The Kentucky Medical Association has been attacked by the Kentucky attorney general and others — including the Herald-Leader editorial board — over the association's stance on recent legislation concerning prescription drugs. Physicians certainly recognize that there is a prescription drug problem in Kentucky, and we stand on the front lines in this battle.
Actions addressing this issue should be carefully balanced among the needs of law enforcement and patient privacy and the need to appropriately treat legitimate pain. That balance is difficult to find; that is why we wanted to be engaged with everyone in this process.
Unfortunately, in a desire to pass something, many did not consider the details of proposed legislation, and many of the details were extremely troublesome.
Most troubling were the proposed infringements on patient privacy through access to the state's Kentucky All Scheduled Prescription Electronic Reporting, or KASPER, system, which contains what is essentially a log of all of the controlled substances an individual has bought.
A controlled substance is not just what many people have characterized as "pain medicine." It also includes prescriptions for medicines for anxiety, depression or attention deficit disorder.
Attorney General Jack Conway wanted control of KASPER and access to the data so it could be used as a law enforcement tool, and House Bill 1 would have done just that.
Over 10 years ago, Congress passed federal privacy legislation commonly known as HIPAA, which does not allow medical professionals to release sensitive patient data without patient authorization. House Bill 1 wanted to move in the opposite direction. It would have opened KASPER data to a host of individuals who could have accessed it without a court order or protocols set out in the bill.
All the KMA desired was that the bill contain the same level of protections provided to sensitive patient information that medical professionals must provide.
Other proposed legislation had specific privacy protections. For example, one bill contained a requirement that there be a log of any government employee who accessed KASPER.
That is a reasonable and valuable patient protection. Unfortunately, House Bill 1 stripped out that simple requirement because, as Conway said, it "watered down" the bill.
If support for such provisions is watering down a bill, KMA was proud to stand as an ocean of reason as we tried to dilute the attempts to trample on basic patient privacy. Thankfully, others agreed and that part of the law did not pass.
The devil was in the details, and many chose to ignore the details. We did not.