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A
A
A
C
You
Mr
chairman,
thank
you.
Honorable
members
of
the
health
committee
on
the
Senate
I,
truly
appreciate
the
opportunity
to
come
before
you
today.
I
am
representative
Brandon
Reed
I
represent
the
24th
house
district.
That's
green
heart
in
LaRue
counties.
I
do
have
a
distinguished
guest
with
me
today.
I
will
allow
her
at
this
time
to
introduce
herself
with
the
record
good.
C
Mr
chairman
members
of
the
committee,
HP
75,
is
aimed
at
improving
access
to
the
Quality
Health
care
for
each
and
every
Kentuckian,
as
well
as
serving
as
a
Lifeline
to
rural
hospitals
serving
communities
throughout
our
Commonwealth
with
HP
75.
Now
Grant
access
to
hospitals
to
be
reimbursed
for
outpatient
services,
hospitals
will
be
able
to
harness
Federal
resources
while
using
no
State
funds.
This
measure
simply
Builds
on
legislation
like
the
chairman
referred
to
earlier.
We
approved
back
in
2019
and
2021
with
House
Bill
183
and
provides
an
additional
opportunity
to
harness
Federal
resources.
C
D
Thank
you
so
much
again,
chairman
Meredith,
for
allowing
me
just
to
make
a
couple
brief
comments
about
the
need
for
this
bill.
It's
very
critical
to
support
our
hospitals,
because
our
hospitals,
as
I've
testified
in
front
of
your
Committee
in
the
past,
are
really
facing
skyrocketing
expenses
and
the
revenues
just
are
not
there
to
cover
that
and
I
wanted
just
to
let
everyone
know
that
today,
a
new
report
is
coming
out
by
Kaufman,
Hall
and
Kaufman.
Hall
is
a
national
management
consulting
firm.
D
They
do
National
reports
on
the
state
of
Hospital
finances,
and
so
we
contacted
them
and
asked
them
if
they
would
do
a
report
just
for
our
state,
and
so
that
is
what
is
being
released
today
and
I
just
wanted
to
let
everyone
know
that
report
is
echoing
what
we
have
been
saying
all
along
and
basically
the
report
founded
in
2022
Kentucky
hospitals
face
their
most
challenging
year.
Financially,
since
the
start
of
the
pandemic,
they
found
that
inflation
record
high
operating
costs
and
lower
patient
volumes
led
to
unprecedented
Financial
losses.
D
They
found
that
38
percent
of
the
state's
hospitals
are
at
risk
of
closure.
A
couple
of
the
other
highlights
operating
expenses
for
our
hospitals
increase
4.2
billion
since
2019
labor
expenses
increased
approximately
3
billion,
the
hospital
spent
1.2
billion
more
in
contract
labor
in
2022
than
they
did
in
2019
prior
to
the
pandemic.
D
We
can't
pass
those
costs
along,
and
so
the
result
is
that
Kentucky
hospitals
ended
2022
with
a
negative
operating
margin,
equal
equaling,
a
loss
of
more
than
a
quarter
billion
dollars,
and,
what's
really
important,
is
that
those
losses
occurred
despite
having
the
inpatient
atrip
program
and
so
had
we
not
had
the
inpatient
Atria
program
in
2020
two,
the
losses
would
have
been
much
greater.
In
fact,
according
to
this
study
that
would
have
exceeded
1.3
billion
dollars,
so
this
bill
is
very
critical.
D
C
A
D
D
A
If
it
hadn't
been
for
HB,
183
I'm
sure
that
number
would
have
been
even
greater
but
I
think
from
a
lot
of
the
facilities
that
that
was
going
to
be
Saving,
Grace
for
them
and
I
heard
from
a
lot
of
hospitals
that
they
were
thrilled
to
have
that
additional
reimbursement,
but
I,
guess
that
that
exuberance
is
short-lived
when
you're
faced
with
the
kind
of
inflationary
pressures
we're
dealing
with
right
now.
