to the Board for written comment would be eliminated. Board Meeting Requirements The Board would be required to meet at least quarterly. The meetings would be open to the public and provide an opportunity for public comments. The Board would be required to post notice of its meetings at least 14 business days before the scheduled meetings.

Section 4: includes new proposal for managing mental health medications in Medicaid (replacing SB 123) Prior Authorizations or Other Restrictions on Mental Health Medications for Medicaid Recipients

The bill would provide that no requirements for prior authorizations or other restrictions on medications used to treat mental illnesses may be imposed on Medicaid recipients, except on medications subject to guidelines developed by the Board in accordance with provisions of the bill.

Existing law prohibits requirements for prior authorization or other restrictions on medications used to treat individuals with mental illnesses who are Medicaid recipients. Medications in the existing statute available without prior authorization or other restrictions include atypical medications, conventional antipsychotic medications, and other medications used for the treatment of mental illness

The bill specifies the following would not be construed as restrictions: ● Any alert to a pharmacist that does not deny the claim and can be overridden by the pharmacist; ● Prescriber education activities; or ● Consolidation of dosing regimens to equivalent doses.

Adoption of Guidelines and Medication Review The Committee would be required to provide the Board with recommendations for the development of guidelines. With regard to the recommendations from the Committee, the Board would have the following options: ● Accept the recommendations in whole, to become effective immediately upon approval; or ● Reject the recommendations in whole, requiring referral back to the Committee for further consideration.

The Board would be prohibited from adopting medication guidelines related to mental health medications without recommendations made by the Committee. 

Prior to July 1, 2016, the Board would be required to review all medications used to treat mental illness available for use on July 1, 2015. The Board would be required to review all medications used to treat mental illness that do not exist on July 1, 2015, but are later developed or believed to be effective in the treatment of mental illness within six months of presentation to the Board.

Concept: Will the agency commit to: 

1. Provide the same public notice as required for the DUR Committee? 

2. Formalize language of the “guard rails” in the formal charter of the mental health medication advisory committee created by Senate Sub for HB 2149? 

3. Begin process with informational briefings – including consumer/family input? 

List of guard rails from the most recent workgroup meeting: 

 Patients who are already on stable, safe regimens will be able to continue their prescribed treatment. 

 Creation of a Mental Health Medication Advisory Committee made up of mental health practitioners and pharmacists with specific experience in providing service to the mental health community. 

 Review certain medications for safety and dose optimization. 

 New prescriptions or changes in medication will be subject to evidence-based guidelines developed by the Drug Utilization Review Board with the counsel of the Mental Health Medication Advisory Committee. 

 Increase length of emergency prescription fills from 3 days to 5 days to allow for processing time in situations where prior authorizations are required and assure that these are paid to the pharmacies. 

 Hold the number of prior authorizations needed to a minimum, while still providing for the appropriate protections. 

 The three MCOs will be required to follow policies set by the state, and no changes to the current system will be allowed until such time that policies are put in place to assure minimal disruptions to providers and patients. 

Bill Language: 

Sec. 3. K.S.A. 2014 Supp. 39-7,120 is hereby amended to read as follows: 39-7,120. (a) The secretary of health and environment shall not restrict patient access to prescription-only drugs pursuant to a program of prior authorization or a restrictive formulary except by rules and regulations adopted in accordance with K.S.A. 75-5625, and amendments thereto. 

Prior to the promulgation of any such rules and regulations, the secretary of health and environment shall submit such proposed rules and regulations to the medicaid drug utilization review board for written comment may implement prior authorization of any new prescription-only drugs until such drugs are reviewed by the medicaid drug utilization review board at the next scheduled meeting. New drugs shall be approved for use when such drugs are used within package insert guidelines approved by the federal food and drug administration and clinically reputable compendia, such as the United States pharmacopeia, as approved by the secretary of health and environment in the rules and regulations, during the period before such drugs are reviewed by the medicaid drug utilization review board. 

The secretary of health and environment may not implement permanent prior authorization until 30 days after receipt of comments by the drug utilization review board. 

