State Legislative Updates: AEDs and EMG

February 10, 2009

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As states introduce legislation to be considered during their 2009 sessions, the Academy's staff have been working to stay on top of the issues that are important to our members. This update describes two current subjects on which the Academy has position statements.

Anti-epileptic Drug (AED)

The American Academy of Neurology Professional Association has a position statement that opposes substitution of anticonvulsant drugs for the treatment of epilepsy without the attending physician's approval. Four state legislatures have introduced AED bills so far in 2009. Advocacy staff have been working with local Epilepsy Foundation chapters, physician advocates, and other interests to ensure patient access to appropriate AED medications is protected.

Connecticut: This legislation would limit substitution of a prescribed antiepileptic drug by a pharmacist to those situations where the pharmacist has received prior written authorization for the substitution from the patient's practitioner. This bill passed through the CT Public Health Committee on February 6 and should receive Senate and House floor votes by the end of February.

Indiana: This bill prohibits a pharmacist from substituting another brand name or generic antiepileptic drug unless the pharmacist receives consent from specified individuals. It has been referred to the Senate Committee on Health and Provider Services and awaits a hearing.

New York: The bill requires that an interchange of an AED or the formulation of an AED, brand or generic, for the treatment of seizures may not occur without prior notification of and the signed informed consent of the prescribing physician and patient, or patient's parent, legal guardian, or spouse. Introduced last session, it has been referred to the House Higher Education Committee, where it failed to receive a hearing in 2008.

New Jersey: Carried over from 2008, this legislation Prohibits substitution of prescribed epilepsy drugs by pharmacists without prior notification to and written consent of physician and patient. This legislation, supported by the AAN, could receive a hearing in March.

EMG

The American Academy of Neurology Professional Association has a position statement that states needle electromyography (EMG) is the practice of medicine and that only a trained physician should be able to perform this diagnostic procedure. Two states are currently considering legislation involving EMG.

Arizona: Seen on paper as a basic chiropractic bill, this legislation could open the door for chiropractors to perform an EMG. Academy members in Arizona have been working with the lobbyist for the Arizona Medical Association on this legislation, with Academy staff providing support as needed.

New Jersey: Carried over from 2008, legislation has been introduced to repeal 2006 legislation, removing a stipulation that only a licensed physician may perform NCV studies. This modification would restore the intent of the original bill and allow New Jersey physicians to resume the standard practice of interpreting NVC studies conducted by technicians. This bill was introduced in June 2008 and remains stalled in the New Jersey Senate Health, Human Services, and Senior Citizens Committee.