So
even
with
the
passages
bill,
which
I
think
is
critical
for
all
health
care
providers,
foreign.
E
A
F
B
A
All
right
bill
passow
was
an
unanimous
consent,
we'll
proceed
them
for
with
favorable
expression,
and
you
know
I
would
ask
for
a
consent
on
this
one.
But
folks,
I
really
would
like
to
be
able
to
speak
about
this
on
the
senate
floor,
because
I
think
we
need
to
make
people
aware
that
to
how
critical
the
situation
is
and
I
Envision
that
when
we
come
back
in
2024,
we'll
need
to
try
to
examine
other
measures.
That
Couldn't
address
the
situation
but
appreciate
you
being
here
this
morning
and
thank.
A
A
For
those
of
you
who
are
not
new
to
this
committee,
we
heard
this
topic
during
the
interim
a
great
presentations
on
a
lot
of
different
folks
apart.
It's
a
very
interesting
subject
matter
with
that
representative
Moser
I'll
refer
to
you.
If
you
would
identify
yourself,
the
record
feel
free
to
proceed.
E
E
I
E
All
right,
thank
you.
I
appreciate
the
opportunity
to
be
before
you
today
and
thanks
to
the
committee
for
hearing
this
bill,
this
house
bill
180,
is
about
getting
the
right
treatment
to
the
right
patient
at
the
right
time.
It
saves
precious
time,
it
saves
health
care
costs
and
it
saves
lives.
So
what
you
know
the
problem
is
that
most
of
us
have
been
touched
by
cancer.
E
What
this
does
is
targets
their
biomarker
identifies
the
patient's
biomarker
and
will
will
identify
Precision
treatment
for
their
cancer.
There's
current
currently
limited
and
disparate
access
to
this
biomarker
testing
because
of
a
lack
of
insurance
coverage
for
everyone,
but
especially
in
the
minority
and
poor
and
Rural
populations.
The
fiscal
impact
study
returned
saying
that
this
is
not
expected
to
materially
increase
premiums
or
the
cost
of
Health
Care
in
the
Commonwealth
oftentimes.
E
E
I
I
have
some
brief
remarks
and
a
few
slides,
I'd,
like
to
start
out
by
letting
you
know
about
the
difference
between
somatic
and
inherited
somatic,
is
something
that
is
only
in
the
cancer.
Where
inherited
is
going
to
be
passed
down
from
children
down
to
your
children.
Approximately
90
of
cancers
are
caused
by
somatic
mutations
and
another
10
percent
are
caused
by
these
inherited
mutations,
and
it's
very
critically
important
that
we
are
able
to
understand
what
these
mutations
are,
because
it
help
us
helps
us
select
the
correct
treatment
for
patients
as
well
as
prevents
adverse
effects.
I
I'd
like
to
next
show
you
how
far
we've
come
since
we've
known
about
biomarkers,
for
those
of
you
who
are
not
used
to
looking
at
these
survival
curves
every
day.
100
means
a
hundred
percent
of
the
patients
are
still
alive
and
40
means
a
time,
and
so
looking
at
the
at
the
left
panel
in
2002,
the
median
survival
for
with
for
patients
diagnosed
with
non-small
cell
lung
cancer
was
eight
months,
and
it
didn't
matter
what
treatment
you
use.
They
all
turned
out
to
be
about
the
same
now,
jumping
ahead.
I
I
Let's
take
a
little
dive
into
what
we
are
seeing
more
commonly
in
Kentucky
what
this,
what
this
slide
is
showing
you
is
that
the
rate
of
testing
is
low.
There
are
a
variety
of
reasons
for
that,
including
the
lack
of
insurance
coverage
and
patients
who
are
unable
to
access
this
treatment
have
poorer
survival.
The
other
thing
that
we
know
is
that
if
you
are
living
in
Appalachia
or
you
have
Medicare
Medicaid
Insurance,
you
are
also
less
likely
to
receive
this
testing.