(b) When considering recommendations from the medicaid drug utilization review board regarding the prior authorization of a drug, the secretary of health and environment shall consider the net economic impact of such prior authorization, including, but not limited to, the costs of specific drugs, rebates or discounts pursuant to 42 U.S.C. § 1396r-8, dispensing costs, dosing requirements and utilization of other drugs or other medicaid health care services which may be related to the prior authorization of such drug. 

Sec. 4. K.S.A. 2014 Supp. 39-7,121b is hereby amended to read as follows: 39-7,121b. 

(a) No requirements for prior authorization or other restrictions on medications used to treat mental illnesses such as schizophrenia, depression or bipolar disorder may be imposed on medicaid recipients. Medications that will be available under the state medicaid plan without restriction for persons with mental illnesses shall include atypical antipsychotic medications, conventional antipsychotic medications and other medications used for the treatment of mental illnesses., except on medications subject to guidelines developed by the drug utilization review board according to subsection 

(c). None of the following shall be construed as restrictions under this subsection: (1) Any alert to a pharmacist that does not deny the claim and can be overridden by the pharmacist; (2) prescriber education activities; or (3) the consolidation of dosing regimens to equivalent doses and other such dose optimization policies. 

(b) The mental health medication advisory committee shall provide recommendations to the drug utilization review board for the purpose of developing guidelines. The drug utilization review board may accept the recommendations of the mental health medication advisory committee in whole and such recommendations shall take effect immediately upon such approval. The drug utilization review board may reject the recommendations of the mental health medication advisory committee in whole and such recommendations shall be referred back to the mental health medication advisory committee for further consideration. No medication guidelines related to mental health medications shall be adopted by the drug utilization review board without recommendations made by the mental health medication advisory committee. 

(c) For the medications used to treat mental illness that are available for use on July 1, 2015, the drug utilization review board shall review all such medications prior to July 1, 2016. For medications used to treat mental illness that do not exist on July 1, 2015, but are later developed or believed to be effective in the treatment of mental illness, the drug utilization board shall review all such medications within six months of presentation to the drug utilization review board. 

(d) The mental health medication advisory committee is hereby established. 

(1) The mental health medication advisory committee shall be appointed by the secretary of health and environment and consist of nine members; including the secretary of health and environment, or the secretary's designee, who shall be the chair of the committee; two persons licensed to practice medicine and surgery with board certification in psychiatry nominated by the Kansas psychiatric society, one of whom specializes in geriatric mental health; two persons licensed to practice medicine and surgery with board certification in psychiatry nominated by the association of community mental health centers of Kansas, one of whom specializes in pediatric mental health; two pharmacists nominated by the Kansas pharmacy association; one person licensed to practice medicine and surgery nominated by the Kansas medical society; and one advanced practice registered nurse engaged in a role of mental health nominated by the Kansas state nurses association. 

All nominating bodies shall provide two nominees for each position for which they provide nominations, with the secretary selecting the appointee from the provided nominees. 

(2) The mental health medication advisory committee shall meet upon the request of the chair of the mental health medication advisory committee, but shall meet at least one time each quarter. 

(3) Members of the mental health medication advisory committee are entitled to compensation and expenses as provided in K.S.A. 75-3223, and amendments thereto. Members of the committee attending committee meetings shall be paid mileage and all other applicable expenses, provided such expenses are consistent with policies established by the secretary of health and environment. 

Sec. 5. K.S.A. 2014 Supp. 39-7,119, 39-7,120 and 39-7,121b are hereby repealed. Sec. 6. This act shall take effect and be in force from and after its publication in the statute book.

March 18th and 19th - the House Health and Human Services Committee hosted hearings on Medicaid Expansion - HB 2319.  Each day, the committee room and hallway were packed with proponents and opponents to the bill.  Many observers do not expect to see any action on Medicaid Expansion during the Veto Session.  Currently, the bill has been referred to the Taxation Committee.

KMHC is cooperating with the Kansas Hospital Association and the Kansas Health Consumer Coalition to promote passage of HB 2319.  Now is the time to weigh in with your legislators and the committee members.

Click Here to read HB 2319.

