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Louisa-Lawrence Co, KY

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April 7, 2018

FRANKFORT – The state Senate gave final passage today to a bill intended to ensure independent pharmacists are fairly reimbursed for filling prescriptions of Medicaid recipients.

“The (amendment) gives the Kentucky Medicaid department clear authority to police pricing terms and contracts while we are not in session,” Sen. Max Wise, R-Campbellsville, who sponsored the legislation said.“The (amendment) gives the Kentucky Medicaid department clear authority to police pricing terms and contracts while we are not in session,” Sen. Max Wise, R-Campbellsville, who sponsored the legislation said.


Senate Bill 5, as amended by the House, would make the Kentucky Department for Medicaid Services in charge of setting the reimbursement rates for a pharmacist. The rate is currently set by pharmacy-benefit managers (PBMs) hired by the state’s Medicaid managed-care organizations (MCOs).

“As many of you know, the Kentucky legislature has spent an inordinate amount of time over the past several sessions of the General Assembly trying to play the role of policeman between PBMs and pharmacists,” said Sen. Max Wise, R-Campbellsville, who sponsored the legislation. “The (amendment) gives the Kentucky Medicaid department clear authority to police pricing terms and contracts while we are not in session.”

He said Kentucky Medicaid spends $1.7 billion annually on prescriptions and SB 5 would help authorities track that money and determine whether locally-owned pharmacies were being reimbursed fairly.

Another provision would allow the state Medicaid and insurance departments to issue penalties if a PBM fails to comply with the legislation.

“This bill ... truly is a very transparent bill,” Wise said, adding SB 5 may become a model for the nation.

Independent pharmacies in several states have claimed in recent months that PBMs owned by national pharmacy chains are not fairly reimbursing them. The dominate PBM in Kentucky, for example, is only paying independent pharmacists a professional dispensing fee of 85 cents per prescription, Wise said. The Centers for Medicare and Medicaid Services states that fee should be around $10.64, plus the cost of the drug being dispensed.

The measure passed by a 37-0 vote.


April 7, 2018



As part of a larger tax bill, the Kentucky General Assembly voted April 2 to increase the state’s cigarette tax by 50 cents, to $1.10 per pack. That fell short of the $1 increase wanted by health The increase is estimated to generate about $132 million in 2019, and decline to $112 million in 2020, apparently on the fact that smokers are dying off and a belief that the tax hike will make some of them quit.The increase is estimated to generate about $132 million in 2019, and decline to $112 million in 2020, apparently on the fact that smokers are dying off and a belief that the tax hike will make some of them quit.advocates, who bemoaned “a missed opportunity” to improve the health of Kentuckians. And in the final hours, legislative leaders dropped a plan to tax electronic cigarettes.

Still, the advocates said the tax increase is historic.

“It’s the biggest increase in Kentucky history, and there is something to be said for that,” said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky. “Having said that, I think it’s apparent to anybody who knows anything about this that it’s not going to get the health benefits that we had been seeking . . . and that’s a missed opportunity.”

And that’s “a huge understatement,” said Amy Barkley, a regional advocacy director for Campaign for Tobacco-Free Kids. “They voted for a tax increase that is just a tax increase,” she told Kentucky Health News after a news conference with Chandler.

Barkley’s group is part of the Coalition for a Smoke-Free Tomorrow, a group of more than 150 organizations chaired by Chandler. It argued that unless the price of a pack of cigarettes goes up by at least $1, tobacco companies can keep smokers hooked by giving discounts to retailers and coupons to consumers, and then gradually raise the price to make up the difference.

Chandler said the “price shock” of a $1 increase would have led to more than “50,000 people here in Kentucky either quitting or not starting.”

At 26 percent, Kentucky has the second highest smoking rate in the country. It also has the nation’s highest cancer rate, and cancer death rate. Chandler has often said that this is not a coincidence, since 34 percent of Kentucky’s cancer deaths are related to smoking.

“We are the cancer capital of this country and we’ve got to do something about it. . . . and I think every method available ought to be on the table to try to do that,” he said.

Despite the coalition’s lobbying and a recent poll that found nearly 70 percent of registered voters would support a $1 cigarette-tax increase, a 50 cent hike was the best the lawmakers could do. After the House passed it, the Senate rejected it, but after the House passed a surprise pension-reform bill, the Senate accepted the tax as part of a package of tax cuts and increases.

“We failed to make our case, or Philip Morris made theirs better,” Barkley said. The Altria Group subsidiary’s chief state-government lobbyist met with top legislative leaders in an effort to make sure the tax didn’t include smokeless tobacco (made in an Altria plant in Hopkinsville) or electronic cigarettes, in which the company has invested.

“It’s really discouraging, to say the least, that legislators continually yield to the tobacco industry, which we know no longer fights for no tobacco increase,” Barkley said. “They fight for a low tobacco increase that they can manage by doing the discounting and so forth.”