I
G
G
At
diagnosis,
they
wanted
to
treat
me
with
chemotherapy
and
immunotherapy,
which
would
have
been
the
standard
course
of
treatment
for
a
typical
lung
cancer
patient.
My
on-call
at
different
oncologists
recommended
that
we
do
biomarker
testing.
So
my
biomarker
testing
revealed
that
I
have
the
egfr
Exxon
19
genetic
marker,
which
qualified
me
for
targeted
therapy
instead
of
traditional
chemotherapy
which
increased
my
life
expectancy.
G
You
know
by
five
years,
so
I've
have
less
side
effects,
less
less
severe
heart
and
hard
side
effects.
I
exercise
six
days
a
week,
I
have
three
kids,
I
run
them
everywhere,
and
I
live
a
pretty
normal,
healthy
life
for
someone
with
stage
four
metastatic
cancer
without
biomarker
testing.
Obviously
we
heard
from
Dr
collesser.
G
My
outcomes
would
have
been
much
less
I
feel
this
bill
is
extremely
important,
not
just
for
people
like
me
that
are
educated
and
have
access
to
this
testing,
but
all
all
kentuckians,
no
matter
their
age,
their
race
or
their
economic
status,
because
it
is
life-changing
and
life-saving
for.
For
many
of
us.
E
H
Sure
I
could
say
a
few
brief
comments
based
on
my
experience.
I've
been
in
family
medicine
for
36
years
now,
and
I've
seen
a
lot
of
patients
with
cancer
and
dealt
with
them
and
their
families,
and
it's
always
been
a
very
difficult
conversation.
That
conversation
has
gotten
a
lot
easier
over
the
last
10
years
or
so.
We've
made
tremendous
progress
with
all
types
of
cancer
and
a
lot
of
that
progress
has
been
based
on
biomarker
testing,
either
through
liquid
biopsies,
which
are
blood
tests
or
through
tissue
biopsies.
H
H
It
moves
quickly
through
the
stages
and
unfortunately,
it's
often
not
found
until
it's
late
in
the
course
of
the
disease,
we're
going
after
it
now
through
our
lung
cancer
screening
program
or
finding
it
early
and
making
a
big
difference
for
the
state
of
Kentucky
and
for
our
country,
but
even
when
we
find
cancer
in
the
late
stages
stage,
three
and
stage
four.
The
message
is
very
different
now
than
it
was
just
10
of
15
years
ago
we
have
patients
now
that
are
living,
5,
10,
15,
20
years
with
stage
3
and
stage
four
lung
cancer.
H
When
I
was
in
practice
just
10
or
15
years
ago,
when
we
saw
a
patient
that
had
stage
three
or
four
lung
cancer,
we
felt
that
it
was
unlikely
that
they
would
be
alive
a
year
later.
50
percent
of
the
people
that
present
with
stage
four
lung
cancer
or
with
any
type
of
lung
cancer,
do
not
survive
more
than
a
year
with
the
Advent
of
biomarker
testing
and
targeted
therapy
through
Precision
medicine
and
through
immunotherapy.
H
We
are
making
a
big
difference,
and
the
family
of
lung
cancer
survivors
is
growing
in
numbers,
their
voices
are
getting
louder
and
stronger
and
I
and
many
others
stand
with
them
and
feel
that
this
type
of
progress
should
be
available
for
all,
and
not
just
for
some
and
that's
what
this
bill
is
about.
Thank
you.
E
Thank
you,
Dr,
gieski
and
I'll.
Just
close
with
this
is
a
standard
of
care.
It's
just
not
being
covered
by
insurance
companies.
This
is
really
cutting
edge
treatment
that
Kentucky
needs
to
get
on
board
with.
We
are
number
one
in
the
nation
for
lung
cancer
and
we
have
to
change
that.
So
that's
what
this
does
and
I
would
appreciate
your
support.
A
J
And
thank
you
and
Leah
thank
God.
Those
three
kiddos
are
blessed.
Is
this
treatment
also
commensurate
with
the
patient's
commitment
to
their
own
recovery
or
or
their
own?
