State Legislative Landscape: What's Coming in 2010

January 27, 2010


With states having either begun, or preparing for, their 2010 legislative sessions, Academy staff continue to stay on top of the issues that are important to our members. Last year was slow for many state legislatures, since all but two states (Montana and North Dakota) were dealing with budget deficits. The year ahead will likely present more of the same, as many states recover from the recent recession and search for new ways to patch any existing budget holes that still exist.

Budget deficits aside, there were a few successes in 2009. A handful of state legislatures did pass some form of stroke legislation, while other states introduced legislation important to members that are still in play in 2010, giving members a reason to be optimistic. (It should be noted that five state legislatures—Montana, Nevada, North Dakota, Oregon, and Texas—will not meet this year.)

The following preview discusses some of the bills staff is currently tracking, and for which the Academy has position statements.

Anti-epileptic Drugs (AEDs)

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. Advocacy staff has been working with local Epilepsy Foundation chapters, physician advocates, and other interests to ensure patient access to appropriate AED medications is protected.


HSB 529 asks that pharmacists notify and receive written consent from the prescribing physician and patient (or patient's representative) when making a substitution of an AED for patients with epilepsy. This bill awaits a hearing in the House Commerce Committee.


LD 1672 would "require a pharmacist to provide prior notification to and obtain consent from the prescribing physician before changing from one formulation or manufacturer of an antiepileptic drug to another." The bill has been referred to Senate Committee on Health and Human Services.


Introduced in 2009, HB 2024 states a pharmacist may not interchange an anti-epileptic drug or formulation of an anti-epileptic drug, brand or generic, for the treatment of seizures (epilepsy) without prior notification of and the signed informed consent of such interchange from the prescribing physician and patient, or patient's parent, legal guardian or spouse of such person. This bill awaits a hearing in the Joint Committee on Public Health.


A carryover bill from 2009, HF 1320 would prohibit a pharmacist from substituting epilepsy drugs without prior consent and notification. The bill was referred to the Health Care and Human Services Policy Oversight Committee and continues to await a hearing.


HB 506 (SB 354) prohibits a "pharmacist from substituting a drug product equivalent if the drug prescribed is a drug for treating epilepsy or for treating convulsions, unless the pharmacist obtains and documents the consent of the prescribing practitioner and the patient or the patient's parent, spouse, or legal guardian. Also, if a pharmacist is dispensing a refill of an epilepsy drug, the bill requires the pharmacist to dispense the same drug product, from the same manufacturer, that was previously dispensed, unless the pharmacist obtains and documents the consent of the prescribing practitioner and the patient or the patient's parent, spouse, or legal guardian. The bill awaits hearings in respective health committees in both of the Assembly and Senate.

Mandatory Reporting

The Academy has a position statement that supports optional reporting of individuals with medical conditions that may impact a patient's ability to drive safely. The Academy also supports the clarification of physician-immunity policies that would make it apparent they should be granted immunity both for reporting or not reporting a patient's condition with the action is taken in good faith, when the patient is reasonably informed of his/her risks, and when such actions are documented in good faith.


The Academy opposes SB 308, which requires a physician to report to local county health department certain information regarding patients diagnosed as having disorders characterized by lapses of consciousness. The Florida legislature does not begin until early March.


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.

North Carolina

Carried over from 2009, HB 1374 is a bill the Academy opposes that would change the scope of practice for physical therapists, allowing allow them to perform EMGs. The Academy was informed by other interested parties working on this legislation last summer that there was an agreement to remove the terms "electrodiagnostic" and "electrophysiologic" from the language of the bill, though this has not officially taken place. The North Carolina legislative does not begin their session until May 12.

The Academy encourages members to check back to the Advocacy issue pages for further updates on these or other bills that may be introduced. The Academy also uses software that allows staff to track any legislation across the country. If you are aware of legislation you believe the Academy should be aware of, or for other assistance or information, please contact Tim Miller, Health Policy Analyst at