Doctors give nurse practitioners more leeway on prescriptions; senator says tort-reform lobbies should play hardball with money

"Concerns about a growing doctor shortage, especially in rural Kentucky, is fueling the urgency for lawmakers and medical groups to agree on an approach to allow nurse practitioners to be able to prescribe certain medicines without physician supervision," Ryan Alessi reports for cn|2's "Pure Politics."

Advanced-practice registered nurses want the legislature to free them of the requirement that they have an agreement with a physician in order to prescribe non-narcotic drugs. The House passed a bill to do that this year, but it stalled in the Senate. Now, "I believe that they have a resolution to that," Senate President Robert Stivers said at the Kentucky Hospital Association's annual health leadership conference Thursday in Louisville.

Stivers, a Republican from Manchester, said Sen. John Schickel, R-Union, has been negotiating with the nurse practitioners and the doctors' lobby, the Kentucky Medical Association. He indicated that the compromise would include an initial four-year period in which an agreement would be required, but with measures to help nurse practitioners and doctors reach such agreements. Schickel didn't immediately return a call seeking comment.

Stivers said he favored the bill that failed. "In rural areas, I believe nurse practitioners are part of the solution for lack of access" to medical care, he said. The access problem is expected to grow as thousands of Kentuckians gain health insurance or Medicaid coverage under federal health reform.

Also at the KHA meeting, Sen. Julie Denton, R-Louisville, chair of the Senate Health and Welfare Committee, said the hospital, doctor and nursing-home lobbies should refuse to give campaign contributions to any legislators who won't support their efforts for tort reform -- the latest attempt at which would create review panels for medical-malpractice lawsuits. The panels could not block the suits, but their findings could give defendants more advantage in settlement negotiations.

Denton's co-panelist, Rep. Jimmie Lee, D-Elizabethtown, chairman of the House budget subcommittee for health, took umbrage at the idea of such a policy for the lobbies' political action committees.

"It's very scary to me, that if you don't give me a PAC check, I'm not going to vote with you, or if you give me one, I'm going to vote with you," Lee said. "That's scary, folks, that your PAC check is going to determine how Jimmie Lee votes."

Denton said it was unfortunate that Lee portrayed campaign money as "influencing your vote or buying your vote. I don't consider you giving a PAC check as trying to buy somebody's vote or influencing it." Lee smiled gapingly in disbelief, and said in rebuttal, "You're saying, don't give 'em any money because they didn't vote with you."

House Speaker Greg Stumbo said on the earlier panel that there is no proof that such measures reduce malpractice and insurance costs, but Stivers, also a lawyer, said the fear of lawsuits results in many unnecessary diagnostic procedures. "I've tried a lot of these cases, and I've seen it," he said. "C.Y.A."

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