When,
when
I
hear
that
you're
working
out
six
days
a
week,
is
patient
compliance
going
to
also
be
a
factor
in
whether
this
biomarker
testing
is
effective
for
one
patient,
if
they're
non-compliant
versus
Leah's
commitment
to
be
very
committed
to
your
own
health
and
Improvement
and
I,
don't
know
that
that's
a
question
for
you
Lee.
It
might
be
more
of
a
question
for
our
oncologist.
H
Yeah
I
can
I
mean
I
could
certainly
add
to
that
patient
compliance
is
very
important.
As
we
know,
cancer
has
many
etiologies
and
factors
in
both
the
diagnosis
and
the
response
to
treatment.
Anyone
that
exercises
eats
well
and
takes
care
of
themselves
is
going
to
be
much
more
likely
to
do
better
with
their
cancer
treatment
if
they
quit
smoking,
for
example,
reduce
drinking
reduce
weight.
G
And
I
would
say
too
the
targeted
therapy
that
I'm
on
typically
has
a
Effectiveness
for
two
to
three
years.
I've
been
on
it
a
little
bit
over
three
years.
When
my
it's
not
a
matter
of.
If
my
cancer
will
progress,
it
is
when
it
when
will
it
progress,
I
will
have
to
have
biomarker
testing
re-performed
to
see
if
I
have
any
new
genetic
mutations.
G
That
would
qualify
me
for
additional
targeted
therapies
that
could
be
either
added
to
the
one
that
I'm
currently
on
or
added
with
traditional
chemo,
in
order
to
prolong
my
life
even
longer.
So
for
those
of
us
that
are
stage
four
that
you're
never
going
to
be
truly
cured
stable
is
what
we
hope
for,
or
no
evidence
of
disease.
Then
we
need
this
biomarker
testing
to
be
able
to
receive
the
next
best
treatment
line
of
treatment.
As
we
go
down
our
journey
of
this
cancer
diagnosis.
J
And
this
is
me
trying
to
learn
a
little
better,
the
legislative
process
as
well,
that
if
we
we
were
talking
just
before
you
about
the
affordability
of
costs
and
such
but
sometimes
I,
wonder
whether
we're
spending
dollars
on
a
path
that
a
person's
not
even
committed
to
being
on
that
path.
But
yet
they've
been
placed
on
that
path
because
their
insurance
might
cover
it,
but
they
haven't
necessarily
been
committed
to
that
path
of
health
or
Improvement
or
or
treatment.
J
E
Improvement
like
yeah
and
I
I
think
I
understand
your
question.
You
know
when,
when
a
patient
is
diagnosed
with
cancer,
I
think
it's
It's
Our
obligation
to
offer
the
best
treatment
and
part
of
that
is
in
doing
this
testing.
We
can't
require
that
a
patient
comply
with
their
treatment.
Certainly,
cancer
patients
are
worn
out
by
the
end
of
some
of
their
treatment.
My
mom
was
that
way
after
three
years
she
said
I've
had
enough.
E
I
think
that
if
a
patient
is
diagnosed
with
this
serious
disease
and
they
are
going
to
through
the
steps
of
getting
biomarker
testing,
they're
likely
going
to
be
very
worried
about
their
situation
and
they
are
going
to
do
everything
they
can
to
be
compliant.
So
you
know,
I
I
know
that
there
are
reasons
why
we
think
that
patients
aren't
being
compliant.
Maybe
they're.
You
know
having
a
hard
time
quitting
smoking
in
Leah's
case.
G
And
being
on
targeted
therapies,
do
give
you
less
harsh
side
effects,
so
I
physically
feel
good,
whereas
I've
met
other
patients
who
are
on
traditional
chemo
and
they
are
so
sick.
They
couldn't
work
out
if
they
wanted
to.
Whereas
since
I've
been
given
this
gift
of
feeling
semi-normal,
then
I
can
take
advantage
of
that
to
help
myself
as
best
I
can,
whereas
someone
who's
on
traditional
therapies
may
not
have
that
luxury
because
they
physically
their
bodies,
just
can't
do
it.
