February 13, 2019


The 2019-2020 legislative session started in earnest in late January, and the PA Chapter of the ACP was active in the halls of the Capitol on behalf of its members and patients.

Medication Synchronization – Patient Advocacy, Prescription Adherence
The first bill moved out of committee – and passed by the House of Representatives – was HB 195, sponsored by Rep. Eric Nelson (R, Westmoreland), that would permit patients to synchronize their prescription medications. PA-ACP was a strong supporter of the bill as an advocate for our patients, working with the Insurance Committee and sponsor to secure its passage.

The bill allows patients to synchronize their medications in order to receive them on the same day each month, instead of having to make multiple visits to the pharmacy. This is a convenience for the patient, especially the elderly, and it is aimed at reducing poor healthcare outcomes that result from decreased medication adherence. It also bars insurance plans from denying coverage for the scripts filled by medication synchronization simply because it is a partial fill of the script, and it provides for prorated cost sharing.

A study by Harvard Medical School found that when medications were not synchronized, patients had adherence rates that were 8.4% lower than patients for which medications were synchronized. Another study at George Washington University noted med synch is an important component of improving adherence. “The Medicaid population would benefit from a policy that allowed for flexibility in medication supplies to improve refill synchronization. This would allow a physician or pharmacist to consider appropriate adjustments and improve adherence in this population."

Surprise Balance Billing – Patient Protection, Access Improvement
At the same time, PA-ACP testified to the House Insurance Committee on surprise balance billing, another patient protection initiative. In its testimony, the Chapter called for legislation that would include several key elements to limit surprise billing. These key elements include:

  1. Support for increased pricing and out-of-pocket cost transparency;
  2. A dispute resolution process;
  3. An assessment of the economic impact on patients, providers, and payers.

While addressing the surprise balance billing issue, the Chapter noted that other issues also impact these bills. With today’s consolidations and market control, fewer options, and narrower networks, especially in rural areas, physicians don’t have the ability to negotiate contract terms or payment levels, and patients often don’t have a choice except to receive services from out-of network providers. The Chapter recommended the Commonwealth also strictly enforce network adequacy requirements as part of any solution, and consumer/patient education on the realities of today’s networks and managed care in hospital situations.

Scope of Practice Legislation
Legislation that would permit Certified Registered Nurse Practitioners to practice medicine in Pennsylvania without collaborative arrangements with physicians is being reintroduced this session. PA-ACP has consistently opposed this legislation.

Amy Davis, DO, Chair of the Chapter’s Health and Public Policy Committee, and John Nikoloff, PA-ACP’s lobbyist, met with the Chairman of the House Professional Licensure Committee and its Executive Director, to express the Chapter’s concerns about patient safety, quality and educational issues involved.

PA-ACP is working with a coalition of primary care physicians’ organizations to forestall passage of this legislation in 2019.

Med Mal Venue Rules Study
The Chapter also worked with legislative leadership in the House and Senate to secure opposition to proposed venue rules changes by the State Supreme Court’s Civil Procedural Rules Committee. The CPRC has proposed changes that would allow venue shopping again in Pennsylvania. PA-ACP met with House leadership and participated in a press conference to call attention to the possible overturn of a 16- year old state law that mandates medical malpractice claims be filed in the county where the alleged action occurred. In the Senate, Sen. Lisa Baker, Chair of the Senate Judiciary Committee, drafted a Resolution requiring the Legislative Budget and Finance Committee to study the history of the venue rule and the impact of the 2003 Act, to determine whether there is sufficient data to support a change, and consider what the impacts to access to quality care might be if the rule is changed. PA-ACP contacted all members of the PA State Senate in support of the Resolution, which passed by a 31-18 vote.

More information on how you can help oppose this venue rules change is available here.