Title 201 | Chapter 009 | Regulation 470
PREVIOUS VERSION
The previous document that this document is based upon is available.
201 KAR 9:470.Standardized medical order for scope of treatment form.
Section 1.
Definition. "MOST form" means the medical order for scope of treatment form defined in KRS 311.621(12).Section 2.
Format of the MOST form.(1)
The MOST form maintained in the patient's medical chart may be electronic or printed.(2)
If printed, it shall be:(a)
Printed on a single double-sided eight and a half (8.5) x eleven (11) inch piece of paper; and(b)
In a typed font of a size and style sufficient to include the information mandated by KRS 311.6225(1) and (3).(3)
The acceptable and prevailing medical practice shall be for a licensee to use the standardized MOST form developed and adopted by the board.Section 3.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"MOST, Medical Orders for Scope of Treatment", June 2022; and(b)
"MOST Form Spanish", June 2022.(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222, Monday through Friday, 8:00 a.m. to 4:30 p.m. This material is also available on the board's Web site at http://kbml.ky.gov.(3)
An electronically fillable version of the MOST form shall be available for print or download on the board's Web site at http://kbml.ky.gov.HISTORY: (42 Ky.R. 1668; 2323; eff. 3-4-2016; 49 Ky.R. 13444; eff. 3-9-2023.)
WILLIAM C. THORNBURY, Board President
APPROVED BY AGENCY: September 15, 2022
FILED WITH LRC: October 31, 2022 at 11:30 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on January 25. 2023 at 9:30 a.m. at the offices of the Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222. Individuals interested in being heard at this hearing shall notify this agency in writing by January 18, 2023, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through January 31, 2023. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: Leanne K. Diakov, General Counsel, Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222, phone (502) 429-7150, fax (502) 429-7118, email leanne.diakov@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Leanne K. Diakov
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes the format of the standardized medical order for scope of treatment form in the Commonwealth of Kentucky as mandated by KRS 311.6225 and to be used by the board’s licensees.
(b) The necessity of this administrative regulation:
This regulation is being promulgated as mandated by the General Assembly and to make available to the board’s licensees a medical order for scope of treatment form consistent with KRS 311.6225.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation acts specifically to establish the format of the standardized medical order for scope of treatment form in the Commonwealth of Kentucky as mandated by KRS 311.6225.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation acts specifically to establish the format of the standardized medical order for scope of treatment form in the Commonwealth of Kentucky as mandated by KRS 311.6225 and to be used by the board’s licensees. (2) If this is an amendment to an existing regulation, provide a brief summary of:
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment allows for the MOST form to be transmitted in print or electronic form and in languages other than English, consistent with directives of SB 173 (2022).
(b) The necessity of the amendment to this administrative regulation:
It is necessary to promulgate this regulation per the directives of the Legislature in SB 173 (2022).
(c) How the amendment conforms to the content of the authorizing statutes:
This administrative regulation conforms to amendments to KRS 311.6225 pursuant to SB 173 (2022).
(d) How the amendment will assist in the effective administration of the statutes:
. This amendment acts specifically to conform to the requirements of amended KRS 311.6225 pursuant to SB 173 (2022).
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This amendment will affect all physicians licensed in Kentucky whose patients wish to memorialize their preferences for levels of life-prolonging treatment within their medical charts.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Physicians whose patients wish to memorialize their preferences for levels of life-prolonging treatment within their medical charts are required to use the standardized MOST form mandated by KRS 311.6225. This regulation sets forth the authorized formats for the MOST form.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There is no cost associated with the requirements of this administrative regulation known to the board.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Benefits to the physician include having clear directives on what information the MOST form must include and the formats in which it may be memorialized.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
None
(b) On a continuing basis:
None
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
None.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increase of fees or funding will be necessary.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation does not establish any fees nor does it directly or indirectly increase any fees.
(9) TIERING: Is tiering applied?
Tiering was not appropriate in this administrative regulation because the administrative regulation applies equally to all those individuals regulated by it.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Kentucky Board of Medical Licensure will be impacted by this administrative regulation.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 311.565(1)(a) and 311.6225(2)
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
None
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
None
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
None
(c) How much will it cost to administer this program for the first year?
None
(d) How much will it cost to administer this program for subsequent years?
None
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
None.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
None.
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
None.
(c) How much will it cost the regulated entities for the first year?
None.
(d) How much will it cost the regulated entities for subsequent years?
None.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)] The amendment of this administrative regulation will not have a major economic impact on state or local government or regulated entities.
201 KAR 9:470.Standardized medical order for scope of treatment form.
Section 1.
Definition. "MOST form" means the medical order for scope of treatment form defined in KRS 311.621(12).Section 2.