A
F
K
F
M
H
Yeah
we're
truly
entering
a
Renaissance
in
the
treatment
of
cancer.
You
just
speak
about
lung
cancer.
For
example,
just
10
years
ago,
50
of
the
non-small
cell
lung
cancers
that
were
biopsied
had
a
targetable
mutation.
Today,
90
of
the
non-smel
small
cell
lung
cancers
that
are
biopsied
have
a
targetable
mutation,
so
we
can
use
Precision
medicine
to
Target
those
mutations
and
get
the
results
that
we're
seeing
here.
This
is
happening
with
many
other
types
of
cancers.
Lung
cancer
has
led
the
charge.
It's
there's
a
lot
of
lung
cancer.
H
I
So
I
could
just
give
a
specific
example
of
something
something
that
happened
in
January
and
breast
cancer.
A
new
drug
was
approved
for
ESR
mutations
and
approximately
50
percent
of
patients
with
breast
cancer
are
going
to
be
a
candidate
for
this
drug
based
on
their
mutation
status,
and
so
it's
really
I
cannot
Echo
enough.
The
tremendous
advances
we're
making
in
both
understanding
cancer
and
identifying
new
treatments
that
are
dozens
of
Studies
have
shown
that
Target
therapies
are
both
more
effective
and
have
less
adverse
effects
than
our
standard
approaches
for
treating
cancer
over
the
decades.
A
N
I
On
that
I
think
so
there
are
a
number
of
different
testing
companies
that
are
across
the
United
States.
There
are
also
local
Laboratories
that
set
up
this
testing,
like
a
hospital,
can
sometimes
set
up.
This
testing
Medicare
does
have
a
code
for
it
and
and
and
so
there
there
is
a
push
for
this,
and
it
is
I
guess.
I
would
also
emphasize
that
it
is
standard
of
care
testing
that
everybody
should
have
access
to.
N
Mr
chairman
these,
these
Technologies
are,
these
advances
are,
are
exciting
and
I.
I
can
say
from
a
personal
experience
with
genetic
testing.
My
daughter
has
cerebral
palsy.
We
had
concerns
about
her
next
surgery
working
or
not
working,
because
the
last
one
did
did
not
work
made
her
worse.
So
we
went
through
genetic
testing
and
were
able
to
determine
the
the
gene
that
the
defective
Gene
that
related
to
her
cerebral
palsy.
N
So
we
know
that
her
surgery
is
is
likely
going
to
be
of
benefit
to
her,
so
the
pharmaco
I
think
that's
the
correct
term.
All
of
these
things
that
are
happening.
You
know
and
I.
You
also
have
seen
the
report
that
we
are
rated
as
one
of
the
worst
if
the
worst
place
to
retire
in
the
country
and
one
of
the
one
of
the
top
three
reasons
has
to
do
with
health
care,
so
anything
that
we
can
do
as
a
state
to
improve
health
care
opportunities.
N
All
the
things
that
we
deal
with
in
this
committee.
We
have
a
lot
of
work
to
do.
That's
embarrassing
to
to
be
the
considered
and
I
know
with
wallet
Hub.
It's
a
lot
of
there
are
a
lot
of
different
organizations
that
make
these
ratings,
but
we're
better
than
that,
and
we
we
have
a
lot
of
work
to
do,
and
it's
things
like
this:
it
can
advance
medicine
within
the
Commonwealth
and
create
for
a
healthier
population,
and
these
things
are
crucial
that
we
take
advantage
of
the
science.
A
You
Senator,
Carol
and
I
agree
with
your
comments
and
I'm
a
little
bit
surprised
by
the
fiscal
note.
It
kind
of
seemed
like
it
was
indifferent.
I
think
there'll
be
a
huge
savings,
we'll
realize
long
term
on
this,
and
we
improve
the
quality
of
life
and
quality
care
for
everyone.