Click Here to contact House Health Committee Members.  Click on the names.

Click Below to sign the petition to support Medicaid Expansion:

http://www.changekansas.org/action/petition/get-kansans-covered-expand-kancare-medicaid

More Information about Medicaid Expansion:

• KMHC Medicaid Expansion Issue Paper
  
• Kaiser Commission Report - The Coverage Gap: Uninsured Poor Adults in States that do not Expand Medicaid - an Update
  
• KHI Brief - Nearly 182,000 Kansans in the Eligibility Gap
  
• National Women's Law Center - What Medicaid Eligibility Expansion means for Women

If you've been watching the news, you know that the Kansas Legislature has rushed through a bill to change the way that K-12 Education is funded in Kansas.  The bill was introduced last week, inserted into a Senate Bill and passed by Appropriations, passed the full House by Friday, and the Senate voted to concur on Monday.  The bill freezes the current school finance formula and provides for block grants to school district, allowing more flexible use of funds.  It was highly controversial and many schools say it reduces their budgets.  This has opened the way for the Legislature to begin working on its major budget bill for the session.  

Yesterday and today, the House Appropriations Committee has been working through its Mega-Budget bill - combining the agency budget reports and adding amendments.   Today, a proviso offered by Social Services Subcommittee Chair Will Carpenter was adopted to preserve funding for NAMI in the KDADS Budget within existing resources.  The motion was seconded by Rep. Barbara Ballard.  The proviso that has been lobbied by mental health advocates also included funding for Keys for Networking, which had been earmarked for consideration at Omnibus.  Both NAMI and Keys for Networking have been notified that their contracts are ending and the funding will not be retained in its current structure in FY 16 and 17.  New contracts will be made available under an integrated prevention block grant format, but these have not yet been defined and may or may not encompass the services provided by these organizations.  Further advocacy will be needed to assure that the services are preserved and funded.

KMHC is watching this process closely - So far, there has been no effort to alter the Governor’s recommendation to add $1 million each year for FY 16 and FY 17 to expand behavioral health crisis and transitional services in the community.  We are also supporting the Governor's recommendation to retain the $1.9 million from the sale of Rainbow, which KDADS proposes to invest in crisis and transitional services in the community through a revolving loan fund.  

The Committee combined HB 2365 - Judiciary Budget and HB 2366 - Capitol Improvements Budget into HB 2370 the Mega-Budget Bill and passed it.  The bill will probably be debated in the full House next week. 

Last week, advocates testified in support of Sub. for HB 2170 before the Senate Education Committee.  KMHC co-signed joint testimony supporting the bill - read here.  The bill passed the House of Representatives 122-1.

The bill puts into statute rules for the use of seclusion and restraint and includes modifications recommended by the Kansas Association of School Boards.  The language incorporates many of the 2012 recommendations from the United States Department of Education (USDE) and regulations/policy of the Kansas Department of Education (KSDE) in order to improve the current policy in Kansas and to better ensure the safety of children and teachers in public schools. 

• The USDE recommendations are minimal standards.  The USDE acknowledges in its report that schools and states “may choose to exceed the framework set by the 15 principles” which make up its recommendations (see pages 12-13, “Restraint and Seclusion: A Resource Document,” USDE, 2012).
• One key USDE recommendation the bill includes is standard of use for restraint and seclusion.  The bill clarifies the currently nebulous standard by adding the USDE language of threat of “serious physical harm to self or others.”  

Rocky Nichols, Disability Rights Center, has been coordinating this effort.  He believes the language of the bill is a middle ground between what the advocates and parents would prefer and reasonable language for the schools to implement.  The bill does not include all of the minimal standards and recommendations of the USDE report because it is a "fair compromise".    

 

However, there may be some opposition to the current language.  It is not clear when the bill will be worked by the Senate Education Committee.

 

Click here to contact members of the Senate Education Committee.  Simply click on the names of committee members.

Republican-controlled committee offers Medicaid expansion bill

Beneficiaries could be required to work, under proposal 

Posted: February 9, 2015 - 10:37am By Jonathan Shorman jonathan.shorman@cjonline.com 

A Republican-controlled House committee put forward legislation Monday to expand Medicaid in Kansas, offering a proposal that would use no state general funds but could require recipients to either work or volunteer. 

