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State Sen. Jimmy Higdon admits that he didn't think "pill mills" were a big concern until one of them showed up in Lebanon last year.
"There had been bills before, but I had never really been sympathetic to it," he said.
Lebanon Medical Solutions wasn't open very long, but it was long enough to get Higdon's attention. He filed a "pill mill bill" during the 2011 session of the General Assembly, but the bill didn't get enough traction to get through the legislature.
Higdon said Bill Doll of the Kentucky Medical Association spoke to him about the bill and explained that Higdon's 2011 bill wouldn't have done what he intended, that is making it difficult for anyone to operate a pill mill in the state.
Actions by other state legislatures also affected Higdon's decision.
"About the time our session ended, Florida and Ohio passed pill mill bills, so it left Kentucky with the door open for them to come here," he said.
Prescription drug abuse has been a growing concern statewide. In August, Gov. Steve Beshear and Attorney General Jack Conway announced a joint Interstate Prescription Drug Task Force with Ohio, Tennessee and West Virginia.
During the summer, Higdon met with representatives of the Kentucky Board of Medical Licensure, the Office of the Inspector General and Kentucky League of Cities to rework the pill mill bill. The revised bill, BR 188, has been prefiled for the 2012 session of the Kentucky legislature.
"There's a lot of people interested in making these pills harder to get," Higdon said.
One of the issues in the law was creating legislation that allowed room for legitimate pain clinics, which offer a a variety of remedies for dealing with pain, such as physical therapy and surgery in addition to prescription medication when needed. In contrast, pill mills generally to deal in cash and only prescribe pain medication, usually in high doses.
During the time Lebanon Medical Solutions operated, Higdon said anyone with an MRI and $200 could get 100 pills at the clinic.
Dr. Najam Azmat, the same doctor who was affiliated with Lebanon Medical Solutions, is now the physician at Lexington Algiatry, which has the same diagnostic and cash requirements. The Lexington Herald-Leader reported earlier this month that Azmat is now under investigation by the Kentucky Board of Medical Licensure.
Under Higdon's proposed legislation, a "pain management facility" is a facility where the primary practice is treating pain or chronic pain and a majority of the patients are provided treatment that includes the use of controlled substances or other drugs. The law specifically excludes hospitals; school, college, university or educational programs; hospice programs; and ambulatory care facilities.
As written, the proposed legislation would require anyone operating a pain management facility to first obtain a license. They would also be required to be owned and operated by one or more physicians, but that physician cannot operate a pain management facility if his or her Drug Enforcement Administration number has ever been revoked, his or her application to prescribe a controlled substance has been denied in any jurisdiction, or he or she has been convicted of a felony. All employees of a pain management facility would be required to submit their criminal records to the medical licensure board.
The bill would also require the board to establish a number of requirements for pain management facilities, including license fees, procedures for maintaining patient records, and inspection procedures, data collection and reporting requirements for the facilities.
Higdon is also more confident that his bill will win support during the 2012 session.
In addition to the recent task force announcement by Beshear and Conway, Kentucky Speaker of the House Greg Stumbo has spoken in support of Higdon's bill.
"It should be one of the first bills we pass," Higdon said. "It's one of the bills that needs to be done."