That's
involved
with
this,
so
I
think
it's
exciting
as
when
we
did
Total
cancer
screening
20
years
ago.
It's
that
revolutionary
and
I'm
looking
forward
to
seeing
what's
next,
but
if
you
folks
will
excuse
yourself
from
the
table.
A
L
Thank
you
Mr
chairman,
my
name
is
Tom
Stevens
I'm,
president
of
the
Kentucky
Association
of
health
plans,
want
to
clarify
that
our
members
do
support
the
legislation.
Today
we
have
shared
with
you
some
concerns
that
we
also
shared
with
chairwoman
Moser
on
the
bill
and
I.
Think
there's
really
just
two
areas
that
we
wanted
to
touch
on
today.
One
is
on
a
limitation
on
the
bill
to
really
focus
on
what
the
testimony
has
been
about,
which
is
to
cancer
screening
processes.
L
I
can
say,
I
just
clarified
again
with
our
membership
this
morning,
and
they
have
in
fact
paid
for
tens
of
thousands
of
these
tests
in
the
last
year.
Talking
to
our
largest
commercial
carrier,
they
provided
me
with
some
numbers
to
107
000
that
they
paid
for
last
year,
so
I
do
agree
that
this
is
becoming
standard
of
care.
The
second
issue
is
specific:
with
limitation
on
the
consensus
statement,
language
that's
contained
within
the
bill
and
I
think
my
colleague,
Mr
Brinkman
is
going
to
discuss
that.
Yes,.
K
And
I'm
Scott
bringman,
with
connecting
the
dots
policy
Solutions
representing
the
Kentucky
Association
of
health
plans
and
I,
want
to
reiterate
that
the
Kentucky
Association
of
health
plans
and
our
member
plans
totally
support
the
spear
certain
intent
of
this
legislation.
As
we
share
with
the
members
of
this
committee,
the
excitement
with
what's
developing
with
mile
marker
testing.
K
So
to
my
colleague's
point,
we
know
that
biomarker
testing
is
very
effective
in
the
area
of
cancer,
and
we've
suggest
that
at
this
point,
the
legislation
be
drafted
to
cover
biomarky
testing,
to
detect
signs
of
cancer
and
cancer
related
conditions,
as
the
science
evolves.
Certainly,
and
if
there
are
non
cancer.
Health
conditions,
for
which
bar
Market
testing
proves
to
be
very
effective.
This
body
certainly
can
expand
upon
that
legislation
in
future
years,
but
to
date,
as
the
proponents
have
so
eloquently
testified,
their
focus
is
on
cancer
and
cancer-related
conditions.
K
The
second
point
is
section
two
of
the
bill.
There's
seven
suggested
sources
of
information
to
provide
the
medical
and
scientific
evidence
supporting
medical
necessity.
We
totally
support
five
of
those
seven
proposed
sources
of
information,
but
two
of
those
sources
of
information.
One
is
the
local
coverage
determinations
in
the
context
of
Medicare
administrative
contractors
plus
consensus
statements.
K
Our
experience
has
been
that
there's
a
wide
variance
of
opinion,
medical
opinion
within
those
two
sources
of
information,
and
we
believe
that
at
this
point
it
would
be
more
appropriate
to
limit
the
suggested
sources
of
information
to
the
to
five
of
the
seven,
but
to
preclude
consensus
stations
and
local
coverage
determination,
simply
because
there's
such
a
wide
variance
of
medical
opinion
within
those
two
sources
of
information.
Other
than
that
we
totally
support
the
bill.
Understand
that
this
is
an
exciting
Frontier
that
will
benefit.
K
No
doubt
you
know
thousands
and
thousands
of
kentuckians,
but
it
is
a
health
insurance
mandate,
and
we
just
believe
that
as
a
philosophical
matter
that
health
insurance
mandates
should
be
drafted
in
a
way
that
accomplishes
the
the
goal
of
the
legislation
but
to
to
not
open
the
door
to
possible
inappropriate
Health
Care
spending.