Format of the MOST form.(1)
The MOST form maintained in the patient's medical chart(2)
If printed, it shall be:(a)
Printed on a single double-sided eight and a half (8.5) x eleven (11) inch piece of(b)
In a typed font of a size and style sufficient to include the information mandated by KRS 311.6225(1) and (3).(3)(2)
The acceptable and prevailing medical practice shall be for a licensee to use the standardized MOST form developed and adopted by the board.Section 3.
Incorporation by Reference.(1)
The following material is incorporated by reference:(a)
"MOST, Medical Orders for Scope of Treatment", June 2022; and(b)
"MOST Form Spanish", June 2022(2)
This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222, Monday through Friday, 8:00 a.m. to 4:30 p.m. This material is also available on the board's Web site at http://kbml.ky.gov.(3)
An electronically fillable version of the MOST form shall be available for print or download on the board's Web site at http://kbml.ky.gov.HISTORY: (42 Ky.R. 1668; 2323; eff. 3-4-2016; 49 Ky.R. 13444; eff. 3-9-2023.)
WILLIAM C. THORNBURY, Board President
APPROVED BY AGENCY: September 15, 2022
FILED WITH LRC: October 31, 2022 at 11:30 a.m.
PUBLIC HEARING AND COMMENT PERIOD: A public hearing on this administrative regulation shall be held on January 25. 2023 at 9:30 a.m. at the offices of the Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222. Individuals interested in being heard at this hearing shall notify this agency in writing by January 18, 2023, five (5) workdays prior to the hearing, of their intent to attend. If no notification of intent to attend the hearing is received by that date, the hearing may be canceled. This hearing is open to the public. Any person who wishes to be heard will be given an opportunity to comment on the proposed administrative regulation. A transcript of the public hearing will not be made unless a written request for a transcript is made. If you do not wish to be heard at the public hearing, you may submit written comments on the proposed administrative regulation. Written comments shall be accepted through January 31, 2023. Send written notification of intent to be heard at the public hearing or written comments on the proposed administrative regulation to the contact person.
CONTACT PERSON: Leanne K. Diakov, General Counsel, Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite 1B, Louisville, Kentucky 40222, phone (502) 429-7150, fax (502) 429-7118, email leanne.diakov@ky.gov.
REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Leanne K. Diakov
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes the format of the standardized medical order for scope of treatment form in the Commonwealth of Kentucky as mandated by KRS 311.6225 and to be used by the board’s licensees.
(b) The necessity of this administrative regulation:
This regulation is being promulgated as mandated by the General Assembly and to make available to the board’s licensees a medical order for scope of treatment form consistent with KRS 311.6225.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
This administrative regulation acts specifically to establish the format of the standardized medical order for scope of treatment form in the Commonwealth of Kentucky as mandated by KRS 311.6225.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation acts specifically to establish the format of the standardized medical order for scope of treatment form in the Commonwealth of Kentucky as mandated by KRS 311.6225 and to be used by the board’s licensees. (2) If this is an amendment to an existing regulation, provide a brief summary of:
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This amendment allows for the MOST form to be transmitted in print or electronic form and in languages other than English, consistent with directives of SB 173 (2022).
(b) The necessity of the amendment to this administrative regulation:
It is necessary to promulgate this regulation per the directives of the Legislature in SB 173 (2022).
(c) How the amendment conforms to the content of the authorizing statutes:
This administrative regulation conforms to amendments to KRS 311.6225 pursuant to SB 173 (2022).
(d) How the amendment will assist in the effective administration of the statutes:
. This amendment acts specifically to conform to the requirements of amended KRS 311.6225 pursuant to SB 173 (2022).
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
This amendment will affect all physicians licensed in Kentucky whose patients wish to memorialize their preferences for levels of life-prolonging treatment within their medical charts.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
Physicians whose patients wish to memorialize their preferences for levels of life-prolonging treatment within their medical charts are required to use the standardized MOST form mandated by KRS 311.6225. This regulation sets forth the authorized formats for the MOST form.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There is no cost associated with the requirements of this administrative regulation known to the board.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Benefits to the physician include having clear directives on what information the MOST form must include and the formats in which it may be memorialized.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
None
(b) On a continuing basis:
None
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
None.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
No increase of fees or funding will be necessary.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
This administrative regulation does not establish any fees nor does it directly or indirectly increase any fees.
(9) TIERING: Is tiering applied?
Tiering was not appropriate in this administrative regulation because the administrative regulation applies equally to all those individuals regulated by it.
FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Kentucky Board of Medical Licensure will be impacted by this administrative regulation.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 311.565(1)(a) and 311.6225(2)
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
None
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
None
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
None
(c) How much will it cost to administer this program for the first year?
None
(d) How much will it cost to administer this program for subsequent years?
None
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
Expenditures (+/-):
Other Explanation:
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
None.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
None.
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
None.
(c) How much will it cost the regulated entities for the first year?
None.
(d) How much will it cost the regulated entities for subsequent years?
None.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
Expenditures (+/-):
Other Explanation:
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)] The amendment of this administrative regulation will not have a major economic impact on state or local government or regulated entities.