218A.175 Pain management facilities -- Physician ownership required -- Additional activities permitted to qualifying facilities -- Certification requirements -- Payment for services rendered or goods provided -- Compliance with section as additional licensure condition -- Penalty for violation. (1) (a) As used in this section, "pain management facility" means a facility where the majority of patients of the practitioners at the facility are provided treatment for pain that includes the use of controlled substances and: 1. 2. The facility's primary practice component is the treatment of pain; or The facility advertises in any medium for any type of pain management services. (b) "Pain management facility" does not include the following: (2) 1. A hospital, including a critical access hospital, as defined in KRS Chapter 216, a facility owned by the hospital, or the office of a hospital- employed physician; 2. A school, college, university, or other educational institution or program to the extent that it provides instruction to individuals preparing to practice as physicians, podiatrists, dentists, nurses, physician assistants, optometrists, or veterinarians; 3. A hospice program or residential hospice facility licensed under KRS Chapter 216B; 4. An ambulatory surgical center licensed under KRS Chapter 216B; or 5. A long-term-care facility as defined in KRS 216.510. (a) Only a physician having a full and active license to practice medicine issued under KRS Chapter 311 shall have an ownership or investment interest in a pain management facility. Credit extended by a financial institution as defined in KRS 136.500 to the facility shall not be deemed an investment interest under this subsection. This ownership or investment requirement shall not be enforced against any pain management facility existing and operating on April 24, 2012, unless there is an administrative sanction or criminal conviction relating to controlled substances imposed on the facility, any person employed by the facility, or any person working at the facility as an independent contractor for an act or omission done within the scope of the facility's licensure or the person's employment. (b) A facility qualifying for the exemption permitted by paragraph (a) of this subsection whose ownership has been continuously held jointly and exclusively by practitioners having full and active licenses to practice in Kentucky since April 24, 2012, may, after June 24, 2015: 1. Open and operate no more than two (2) additional facilities in locations other than those locations existing and operating on April 24, 2012; 2. Transfer whole or partial ownership between existing practitioner owners; 3. Transfer whole or partial ownership interests to new owners if the new owners are physicians having full and active licenses to practice in Kentucky and the facility notifies the cabinet of the transfer thirty (30) days before it occurs; and 4. Pass the ownership interest of a deceased former owner through that person's estate to a physician having a full and active license to practice in Kentucky without disqualifying the facility's grandfathered status under this subsection if the facility notifies the cabinet of the transfer thirty (30) days before it occurs in cases where the interest is being transferred to a physician who is not an existing owner in the facility. (3) Regardless of the form of facility ownership, beginning on July 20, 2012, at least one (1) of the owners or an owner's designee who is a physician employed by and under the supervision of the owner shall be physically present practicing medicine in the facility for at least fifty percent (50%) of the time that patients are present in the facility, and that physician owner or designee shall: (a) Hold a current subspecialty certification in pain management by a member board of the American Board of Medical Specialties, or hold a current certificate of added qualification in pain management by the American Osteopathic Association Bureau of Osteopathic Specialists; (b) Hold a current subspecialty certification in hospice and palliative medicine by a member board of the American Board of Medical Specialties, or hold a current certificate of added qualification in hospice and palliative medicine by the American Osteopathic Association Bureau of Osteopathic Specialists; (c) Hold a current board certification by the American Board of Pain Medicine; (d) Hold a current board certification by the American Board of Interventional Pain Physicians; (e) Have completed a fellowship in pain management or an accredited residency program that included a rotation of at least five (5) months in pain management; or (f) If the facility is operating under a registration filed with the Kentucky Board of Medical Licensure, have completed or hold, or be making reasonable progress toward completing or holding, a certification or training substantially equivalent to the certifications or training specified in this subsection, as authorized by the Kentucky Board of Medical Licensure by administrative regulation. (4) A pain management facility shall accept private health insurance as one (1) of the facility's allowable forms of payment for goods or services provided and shall accept payment for services rendered or goods provided to a patient only from the patient or the patient's insurer, guarantor, spouse, parent, guardian, or legal custodian. (5) If the pain management facility is operating under a license issued by the cabinet, the cabinet shall include and enforce the provisions of this section as additional conditions of that licensure. If the pain management facility is operating as the private office or clinic of a physician under KRS 216B.020(2), the Kentucky Board of Medical Licensure shall enforce the provisions of this section. The provisions of this subsection shall not apply to the investigation or enforcement of criminal liability. (6) Any person who violates the provisions of this section shall be guilty of a Class A misdemeanor. Effective: June 24, 2015 History: Amended 2015 Ky. Acts ch. 33, sec. 1, effective June 24, 2015. -- Amended 2013 Ky. Acts ch. 2, sec. 2, effective March 4, 2013. -- Created 2012 (1st Extra. Sess.) Ky. Acts ch. 1, sec. 1, effective July 20, 2012.