One version of the tax bill included a 15 percent tax on electronic cigarettes, which are now more popular among teenagers than cigarettes, but was removed before the final vote. — apparently not long before, because the list of effective dates for various provisions mentioned both cigarettes and e-cigarettes. One clause in the bill excludes e-cigs from the definition of cigarettes.

John Cox, spokesman for Senate Republican leaders, declined to say why the late changes were made, and Philip Morris declined to comment. Rudy didn’t return an e-mail seeking comment.

The tax measure, House Bill 366, narrowly passed the Senate 20-18 and out of the House 51-44, with no Democrats voting for it. Its main sponsor, House Appropriations and Revenue Committee Chair Steven Rudy, R-Paducah, said during his April 2 floor pitch that the 50-cent tax hike on cigarettes would improve Kentuckians’ health.

The increase is estimated to generate about $132 million in 2019, and decline to $112 million in 2020, apparently on the fact that smokers are dying off and a belief that the tax hike will make some of them quit.

Asked if a 50 cent hike was better than nothing, Chandler said the foundation’s view is that “It is better than zero,” but also said there are differences of opinion inside the coalition.

For example, Barkley said in an email, “Nothing would have been better from a health standpoint because we have lost our chance. They aren’t going to raise it by $1 or more so soon after the 50 cents.”

Chandler said the coalition and the foundation would keep working for a higher tax. “We don’t believe that it’s over because that’s not been the history of the cigarette tax in Kentucky,” he said, noting that this is the third time the cigarette tax has been raised since the last 20 years. “I don’t think it’s accurate to say that once you’ve had an increase somehow it’s over.”

Chandler said the foundation supports the increase because it raises revenue, which is often spent on things that improve “social determinants of health,” like providing school transportation. “It’s a good thing for health to have added revenue,” he said.

He said the foundation will also continue to work on tobacco-cessation efforts and “ramping up our efforts” on local smoke-free policies.

This is the first year the foundation has actively lobbied. Tom Loftus of the Louisville Courier Journal reported the foundation was the second-largest spender on lobbying for the first two months of the session, at $107,336, and that Altria spent “far more” than any other lobby, spending $156,000.

Asked why the foundation had made a shift to lobbying, Chandler said, “We believe that you can make a bigger impact on health through getting the government to act in certain ways, and adopt certain policies to get their people to be healthy, than you can by simply making grants and through solely philanthropic efforts. . . . We believe that we can have an outsize impact, we can punch above our weight if we are active in public policy matters.”

By Melissa Patrick
Kentucky Health News


March 26, 2016

Celebrate the great work of practitioners, educators...

By Jay Miller and Ann Vail

University of Kentucky

March is designated Social Work Month. Since the 1960s, this month has been marked as a time to celebrate the significant work of social work practitioners, educators, researchers and students.
Social work has a rich and storied history. The foundational impact of Jane Adams’ Hull House, and Mary Richmond’s Charity Organization Societies has reverberated through the decades. The pioneering legacies of social workers like Dorothy Height and Kentucky native Whitney Young, Jr. continue to positively shape people’s lives. These early influences engendered a profession committed to ethical standards and competent practice, with a vision of a just world for all persons.

Today, as has been the case historically, social workers provide services germane to healthy, safe and well-functioning communities. Whilst mostly unheralded and sometimes misunderstood, social workers are a central component of societal well-being. In countless ways, social workers activate our primary mission “to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.”

In fulfilling our mission, social workers are at the forefront of addressing many of the inimical social ills plaguing society. Whether dealing with the substance misuse epidemic plaguing parts of Northern and Eastern Kentucky, the effects of the tragic school shooting in Marshall County, or the deleterious violence plaguing Kentucky cities, social workers are educated and trained to adeptly respond to and assuage the impact of these problematic circumstances. Indeed, one would be hard-pressed to find a professional human service not impacted by social work.
Social work professionals are employed in hospitals, schools, nursing homes, rehabilitation facilities, veterans’ centers and mental health agencies, among other settings. Social workers use a broad range of skills, consistent core values, and systemic knowledge to fulfill varied roles, including advocacy, therapy and administration. Moreover, social workers are at the helm of some of Kentucky’s venerable service institutions, such as the Center for Women and Families, Volunteers of America-Mid-States, and Catholic Charities of the Diocese of Lexington, to name a few.
Furthermore, social work educational programs at the state’s colleges and universities are conducting cutting-edge research aimed at ameliorating social problems, thus, improving the social conditions that impact individuals’ lives.

Today, social work, as a profession, remains steadfastly committed to its mission. And perhaps now, more than ever, our society needs this commitment. In an era of divisiveness and uncertainty, people can find solace in the fact that social workers continue to advocate, broker and serve the most vulnerable among us. Assuredly, the resolve of social work endures. 

So now, we issue a clarion call to all Kentuckians: Take time to celebrate and honor the work and contributions of social workers – not just this month, but every month. Because, although the months may change, social workers will continue to steadfastly answer the call to meet the needs of Kentuckians, strengthen our communities and “enhance human well-being.”