Thank
you,
Mr
chairman
members
of
the
committee.
Thank.
M
K
K
M
You
know,
I
think
it's
honestly
sad
that
we're
here
I
think
it's
really
sad
that
we
have
to
legislate
that
insurance
companies
are
actually
going
to
cover
exams
that
dictate
how
we
treat
patients
I
mean
for
me
personally,
when
I
was
diagnosed
with
breast
cancer
I
had
excellent
insurance.
I
was
in
private
practice.
I
paid
almost
nothing
except
for
this,
except
for
my
genomic
testing,
which
actually
made
the
difference
on
how
long
I
stayed
on
chemotherapy.
The
cost
of
the
test
was
less
than
the
two
cycles
of
chemo
that
I
opted
out
of
on.
M
I
I
would
I
support
that
I
strongly
disagree
with
taking
out
consensus
statements,
because
those
are
well
established
in
oncology.
As
to
the
expert
opinion
based
on
a
very
very
intense
scrutiny
of
the
literature
and
coming
together,
the
nccn
guidelines
are
the
most
common
consensus
statements
in
oncology
and
those
statements
are
put
together
by
national
National
body
of
Comprehensive,
Cancer,
Centers
and
experts.
So.
A
E
Foreign
I
I
think
I'd
just
like
to
clarify
a
few
things.
We
have
talked
in
great
length
at
Great
length
about
the
consensus
statements
and
it
has
been
narrowly
tailored
to
nationally
recognized
clinical
standards
and
so
I
I
think
that
you
know
we
are
pretty
clear
on
the
consensus
statement
being
a
part
of
this
bill.
E
Also,
I
I
should
just
add
that
I'm
very
glad
that
the
insurance
providers
are
beginning
to
cover
this.
This
testing,
but
Kentucky
still
ranks
42nd
in
the
nation
for
this
testing,
with
our
number
one
standing
as
as
number
one
in
the
nation
with
lung
cancer.
I
strongly
suggest
that
we
move
ahead
with
some
of
these
Cutting
Edge
treatments
and
testing
to
Senator
Carroll's
point
and
Mr
Brinkman
brought
up
I
think
he
was
he.
E
We
don't
want
to
put
these
patients
through
trial
and
error
of
of
periods
of
great
instability
in
their
life
if
they
can
simply
get
the
right
drug,
the
right
medication
at
the
right
time,
and
so
that's
what
this
does.
All
of
these
tests
have
to
be
prescribed
by
a
physician.
They
all
have
to
be
medically
necessary.
We
did
not
actually
change
the
prior
authorization
in
this
bill.
E
It's
it's
unchanged,
so
it
still
has
to
be
approved
by
the
insurance
companies,
and
so
we
have
worked
for
a
long
time
to
get
this
right
to
ensure
that
there
are
guard
rails
and
that
patients
can
still
get
the
right
testing
at
the
right
time.
So
if
you
have
any
further
questions,
I'm
happy
to
to
answer
any
any
of
your
questions,
seeing.
A
M
F
N
A
E
A
My
sort
of
business,
we
do
have
some
regulations
that
have
been
circulated
to
you
most
of
these.
If
you
have
reviewed
them,
you
know
they're,
wordsmithing
kind
of
in
nature.
I
didn't
see
anything
of
substance,
but
there
are
no
questions
comments.
We
will
consider
them
reviewed
with
that.
I
want
to
remind
you
that
our
next
meeting
is
scheduled
for
Tuesday
March
15th
at
10.
A.M.
A
Excuse
me,
Wednesday
I
can't
believe
that
Becky
actually
made
a
mistake.
First,
first
time
in
seven
years,
I've
been
here
but
again,
Wednesday
March
15th
at
10
o'clock,
we'll
be
in
this
room,
but
just
want
to
caution
you
that
as
we're
ending
this
session,
this
is
subject
to
change
and
so
just
be
prepared
for
that.
With
that,
there's
no
other
business.
We
stand
adjourned,
appreciate
everyone
attending.