The legislation expands the KanCare program – the state’s managed care program – to include individuals earning up to 138 percent of the federal poverty level. That’s the income threshold that will allow Kansas to receive additional federal funding to help pay for part of the cost of expansion. 

The legislation sets out to help extend coverage to approximately 169,000 people, and collect about $2.2 billion federal funds between 2016 and 2020. 

A number of moderate Republicans sit on the House Vision 2020 Committee, which put forward the bill after hearings on Medicaid expansion. The committee chairman, Rep. Tom Sloan, R-Lawrence, said the legislation attempts to balance the “political realities” within the state through the a requirement in addition to financial realities.

“It balances the need to pay for this expanded service without going into the state general fund because there is no money there,” Sloan said. 

Sloan said he hopes the bill is referred to a House Appropriations subcommittee that will keep the discussion going and the bill alive. 

The proposal works by establishing a health care administrative support fee on hospitals, safety net clinics and other recipients of federal or state health care reimbursements to help pay for it. 

The secretary of health and environment would also be tasked with creating a concierge-like statewide pilot program for KanCare beneficiaries and promoting tele-health monitoring for individuals with chronic conditions and individuals with disabilities.

The plan also calls for health care outcomes to be analyzed quarterly by the KU Medical Center to identifying the most successful patient treatment, monitoring and education programs in improving cost-effectiveness in terms of health outcomes. 

In addition, the secretary would be allowed -- but not mandated -- to require a work component for ablebodies beneficiaries. The work could include volunteering. 

Sloan said the bill directs the administration to seek any necessary federal waivers to allow the state to receive additional federal funding. Sloan said he has spoken with the federal Health and Human Services Administration about the plan. “They were very pleased that the Legislature is looking at expanding,” Sloan said. 

Sean Gatewood with the Kansas Health Consumer Coalition indicated he is receptive to the proposal. Gatewood said he appreciated any opportunity that creates conversation about insuring more Kansans. He said he is still getting up to speed on all the details, but did express some concern about potential work requirements and how they would interact with federal regulations. “So I’ve got some questions as to if that would work, things like that. But any attempt I’m extremely grateful for. Getting a new bill in the hopper makes a good day for me,” Gatewood said. 

The proposal comes after Rep. Jim Ward, D-Wichita, introduced his own plan last month to expand Medicaid. The Democratic proposal is unlikely to gain traction in the Republican-dominated Legislature. Rep. Pam Curtis, D-Kansas City, is the ranki

For years, mental health advocates have opposed managed care restrictions that could stand between mental health consumers and their preferred medications. This year, the state agency that oversees Kancare (Kansas' Medicaid program) is recommending the Kansas Legislature repeal the law that exempts mental health medications from prior authorizations or preferred drug lists.

A bill was introduced Thursday, Jan. 29th, in the Senate Public Health Committee to repeal the law that exempts mental health medications from prior authorizations or preferred drug lists. The language is not yet available but should be published soon.

Governor Brownback has made a mental health drug formulary part of his proposed budget. An article at KHI.org cites state officials estimate the repeal could save the Medicaid program more than $8 million - a surprising assessment since one of the most cited high cost medications will have a generic alternative in the next few months, whether or not the law is repealed.

Coalition members expressed their concerns about this proposal to Kari Bruffett, KDADS Secretary, at the January KMHC Meeting. The Secretary indicated an interest in receiving recommendations from Coalition members if an appropriate process can be identified. At this point, KDADS and KDHE are recommending the statute be repealed, citing the need to have full flexibility to implement prior authorization rules (PAs) and safety edits without any restrictions. It is unclear if a Preferred Drug List is intended. The Secretary also expressed an interest in deleting the prohibition for step therapy. In testimony to the Legislature, Secretary Mosier, KDHE, has indicated that they were not planning to change medications for individuals with chronic and persistent mental illness who are already on a successful medication plan. The rules for this exception would need to be developed. READ THE KHI ARTICLE.